Bendeka
Bendeka (bendamustine) is a chemotherapy medication that works as an alkylating agent. It treats some blood cancers, like chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL). Bendeka (bendamustine) is given as an infusion through a vein at a medical center or clinic. It’s given on the first 2 days of each treatment cycle. Side effects include nausea, tiredness, and low blood cell counts. Bendeka (bendamustine) is available as a brand-name medication.
What is Bendeka (bendamustine)?
What is Bendeka (bendamustine) used for?
- Chronic lymphocytic leukemia (CLL)
- B-cell non-Hodgkin lymphoma (NHL), after previous treatment with rituximab (Rituxan) within the last 6 months
How Bendeka (bendamustine) works
Bendeka (bendamustine) is a type of traditional chemotherapy known as an alkylating agent. It works by damaging fast-growing cells in the body, like cancer cells. The medication damages the cells’ DNA, which usually causes them to die. This helps fight cancer.
Drug facts
| Common Brands | bendamustine |
|---|---|
| Drug Class | Alkylating agent |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Bendeka (bendamustine)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Lower white blood cells (up to 99%)
- Lower hemoglobin levels (up to 88%)
- Lower platelet levels (86%)
- Nausea (75%)
- Tiredness (57%)
- Vomiting (40%)
- Diarrhea (37%)
- Fever (34%)
- Constipation (29%)
- Lower appetite (23%)
- Cough (22%)
- Headache (21%)
Less Common Side Effects
- Chills
- Weakness
- Dizziness
- Mouth sores
- Stomach pain
- Indigestion
- Acid reflux
- Swelling in the legs, ankles, or feet
- Weight loss
- Dehydration
- Back pain
- Shortness of breath
- Trouble sleeping
- Infection (e.g., shingles, upper respiratory, urinary tract)
- Rash
Note: Side effects were reported by people with B-cell NHL taking bendamustine (Treanda). Side effects are expected to be similar for Bendeka (bendamustine).
Bendeka (bendamustine) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Low white blood cell count and risk of infection: fever, chills, cough, muscle aches, very fast heartbeat, severe tiredness
- Low platelets: easy bruising or bleeding, nosebleeds, blood in urine, blood in stool
- Progressive multifocal leukoencephalopathy (PML): confusion, weakness, clumsiness, trouble speaking, trouble walking
- Infusion reaction or allergic reaction: fever, chills, itching, rash, trouble breathing
- Serious skin reaction: rash, painful blisters, skin wounds, peeling skin, fever, sore throat, body aches
- Serious liver problems: yellow skin, yellow eyes, sudden stomach pain, swollen belly
The following Bendeka (bendamustine) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Black, tarry stools
bleeding gums
blood in the urine or stools
chills
cough or hoarseness
headache
joint pain, stiffness, or swelling
lack or loss of strength
lower back, side, or stomach pain
muscle aches
painful or difficult urination
pale skin
pinpoint red spots on the skin
stuffy or runny nose
swelling of the feet or lower legs
swollen glands
troubled breathing with exertion
ulcers, sores, or white spots in the mouth
unusual bleeding or bruising
unusual tiredness or weakness
vomiting
Less common
Burning or stinging of the skin
fast heartbeat
irritation
painful cold sores or blisters on the lips, nose, eyes, or genitals
redness of the skin
stiffness or swelling
swelling of the eyelids, face, lips, hands, or feet
tightness in the chest
troubled breathing or swallowing
Incidence not known
Blistering, flaking, or peeling of the skin
bluish color
changes in skin color
dizziness
pain, tenderness, or swelling of the foot or leg
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
red, irritated eyes
weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Decreased weight
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Bendeka (bendamustine)
Pros
- Given on the first 2 days of each treatment cycle (every 3 or 4 weeks, depending on your type of cancer)
- Infusion takes about 10 minutes
- Doesn’t typically cause hair loss
Cons
- Must be given as an infusion through a vein at a medical center
- Can cause nausea
- Raises your risk for infections
Pharmacist tips for Bendeka (bendamustine)
- Mark your Bendeka (bendamustine) treatment days on your calendar. You’ll get your infusion on the first 2 days of each treatment cycle. Each cycle starts every 3 or 4 weeks, depending on the type of cancer you have. If you miss a visit, call the clinic right away to set up a new appointment.
- While you’re getting your Bendeka (bendamustine) through your IV, pay attention to the area where the needle goes in. Watch for redness, pain, swelling, burning, or warmth. If this happens, let your nurse know right away so they can help relieve these symptoms.
- You might feel nauseous with Bendeka (bendamustine). Your oncologist can give you medication to help prevent nausea before your infusion. You might also get anti-nausea medications to take at home if needed. Ask your care team about other ways to feel better, such as eating small meals during the day. Call them if the nausea doesn’t get better or if you need more help.
- Drink plenty of fluids while taking Bendeka (bendamustine). This is helpful if you have side effects like nausea, vomiting, diarrhea, or constipation. It helps keep you from getting dehydrated and manage these side effects.
- To help avoid getting sick, try to stay away from large crowds and wash your hands often. Be sure to wash raw fruits and vegetables before eating them. This is important because Bendeka (bendamustine) can lower white blood cell count, which can make it harder for your body to fight germs.
- Check your temperature often while taking Bendeka (bendamustine). Call your oncology care team right away if your temperature is 100.4ºF or higher. A fever might be the only sign that you have an infection.
- Ask your oncologist if taking allopurinol (Zyloprim) is a good choice for you. Allopurinol (Zyloprim) is sometimes used to help prevent problems from tumor lysis syndrome, which can happen during treatment. But taking it with Bendeka (bendamustine) can also raise the risk of a serious skin rash.
- If you can become pregnant, use a reliable birth control method while taking Bendeka (bendamustine) and for 6 months after your last infusion. If you’re a man and can get someone pregnant, use birth control like condoms during treatment and for 3 months after your last infusion. Tell your oncologist as soon as possible if you or your partner becomes pregnant.
- Don’t breastfeed while taking Bendeka (bendamustine) and for 1 week after your last infusion. It’s not known if this medication can pass into breast milk. If it does, it’s possible that it could harm your baby. Talk to your oncologist or a breastfeeding specialist about safe ways to feed your baby.
Risks and warnings for Bendeka (bendamustine)
Bendeka (bendamustine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Low blood cell counts
Bendeka (bendamustine) commonly causes low blood cell counts. Sometimes, your blood cell counts can drop dangerously low. Most times, they drop to their lowest in the third week of treatment.
To help keep you safe, your oncologist will check your blood count often. They’ll also check before each new treatment cycle to make sure Bendeka (bendamustine) is safe for you. If your blood cell counts are too low, your oncologist might delay the infusion until your labs get back up.
Look out for signs and symptoms of a low blood cell count. When your white blood cell count is low, you’re at risk of infection because your body can’t fight it as well. You might also feel more tired than usual when your red blood cell count is low. And, it might be easier for you to bleed or bruise with a low platelet count. If you have fever, severe tiredness, or unexplained bruising or bleeding, let your care team know.
Risk of infection
People taking Bendeka (bendamustine) have a higher risk of infections, which can sometimes be serious. These can include infections like pneumonia or sepsis. Old infections, such as tuberculosis (TB), hepatitis B, or shingles, can also come back.
Before starting Bendeka (bendamustine), tell your oncologist about any past or ongoing infections. You might need to get them treated first.
During treatment with Bendeka (bendamustine), your oncologist might give you antibiotics or antiviral medications to help prevent infections. Still, watch closely for signs of infection. Get medical help right away if you have a fever that’s 100.4ºF or higher, chills, or weakness.
Risk of progressive multifocal leukoencephalopathy
- Risk factors: Taking with rituximab (Rituxan) or Gazyva (obinutuzumab)
Rarely, some people developed a serious brain problem after taking Bendeka (bendamustine). This problem is called progressive multifocal leukoencephalopathy (PML). It’s caused by a virus that can be very dangerous for people with a weak immune system, like those taking Bendeka (bendamustine).
Symptoms of PML can include weakness and clumsiness. It can also cause trouble walking or speaking. If you notice any of these symptoms, call your oncologist right away so you can get checked out.
Allergic reactions and infusion reactions
Some people have had uncomfortable reactions during their Bendeka (bendamustine) infusion. These infusion reactions can include fever, chills, itching, and rash. Rarely, reactions can be severe and cause anaphylaxis. These reactions can happen during any treatment cycle. Let your nurse know right away if you have symptoms of a reaction during your infusion.
If you have a mild reaction, your oncologist might prescribe medications for you to take before your next infusions to prevent another reaction. These medications can include diphenhydramine (Benadryl), acetaminophen (Tylenol), and steroids. If you have a severe reaction, you might need to stop taking Bendeka (bendamustine) completely.
Tumor lysis syndrome
People taking Bendeka (bendamustine) have had a reaction called tumor lysis syndrome (TLS). This happens when many cancer cells are destroyed quickly. This can cause high levels of potassium and uric acid in the blood, which can lead to serious heart or kidney problems.
If you develop TLS, it most often happens during the first cycle of Bendeka (bendamustine). To keep you safe, your oncologist will monitor you closely during treatment. They might give you extra fluids or medications to help prevent serious problems from TLS.
Serious skin reactions
- Risk factors: Taking with other cancer medications | Taking with allopurinol (Zyloprim)
Rarely, some people had had serious skin reactions while taking Bendeka (bendamustine). These reactions can sometimes be life-threatening. Examples include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS).
Watch for signs of serious skin reactions while taking Bendeka (bendamustine). They can look like a rash, painful blisters, open sores, peeling skin, or a fever. If this happens, get medical help right away. If the reaction is severe or keeps getting worse, you might need to stop Bendeka (bendamustine).
Serious liver problems
- Risk factors: Taking with other cancer medications | Hepatitis B infection
Some people taking Bendeka (bendamustine) have had serious and sometimes life-threatening liver problems. Most cases happened during the first 3 months of treatment.
To be safe, your oncologist will check your liver with blood tests before you start Bendeka (bendamustine) and during treatment. Most times, you won’t feel symptoms when your liver is irritated. But tell your oncologist right away if you notice yellowing of your skin or eyes, stomach pain, or swelling in your belly. These can be signs of liver problems.
Risk of new cancers
Although it’s not common, some people who took Bendeka (bendamustine) later developed new cancers. These included blood cancers like myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Others were lung cancer and skin cancers.
Your oncologist will keep checking in on you for signs of new cancers, even after you stop treatment. Watch for unusual skin changes, such as spots that change size or color. If you notice any new symptoms or unusual skin spots, call your oncologist or primary care provider right away.
Tissue damage around the infusion site
Bendeka (bendamustine) can sometimes leak out into the surrounding tissues from the IV line. This can cause irritation, like burning pain and swelling, and tissue damage.
To prevent this, your oncologist might recommend a certain type of IV access device, such as a port. But still watch out for any redness, swelling, pain, burning, or warmth during and after your Bendeka (bendamustine) infusion. If this happens, tell your nurse right away.
Harm to an unborn baby
- Risk factors: Pregnancy
Based on animal studies and how the medication works, Bendeka (bendamustine) can harm an unborn baby. If you can have a child, your oncologist might ask you to take a pregnancy test before starting treatment to make sure you aren’t pregnant.
If you can get pregnant, also use effective birth control while taking Bendeka (bendamustine) and for 6 months after your last dose. If you’re a man who can father a child, use birth control, like condoms, during treatment and for 3 months after stopping the medication. Tell your oncologist right away if you or your partner becomes pregnant.
Bendeka (bendamustine) dosage
Typical dosage for Bendeka (bendamustine)
Your oncologist will find the right dose for you. It’s based on your body size or body surface area (BSA), which is calculated in units of m². To figure this out, your oncologist will use your height and weight to calculate how much medication you need.
-
CLL: The typical dose is 100 mg/m² given as an infusion through the vein (an intravenous or IV infusion). It’s given over 10 minutes on days 1 and 2 of each 28-day cycle for up to 6 cycles.
-
B-cell NHL: The typical dose is 120 mg/m² given as an IV infusion. It’s given over 10 minutes on days 1 and 2 of a 21-day cycle for up to 8 cycles.
Interactions between Bendeka (bendamustine) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Measles Virus Vaccine, Live
- Mumps Virus Vaccine, Live
- Rotavirus Vaccine, Live
- Rubella Virus Vaccine, Live
- Varicella Virus Vaccine, Live
- Zoster Vaccine, Live
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Adenovirus Vaccine
- Amiodarone
- Bacillus of Calmette and Guerin Vaccine, Live
- Carbamazepine
- Cholera Vaccine, Live
- Ciprofloxacin
- Dengue Tetravalent Vaccine, Live
- Enoxacin
- Fluvoxamine
- Fosphenytoin
- Influenza Virus Vaccine, Live
- Interferon Alfa-2b
- Nicotine
- Peginterferon Alfa-2a
- Phenytoin
- Poliovirus Vaccine, Live
- Rifampin
- Smallpox Vaccine
- Typhoid Vaccine, Live
- Yellow Fever Vaccine
Bendeka (bendamustine) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Bendeka (bendamustine) will not be safe for you to take.
- Serious allergic reaction to bendamustine