WHAT IS THIS MEDICINE AND
WHAT IS IT USED FOR?
Bendamax contains bendamustine, a
chemotherapy medicine that works by damaging the DNA inside cancer cells,
stopping them from growing and dividing. It belongs to a group called
alkylating agents. Bendamustine is used to treat: chronic lymphocytic leukaemia (CLL)
— a slow-growing cancer of white blood cells, and indolent (slow-growing)
B-cell non-Hodgkin lymphoma (NHL) — a type of immune system cancer that has
returned or continued growing after treatment with rituximab.
3. HOW TO TAKE THIS MEDICINE
Bendamax is prepared and given by
trained healthcare professionals as an intravenous (IV) drip in a hospital or
cancer clinic. It is never taken by mouth. The powder is dissolved in sterile
water, then further diluted and infused over 30–60 minutes. Doses are
calculated based on your body surface area. For CLL, it is given on Days 1 and
2 of a 28-day cycle; for lymphoma, on Days 1 and 2 of a 21-day cycle.
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💡
PATIENT TIP: Your doctor will delay or reduce your dose if your blood cell
counts are too low (white cells or platelets) or if you develop significant
side effects. For severe liver disease, bendamustine is not recommended. Used
with caution in significant kidney impairment. |
4. POSSIBLE SIDE EFFECTS
|
How Common? |
Side Effects to Know About |
|
Common (>1 in 10) |
Low blood cell counts
(affects virtually all patients — leads to increased infection risk, anaemia,
and bruising), nausea, vomiting, tiredness, diarrhoea, fever, reduced
appetite, mouth sores, headache, cough |
|
Less Common |
Skin rash, nerve pain, low
potassium/sodium, raised liver enzymes, infusion site reactions |
|
Seek Medical Help |
Severe bone marrow
suppression leading to life-threatening infection (neutropenic sepsis).
Tumour lysis syndrome (dangerous release of chemicals from dying cancer
cells). Severe allergic reactions, including DRESS and Stevens-Johnson
syndrome (SJS). A rare but serious brain infection called PML. Reactivation
of hepatitis B or other latent infections. Risk of developing secondary
cancers. |
5. WHO SHOULD NOT TAKE THIS
MEDICINE
Known allergy to bendamustine or its
excipients. Pregnancy (can cause birth defects). Severe liver disease. Live
vaccines during treatment.
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IMPORTANT SAFETY INFORMATION: BONE MARROW: Blood counts
must be monitored at least weekly — treatment is held if levels fall too low.
INFECTIONS: Report fever,
chills, or any sign of infection immediately. Before starting, you may be
tested for hepatitis B, TB, and CMV. TUMOUR LYSIS SYNDROME:
Drink plenty of water and have regular blood tests during early treatment
cycles. SKIN REACTIONS: Stop
treatment and seek urgent medical help if you develop a severe rash. CONTRACEPTION: Both men
and women must use effective contraception during treatment and for at least
3–6 months after. |
6. MEDICINES THAT INTERACT
WITH THIS TREATMENT
CYP1A2 inhibitors (ciprofloxacin,
fluvoxamine): increase bendamustine levels — your oncologist may adjust the
dose. CYP1A2 inducers (omeprazole, tobacco smoke): reduce effectiveness. Live
vaccines are contraindicated during treatment. Additive bone marrow suppression
with other chemotherapy agents.
7. HOW TO STORE THIS
MEDICINE
Intact vials: refrigerate at 2°C–8°C.
Allow the vial to reach room temperature before use. Once dissolved and
diluted, use within 3 hours at room temperature, or 24 hours refrigerated. Must
be protected from light. Dispose of as cytotoxic hazardous waste.
8. PRESCRIPTION REQUIREMENT
|
Status |
Prescription Only Medicine
(POM) — Oncology Specialist Required |
9. GUIDANCE FOR PATIENTS
& CAREGIVERS
Bendamustine is a hospital chemotherapy
given by IV infusion. Blood tests before each cycle confirm it is safe to
proceed. You are at higher risk of infection during treatment — avoid crowded
places, unwell people, and ask about any recommended preventive
medications. Drink plenty of fluids, especially in the first few days of a
cycle. Report fever, skin rash, unusual bruising, difficulty thinking clearly,
or vision changes immediately. Use reliable contraception. Tell your dentist
you are receiving chemotherapy.
10. PHARMACIST &
PRESCRIBER NOTES
|
Clinical Dispensing Notes |
Hospital/oncology pharmacy
only. CYTOTOXIC — mandatory PPE and institutional preparation protocols. 25
mg vial: reconstitute with 5 mL sterile water to yield 5 mg/mL. Dilute into
500 mL 0.9% NaCl or 2.5% Dextrose/0.45% NaCl. Final concentration 0.2–0.6 mg/mL.
Administer within 3 hours (room temperature) or 24 hours (refrigerated).
Monitor CBC weekly, liver, and renal function each cycle. Pre-medication with
antihistamine and corticosteroid may reduce infusion reactions. |
11.
FREQUENTLY ASKED QUESTIONS
Q: Why does my doctor monitor my blood
counts so carefully during bendamustine treatment?
A: Bendamustine significantly reduces
bone marrow function, which means your body makes fewer white blood cells, red
blood cells, and platelets. Low white blood cells increase infection risk, low
red blood cells cause anaemia and tiredness, and low platelets increase
bleeding risk. Weekly blood count monitoring allows your doctor to adjust doses
safely.
Q: What is tumour lysis syndrome and
should I worry about it?
A: Tumour lysis syndrome happens when
many cancer cells die quickly and release their contents into the bloodstream,
causing electrolyte imbalances that can affect the kidneys and heart. Your
doctor will take preventive steps — including ensuring you drink plenty of
fluids and monitoring your blood chemistry. Contact your care team if you feel
confused, have muscle cramps, or feel your heart racing.
Q: Can I receive vaccinations while on
bendamustine?
A: No live vaccines (such as MMR, yellow
fever, BCG) should be given during treatment or shortly after. Inactivated
vaccines (like flu shots) may be recommended — check with your oncologist.
Q: Will bendamustine affect my ability
to have children?
A: Bendamustine can harm a developing
baby and may affect fertility in both men and women. Effective contraception is
essential during treatment — women for at least 6 months after, men for at
least 3 months after the last dose. Fertility preservation options should be
discussed with your doctor before starting treatment.