Generic Name: bendamustine (BEN da MUS teen)Brand Names: Treanda
Bendamustine is a cancer medication that interferes with the growth of cancer cells and slows their growth and spread in the body.
Bendamustine is used to treat chronic lymphocytic leukemia. Bendamustine is also used to treat indolent B-cell non-Hodgkin lymphoma after other medications have been tried without successful treatment of this condition.
Bendamustine may also be used for other purposes not listed in this medication guide.
Before you receive bendamustine, tell your doctor if you have a weak immune system, fever or other signs of infection, a metabolic disorder or electrolyte imbalance, liver or kidney disease, or if you smoke.
Tell your doctor about all other medications you use, especially carbamazepine (Carbatrol, Equetro, Tegretol), cimetidine (Tagamet), ciprofloxacin (Cipro), fluvoxamine (Luvox), omeprazole (Prilosec), thiabendazole (Mintezol), or a barbiturate such as phenobarbital (Solfoton) and others.
Do not use this medication without telling your doctor if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. Tell your caregiver right away if you have a fever, chills, itching, or skin rash during or shortly after the injection.Other serious side effects to tell your doctor about include fever, chills, cough, sore throat, feeling short of breath, pale skin, easy bruising or bleeding, severe skin rash or itching, vomiting, diarrhea, pain, urinating less than usual, weak pulse, muscle weakness or stiffness, confusion, hallucinations, or white patches or sores inside your mouth or on your lips.
To be sure this medication is not causing harmful effects, your blood may need to be tested on a regular basis. Your blood pressure may also need to be checked. Do not miss any scheduled appointments.
If you have any of these other conditions, you may need a dose adjustment or special tests to safely receive bendamustine:
a weak immune system;
fever or other signs of infection;
a metabolic disorder or electrolyte imbalance;
if you smoke.
Some people receiving bendamustine have developed certain types of cancers. It is not known whether this medication causes cancer. Talk with your doctor about the risks and benefits of using bendamustine.
Bendamustine is given as an injection through a needle placed into a vein. You will receive this injection in a clinic or hospital setting. The medicine must be given slowly through an IV infusion, and can take at least 30 minutes to complete.
Bendamustine is usually given for 2 days in a row every 21 to 28 days. You may receive up to 8 treatments total, depending on the condition being treated. Follow your doctor's instructions.
You may be given other medications to help prevent certain side effects of bendamustine.
To be sure this medication is not causing harmful effects, your blood may need to be tested on a regular basis. Your blood pressure may also need to be checked. Do not miss any scheduled appointments.
Call your doctor for instructions if you miss an appointment for your bendamustine injection.
Overdose symptoms may include drowsiness, tremors, slow or shallow breathing, loss of balance or coordination, or seizure (convulsions).
fever, chills, body aches, flu symptoms;
cough with yellow or green mucus, stabbing chest pain, feeling short of breath;
pale skin, easy bruising or bleeding, extreme weakness;
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
the first sign of any skin rash, no matter how mild;
nausea, vomiting, diarrhea, loss of appetite, lower back pain, urinating less than usual;
slow heart rate, weak pulse, muscle weakness or stiffness;
confusion, hallucinations; or
white patches or sores inside your mouth or on your lips.
Less serious side effects may include:
mild nausea, vomiting, constipation;
dry mouth, decreased sensation of taste;
drowsiness, tired feeling;
headache;
weight loss; or
pain, itching, swelling or other irritation around the IV needle.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Chronic Lymphocytic Leukemia:
Recommended dose: 100 mg/m2 administered intravenously on days 1 and 2 of a 28 day cycle, up to 6 cycles. Bendamustine is intended for administration as an intravenous infusion over 30 minutes.Consider using allopurinol as prevention for patients at high risk of tumor lysis syndrome for the first few weeks of treatment.Bendamustine administration should be delayed in the event of grade 4 hematologic toxicity or clinically significant greater than or equal to grade 2 nonhematologic toxicity. Once nonhematologic toxicity has recovered to less than or equal to grade 1 and/or the blood counts have improved [Absolute Neutrophil Count (ANC) greater than or equal to 1 x 10^9/L, platelets greater than or equal 75 x 10^9/L], bendamustine can be reinitiated at the discretion of the treating physician. Dose delays may be warranted.Dose modifications for hematologic toxicity: for grade 3 or greater toxicity, reduce the dose to 50 mg/m2 on days 1 and 2 of each cycle; if grade 3 or greater toxicity recurs, reduce the dose to 25 mg/m2 on days 1 and 2 of each cycle.Dose modifications for nonhematologic toxicity: for clinically significant grade 3 or greater toxicity, reduce the dose to 50 mg/m2 on days 1 and 2 of each cycle.Dose reescalation in subsequent cycles may be considered at the discretion of the treating physician.
Usual Adult Dose for non-Hodgkin's Lymphoma:
Recommended dose: 120 mg/m2 intravenously on days 1 and 2 of a 21 day cycle for up to 8 cycles. Bendamustine is intended for administration as an intravenous infusion over 60 minutes.Bendamustine administration should be delayed in the event of a grade 4 hematologic toxicity or clinically significant greater than or equal to grade 2 nonhematologic toxicity. Once nonhematologic toxicity has recovered to less than or equal to grade 1 and/or the blood counts have improved [Absolute Neutrophil Count (ANC) greater than or equal to 1 x 10^9/L, platelets greater than or equal 75 x 10^9/L], bendamustine can be reinitiated at the discretion of the treating physician. In addition, dose reduction may be warranted.Dose modifications for hematologic toxicity: for grade 4 or greater toxicity, reduce the dose to 90 mg/m2 on days 1 and 2 of each cycle; if grade 4 or greater toxicity recurs, reduce the dose to 60 mg/m2 on days 1 and 2 of each cycle.Dose modifications for nonhematologic toxicity: for grade 3 or greater toxicity, reduce the dose to 90 mg/m2 on days 1 and 2 of each cycle; if grade 3 or greater toxicity recurs, reduce the dose to 60 mg/m2 on Days 1 and 2 of each cycle.
Tell your doctor about all other medications you use, especially:
carbamazepine (Carbatrol, Equetro, Tegretol);
cimetidine (Tagamet);
ciprofloxacin (Cipro);
fluvoxamine (Luvox);
omeprazole (Prilosec);
thiabendazole (Mintezol); or
a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Solfoton).
This list is not complete and there may be other drugs that can interact with bendamustine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.