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.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.