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Overview: Bendamustine is used to treat certain types of blood cancer. Common side effects include stomach upset, tiredness, bone marrow suppression, loss of appetite, weight loss, fever, cough, headache, and mouth sores. Keep all appointments to have your blood checked. Contact your health care provider right away if you have a rash, fever, infection, changes in thinking or vision, trouble walking or speaking, seizures, swelling, or yellowing of your skin or eyes.

Uses

What is bendamustine used for?

Bendamustine is commonly used to treat certain people with the following types of cancer.

Bendamustine may also be used for other conditions as determined by your health care provider.

How does bendamustine work (mechanism of action)?

Bendamustine is a type of chemotherapy. Bendamustine is known as an alkylating agent. This medicine damages DNA, which helps kill cancer cells.

How is bendamustine supplied (dosage forms)?

Brands and other names

  • Treanda

Dosage forms and strengths

Bendamustine is available in an injectable form that is given by a health care provider.

How should I store bendamustine?

Bendamustine is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of bendamustine?

The most common side effects of bendamustine are listed below. These side effects may vary depending on the condition that is being treated. Tell your health care provider if you have any of these side effects that bother you.

  • Nausea and vomiting
  • Tiredness
  • Bone marrow suppression (see below)
  • Fever
  • Diarrhea
  • Constipation
  • Loss of appetite
  • Cough
  • Headache
  • Weight loss
  • Shortness of breath
  • Rash
  • Mouth sores

There may be other side effects of bendamustine that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of bendamustine?

While less common, the most serious side effects of bendamustine are described below, along with what to do if they happen.

Severe Allergic Reactions. Bendamustine can cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for drug reaction with eosinophilia and systemic symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark colored urine
  • Your skin or the whites of your eyes turning yellowish (also called jaundice)

Bone Marrow Suppression. Bendamustine may cause your bone marrow to not make enough cells. This can lead to low blood levels of important cells, such as red blood cells (anemia), white blood cells (leukopenia), platelets (thrombocytopenia), and neutrophils (neutropenia). Bone marrow suppression can lead to life-threatening infections or bleeding. Keep all appointments to have your blood checked. Tell your health care provider right away if you have any of the following symptoms of bone marrow suppression.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infections
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Infections. Bendamustine can increase your risk of infections, including serious infections. Call your health care provider right away if you have an infection or any of the following symptoms.

  • Burning or stinging when you pee
  • Coughing, or coughing up blood
  • Fever, sweats, chills, or muscle aches
  • Shortness of breath
  • Diarrhea or stomach pain
  • Weight loss

Reactivated Infections. Some types of microbes that cause infections (such as bacteria or viruses) can remain in the body after you recover from that infection. When a microbe stays in the body but does not cause an infection, it is called a “latent” microbe. Bendamustine may increase your risk of a latent microbe becoming active again, causing an infection. Before you start treatment with bendamustine, tell your health care provider if you have ever had tuberculosis (TB), hepatitis B, cytomegalovirus (CMV), herpes zoster (shingles), or any other serious infections.

Progressive Multifocal Leukoencephalopathy (PML). People using bendamustine may get a rare brain disease called PML. It is caused by a virus called the John Cunningham (JC) virus. PML is very serious and can lead to death. Call your health care provider right away or get emergency help if you have any of the following symptoms of PML.

  • Clumsiness or loss of coordination
  • A hard time walking or speaking
  • Facial drooping
  • Vision problems
  • Thinking, memory, or personality changes
  • Weakness on one side of your body that gets worse
  • Seizures

Tumor Lysis Syndrome. Bendamustine can cause a fast breakdown of cancer cells. This can lead to a condition called tumor lysis syndrome, which can be serious. It is important to drink plenty of water while receiving bendamustine and to keep all appointments for blood tests so your health care provider can see how your body is responding to bendamustine. Tell your health care provider right away if you have any of the following signs of tumor lysis syndrome while using bendamustine.

  • Nausea and vomiting
  • Weakness
  • Swelling or fluid retention
  • Shortness of breath
  • Muscle cramps
  • Seizures

Severe Skin Reactions. Bendamustine can cause severe skin reactions, called Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), that can lead to death if not treated. If you get a rash, stop using bendamustine and call your health care provider right away. Get emergency help if you have any of the following symptoms of SJS or TEN.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes
  • Flu-like symptoms, including fever, chills, and muscle aches

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using bendamustine. Liver damage can be life-threatening. Keep all appointments to have your blood checked. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish (also called jaundice)

Cancer. Bendamustine can cause a new cancer to form or cause a previously treated cancer to recur. Tell your health care provider about any new symptoms that you may get. Keep all appointments to have your skin checked.

Tissue Irritation. Bendamustine is given as an infusion into a vein. If the medicine does not go into your vein, it could irritate nearby tissue. Tell your health care provider right away if you have pain, swelling, warmth, or skin color changes where the medicine is being given or was given.

Warnings & Precautions

Who should not use bendamustine?

Allergies to Ingredients. People who are allergic to any of the following should not use bendamustine.

  • Bendamustine
  • Treanda
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific bendamustine products they stock.

What should I know about bendamustine before using it?

Bendamustine is usually given by a health care provider in a hospital or clinic.

Bendamustine can make you feel tired and affect your alertness. Do not drive or do other activities that require alertness or coordination until you know how bendamustine affects you.

Tell your health care provider if you get nausea, vomiting, or diarrhea. Your health care provider may be able to give you certain medicines or recommendations to help reduce these side effects.

Bendamustine may make it hard for you to get your partner pregnant. If you may want children one day, talk to your health care provider.

If you can get pregnant, use effective birth control while using bendamustine and for six months after your last dose. If you can get your partner pregnant, use effective birth control such as condoms with spermicide while using bendamustine and for three months after your last dose. Talk to your health care provider about your birth control options.

What should I tell my health care provider before using bendamustine?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if bendamustine is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Tuberculosis (TB)
  • Hepatitis B
  • Cytomegalovirus (CMV)
  • Herpes zoster (shingles)
  • Prior cancer
  • Kidney problems
  • Liver problems

Vaccines. Talk with your health care provider about any vaccines that you may need. You should not receive certain vaccines right before or while using bendamustine. Tell your health care provider about any vaccines you have recently received or have scheduled.

Other Medicines and Supplements. Bendamustine may interact with other medicines and supplements. Before using bendamustine, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Bendamustine can harm a fetus. Your health care provider will likely do a test to make sure you are not pregnant before starting bendamustine. Tell your health care provider right away if you are pregnant, think you may be pregnant, or plan to become pregnant.

Breastfeeding. Do not breastfeed during treatment with bendamustine and for seven days after your last dose. It is not known if bendamustine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does bendamustine interact with foods or drinks?

There are no known interactions between bendamustine and foods or drinks.

There are no known interactions between bendamustine and alcohol, but heavy drinking can slow your immune response and make it harder for your body to fight cancer.

Does bendamustine interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are taking fluvoxamine (Luvox), which is a medicine commonly used for obsessive-compulsive disorder (OCD).

Some other medicines may alter the blood levels of bendamustine. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with bendamustine. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much bendamustine?

If you or someone else has used too much bendamustine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of bendamustine?

Bendamustine is usually given by a health care provider in a hospital. Your health care provider will make sure you are receiving bendamustine as scheduled.

If you miss an appointment to get your bendamustine dose, call to make another appointment as soon as possible.

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