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Bendamustine Brand Names
BELRAPZO | BENDEKA | Treanda
What is Bendamustine
Bendamustine is a mechlorethamine derivative containing a purine-like benzimidazole ring; it has properties of both antimetabolites and alkylating agents.
In a multicenter, randomized, phase III study (n = 319), the median progression-free survival time was significantly improved with bendamustine compared with chlorambucil (21.6 months vs. 8.3 months; p < 0.0001) in previously untreated patients with advanced chronic lymphocytic leukemia (CLL) at a median follow-up of 35 months.
In this study, the median overall survival times were not significantly different between treatment arms at a median follow-up time of 54 months.
Treatment with bendamustine led to an overall response rate of 75% and a 9.2 month duration of response in patients with rituximab-refractory, indolent B-cell non-Hodgkin lymphoma (NHL) in a multicenter, single-arm study (n = 100).
Bendamustine (Treanda) received FDA approval for the treatment of CLL in March 2008 and for the treatment of indolent B-cell NHL that has progressed during or within six months of treatment with rituximab or a rituximab-containing regimen in October 2008.
A rapid infusion formulation of bendamustine (Bendeka) was approved by the FDA in December 2015.
Indications
- acute lymphocytic leukemia (ALL)
- chronic lymphocytic leukemia (CLL)
- mantle cell lymphoma (MCL)
- non-Hodgkin’s lymphoma (NHL)
- peripheral T-cell lymphoma (PTCL)
- small lymphocytic lymphoma (SLL)
Side Effects
- abdominal pain
- anaphylactoid reactions
- anemia
- anorexia
- anxiety
- arthralgia
- asthenia
- atrial fibrillation
- azoospermia
- back pain
- bone pain
- bullous rash
- candidiasis
- chest pain (unspecified)
- chills
- constipation
- cough
- dehydration
- depression
- diarrhea
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysgeusia
- dyspepsia
- dyspnea
- elevated hepatic enzymes
- erythema
- fatigue
- fever
- gastroesophageal reflux
- headache
- heart failure
- hemolysis
- hepatitis
- hyperbilirubinemia
- hyperglycemia
- hyperhidrosis
- hypertension
- hypertensive crisis
- hyperuricemia
- hyperuricemia
- hypocalcemia
- hypokalemia
- hyponatremia
- hypotension
- infection
- infertility
- infusion-related reactions
- injection site reaction
- insomnia
- leukopenia
- lymphopenia
- myocardial infarction
- nasal congestion
- nausea
- neutropenia
- new primary malignancy
- night sweats
- palpitations
- pancytopenia
- peripheral edema
- pharyngitis
- phlebitis
- pneumonitis
- pruritus
- pulmonary fibrosis
- rash
- renal failure (unspecified)
- sinus tachycardia
- sinusitis
- skin irritation
- skin necrosis
- spermatogenesis inhibition
- Stevens-Johnson syndrome
- stomatitis
- thrombocytopenia
- toxic epidermal necrolysis
- tumor lysis syndrome (TLS)
- vomiting
- weight loss
- wheezing
- xerosis
- xerostomia
Monitoring Parameters
- CBC with differential
- LFTs
- pregnancy testing
- serum creatinine/BUN
- serum electrolytes
- serum uric acid
Contraindications
- anemia
- bone marrow suppression
- breast-feeding
- children
- contraception requirements
- extravasation
- hepatic disease
- hepatitis
- hepatotoxicity
- herpes infection
- infants
- infection
- infertility
- infusion-related reactions
- male-mediated teratogenicity
- mycobacterial infection
- neonates
- neutropenia
- pregnancy
- pregnancy testing
- renal impairment
- reproductive risk
- sepsis
- serious hypersensitivity reactions or anaphylaxis
- serious rash
- thrombocytopenia
- tuberculosis
- tumor lysis syndrome (TLS)
- viral infection
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Amobarbital
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Butabarbital
- Carbamazepine
- Cimetidine
- Ciprofloxacin
- Clozapine
- Diclofenac
- Diclofenac; Misoprostol
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Esomeprazole; Naproxen
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Etodolac
- Famotidine; Ibuprofen
- Fenoprofen
- Fluvoxamine
- Hydrocodone; Ibuprofen
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Indomethacin
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Mephobarbital
- Methohexital
- Mexiletine
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Norfloxacin
- Obeticholic Acid
- Oxaprozin
- Palifermin
- Peginterferon Alfa-2b
- Penicillamine
- Pentobarbital
- Phenobarbital
- Piroxicam
- Primidone
- Rifampin
- Rofecoxib
- Rucaparib
- Secobarbital
- Segesterone Acetate; Ethinyl Estradiol
- Simeprevir
- Sulindac
- Tacrine
- Thiabendazole
- Thiopental
- tobacco
- Tolmetin
- Tuberculin Purified Protein Derivative, PPD
- Valdecoxib
- Vemurafenib
- Zileuton
