Class: Chemotherapy

Generic Name: Bendamustine (ben-duh-MU-steen) hydrochloride
Trade Name: Treanda®

For which conditions is this drug approved? Bendamustine is approved for treatment of chronic lymphocytic leukemia (CLL) and indolent (slow-growing) B-cell non-Hodgkin’s lymphoma (NHL) that has progressed during or within six months of treatment that includes the agent Rituxan® (rituximab). It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.

What is the mechanism of action? Bendamustine belongs to a group of drugs referred to as alkylating agents. Bendamustine is believed to produce its anticancer effects by preventing DNA function properly. This results in cellular death.

How is bendamustine typically given (administered)? Bendamustine is administered into a vein (intravenous). The dose depends on several factors, including the condition being treated, the size of the patient, the particular regimen being used and the overall health of the patient.

How are patients typically monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with blendamustine. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver. Patients may also undergo physical examinations, scans, blood draws and other measures to assess side effects and response to therapy.
Rarely, patients will experience an allergic reaction to bendamustine, so they will be closely monitored for symptoms including low blood pressure, fever, chills, difficulty breathing, wheezing, and mental confusion. Patients are also monitored for skin reactions and tumor lysis syndrome, a condition in which the byproducts of dying cancer cells can cause harm to certain organs such as the kidneys.

What are the common (occur in 30% or more of patients) side effects of treatment with bendamustine?
• Low levels of white blood cells (immune cells) which increases the risk for infection
• Low levels of red blood cells which increases the risk for anemia
• Low levels of platelets which increases the risk of uncontrolled bleeding
• Nausea, vomiting, loss of appetite
• Rash
• Diarrhea
• Constipation
• Fatigue, insomnia
• Fever
• Pain (back pain, headache)

What are the less common (occur in 10% to 29% of patients) side effects of treatment with bendamustine?
• Mouth sores, dry mouth
• Difficulty breathing
• Anxiety, depression
• Sinus and lung infection

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?
• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Avoid large crowds or individuals who are sick to reduce risk of infection.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• Eat small meals frequently to help alleviate nausea.

Are there any special precautions patients should be aware of before starting chemotherapy?
• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.

When should patients notify their physician?
• Difficulty breathing, cough, shortness of breath, any changes in respiratory status
• Wheezing
• Mental confusion
• Mouth sores
• Persistent nausea, vomiting or loss of appetite
• Fever
• Chest pain
• Visual changes
• Severe, sudden headache
• Difficulty speaking
• Lightheadedness
• Confusion
• Excessive bruising or uncontrolled bleeding
• Skin ulcerations
• Persistent fever or chills
• Allergic reaction including swelling of the lips, mouth, or throat, rash, hives, itchy and/or watery eyes

What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.  A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

Copyright © 2010 CancerConnect Last updated 07/10.

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