Bendamustine (Generic Name)

Other Names: Treanda®

About This Drug

This drug is used to treat cancer. It is given in the vein (IV).

Possible Side Effects (More Common)

  • Loose bowel movements (diarrhea) that may last for a few days
  • Constipation (not able to move bowels)
  • Fatigue
  • Fever
  • Nausea and vomiting. These symptoms may happen within several hours after you get the drug and may last up to 4 days after the drug has stopped. Medicines are available to prevent and lessen these side effects.
  • Rash or other skin problems
  • Weakness
  • Swelling (fluid retention) in the legs, ankles, and/or feet.
  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Decreased appetite (decreased hunger)
  • Feeling dizzy
  • Increased total bilirubin in your blood. This may mean that you have changes in your liver function. Your blood work will be checked by your doctor.
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.

Possible Side Effects (Less Common)

  • Electrolyte changes. Your blood will be checked for electrolyte changes as needed.
  • While getting the drug in your vein, tell your nurse right away if you experience pain, redness, or swelling at the site of the IV infusion.
  • This drug may affect how your kidneys work. Your kidney function will be checked as needed.
  • Changes in your liver function. Your doctor will check your liver function as needed.

Infusion Reactions

  • Skin and tissue irritation may include redness, pain, warmth, or swelling at the IV site. This occurs if the drug leaks out of the vein and into nearby tissue.
  • While you are getting this drug in your vein, you may have a reaction. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain.
  • These reactions may happen the first 24 hours after you get this drug. Call 911 for emergency care.

Allergic Reactions

Serious allergic reactions including anaphylaxis are rare. While you are getting this drug in your vein (IV), tell your nurse right away if you have any of the following symptoms of an allergic reaction:

  • Trouble catching your breath
  • Feeling like your tongue or throat are swelling
  • Feeling your heart beat quickly or in a not normal way (palpitations)
  • Feeling dizzy or lightheaded
  • Flushing, itching, rash, and/or hives

Treating Side Effects

  • Ask your doctor or nurse about medicine that is available to help stop or lessen nausea, vomiting, diarrhea, or a fever.
  • Drink 6-8 cups of fluids every day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements you should drink more fluids so that you do not become dehydrated (lack water in the body due to losing too much fluid)
  • Do not put anything a rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • If you are dizzy, get up slowly after sitting or lying down.
  • Mouth care is very important. Your mouth care should consist of regular, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that has alcohol. Avoid alcohol and smoking because they can bother your mouth and throat.
  • Ask your doctor or nurse about medicine that is available to help stop or lessen constipation.
  • If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories

Food and Drug Interactions

There are no known interactions of bendamustine with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor’s help.

Other Instructions

Tell your doctor if you are allergic to Mannitol (found in some artificial sweeteners and breath fresheners).

When to call the doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Bleeding or bruising that is not usual
  • Wheezing or trouble breathing
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
  • Blurred vision or other changes in eyesight
  • Pain when passing urine; blood in urine
  • Pain in your lower back or side
  • Confusion or agitation
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired or weak, unusual itching, or yellowing of the eyes or skin.

Call your doctor or nurse as soon as possible if any of these symptoms happen:

  • Change in hearing, ringing in the ears
  • Decreased urine
  • Unusual thirst or passing urine often
  • Painful mouth or throat that makes it hard to eat or drink
  • Nausea not relieved by prescribed medicines
  • Rash that is not relieved by prescribed medicines
  • Heavy menstrual period lasting longer than normal
  • Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
  • Trouble walking or changes in the way you walk, clumsiness in buttoning clothes, opening jars, or other routine hand motions
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Headache that does not go away
  • Painful, red, or swollen areas on your hands or feet.
  • No bowel movement for 3 days or you feel uncomfortable
  • Extreme weakness that interferes with normal activities

Reproduction Concerns

  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used by both men and women during your cancer treatment, and for at least 3 months after your treatment is finished.
  • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Breast feeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

Infertility

  • Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your treatment. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.
  • In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.
  • In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
  • Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
  • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.

Revised July 2014

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