Home Drug Guide Bendamustine Hydrochloride

Drug Guide

Generic Name

Bendamustine Hydrochloride

Brand Names Treanda, Belrapzo, Bendeka, Vivimusta

Classification

Therapeutic: Antineoplastic agent

Pharmacological: Alkylating agent, Nitrogen mustard derivative

FDA Approved Indications

Chronic lymphocytic leukemia (CLL)
Non-Hodgkin lymphoma (NHL)

Mechanism of Action

Bendamustine causes cross-linking of DNA strands, leading to cell death. It combines properties of alkylating agents and purine analogs, interrupting DNA synthesis and repair.

Dosage and Administration

Adult: Typically 90 mg/m² IV on days 1 and 2 of a 28-day cycle, adjusted based on patient response and tolerability.

Pediatric: Not commonly used in pediatric patients; consult specific protocols.

Geriatric: Use with caution; consider renal and hepatic function.

Renal Impairment: Dose adjustments may be necessary based on renal function.

Hepatic Impairment: Adjust dosage; use caution in severe hepatic impairment.

Pharmacokinetics

Absorption: Administered IV, bypassing absorption considerations.

Distribution: Widely distributed, crosses blood-brain barrier poorly.

Metabolism: Hepatically metabolized via non-enzymatic hydrolysis.

Excretion: Primarily renal excretion of metabolites.

Half Life: Approximately 40 hours in plasma.

Contraindications

Hypersensitivity to bendamustine or other components.
Severe myelosuppression.

Precautions

Risk of myelosuppression, infections, secondary malignancies.
Monitor blood counts regularly.
Use contraception during and for 6 months after therapy.

Adverse Reactions - Common

Myelosuppression (neutropenia, thrombocytopenia, anemia) (Very common)
Nausea, vomiting (Common)
Fatigue (Common)

Adverse Reactions - Serious

Infections (including opportunistic infections) (Serious)
Secondary malignancies (Less common)
Severe hypersensitivity reactions (Uncommon)

Drug-Drug Interactions

Immunosuppressants, other myelosuppressive agents
Vaccines: avoid live vaccines during treatment.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor CBC closely, assess for signs of infection, bleeding, and anemia.

Diagnoses:

Risk for infection,

Implementation: Administer IV in infusion center, premedicate as needed, monitor blood counts.

Evaluation: Assess blood counts regularly, monitor for adverse effects, adjust dose accordingly.

Patient/Family Teaching

Report signs of infection, bleeding, or unusual symptoms immediately.
Use effective contraception during and for 6 months after therapy.
Avoid live vaccines.
Keep appointments for blood tests and follow-up.

Special Considerations

Black Box Warnings:

Severe myelosuppression leading to infections, bleeding, and cytopenias.
Potential for secondary malignancies.
Use in pregnancy is contraindicated due to risk of fetal harm.

Genetic Factors: None specified.

Lab Test Interference: May cause transient elevations or decreases in lab parameters, monitor as indicated.

Overdose Management

Signs/Symptoms: Severe myelosuppression, infections, hemorrhage.

Treatment: Supportive care, growth factor support, antibiotic therapy as needed, and symptomatic management.

Storage and Handling

Storage: Store at controlled room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended storage conditions.