Cancer Home > Precautions and Warnings With Bendamustine

Some people who have a weakened immune system or problems with their liver or kidneys may not be able to safely use bendamustine. This chemotherapy drug can be an effective form of treatment, but it is not appropriate for everyone. Some of the precautions with bendamustine include potential warnings of life-threatening rashes, drug interactions, or dangerous infections.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to receiving bendamustine (Treanda®) if you have:
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • Kidney disease, such as kidney failure (renal failure)
  • A weakened immune system, an infection, or if you easily get infections
  • Anemia (low red blood cells)
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Bendamustine Precautions and Warnings

Some warnings and precautions to be aware of prior to using this medication include the following:
  • There have been reports of serious skin rashes, such as life-threatening rashes known as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), occurring in people who received this medicine. Contact your healthcare provider right away if you notice any rash on your skin during treatment.
  • Like other cancer medicines, bendamustine can reduce the activity of the bone marrow, decreasing red blood cells, white blood cells, and platelets. As a result, you will be at risk for certain potentially serious problems, such as:
Your healthcare provider will monitor your blood cell counts frequently during treatment and may decrease your dosage or delay treatment if your blood cell counts drop too low.
  • Immediately report any signs of infection to your healthcare provider, as an infection during bendamustine treatment can become life-threatening. You may also want to avoid being near people who are sick or have infections. Make sure to tell your healthcare provider if you develop any signs of an infection, such as:
    • Fever
    • Abnormal bleeding
    • Shortness of breath
    • Significant fatigue.
  • Some people may experience a potentially serious allergic-type reaction, known as an infusion reaction, while receiving or shortly after receiving a bendamustine dose. Let your healthcare provider know if you experience any signs of an infusion reaction, such as:
    • A rash
    • Fever
    • Chills
    • Itching.
Your healthcare provider may give you other medicine to help prevent such a reaction from occurring.
  • Like other cancer medications, bendamustine is associated with a condition known as tumor lysis syndrome. This condition occurs when dying cancer cells break down and cause problems in the body, which can lead to kidney failure and death. Your healthcare provider will monitor you closely for this condition throughout treatment. Make sure to tell your healthcare provider if you have persistent diarrhea or vomiting, especially if you cannot keep fluids down, as dehydration may increase your risk for tumor lysis syndrome.
  • There have been reports of other cancers, including certain types of leukemia and lung cancer, developing in people who have been treated with bendamustine. It is unclear whether this medication caused the other cancers.
  • Bendamustine can make you tired or drowsy. You should avoid driving a vehicle or operating any heavy machinery if you develop this side effect.
  • Immediately tell your healthcare provider if you develop redness, swelling, or pain around your infusion site (the site where you receive your injection) during or after your dose. These could be signs of a potentially serious problem.
  • The manufacturer recommends the drug not be used in people with severe kidney disease or moderate-to-severe liver disease.
  • You are likely to experience nausea, vomiting, and diarrhea during treatment. Talk to your healthcare provider about ways to manage these side effects. He or she may be able to give you other medicines that will help.
  • Bendamustine is a pregnancy Category D medication, which means it may harm an unborn child if used during pregnancy (see Treanda and Pregnancy).
  • It is unknown whether bendamustine passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to receiving the drug (see Treanda and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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