Bendamustine

What is bendamustine?

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.

What is the most important information I should know about bendamustine?

You should not receive this medication if you are allergic to bendamustine or mannitol (Osmitrol).

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, Tegretal), cimetidine (Tagamet), ciprofloxacin (Cipro), fluvoxamine (Luvox), omeprazole (Prilosec), thiabendazole (Mintezol), or a barbiturate such as phenobarbital (Solfoton) and others.

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.

What should I discuss with my healthcare provider before I receive bendamustine?

You should not receive this medication if you are allergic to bendamustine or mannitol (Osmitrol).

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. 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 disease;
• kidney disease; or

• 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.

How is bendamustine given?

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.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your bendamustine injection.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine.

Overdose symptoms may include drowsiness, tremors, slow or shallow breathing, loss of balance or coordination, or seizure (convulsions).

What should I avoid while receiving bendamustine?

Bendamustine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Bendamustine side effects

Some people receiving a bendamustine injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you have fever, chills, itching, or skin rash during or shortly after the injection. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Tell your caregivers at once if you have a serious side effect such as:

• 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 ususal;

• 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.

What other drugs will affect bendamustine?

Tell your doctor about all other medications you use, especially:

• carbamazepine (Carbatrol, Equetro, Tegretal);

• 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.

Where can I get more information?

• Your doctor or pharmacist can provide more information about bendamustine.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.