What is Treanda?
Treanda (bendamustine) is a cancer medicine that interferes with the growth and spread of cancer cells in the body.
Treanda is used to treat chronic lymphocytic leukemia.
Treanda is also used to treat indolent B-cell non-Hodgkin lymphoma after other medicines have been tried without successful treatment of this condition.
Important information
Before you receive Treanda, tell your doctor if you have a weak immune system, fever or other signs of infection, a metabolic disorder or electrolyte imbalance, liver or kidney disease, or if you smoke.
Tell your caregiver right away if you have a fever, chills, itching, or a skin rash during or shortly after the injection.
Treanda can lower blood cells that help your body fight infections and help your blood to clot. You may get an infection or bleed more easily. Call your doctor if you have unusual bruising or bleeding, or signs of infection (fever, chills, body aches).
Before taking this medicine
You should not be treated with Treanda if you are allergic to bendamustine or mannitol (Osmitrol).
To make sure Treanda is safe for you, tell your doctor if you have:
a weak immune system;fever or other signs of infection;a metabolic disorder or electrolyte imbalance;liver disease;kidney disease; orif you smoke.
Some people receiving Treanda have developed certain types of cancers. It is not known whether this medication causes cancer. Talk with your doctor about the risks and benefits of using Treanda.
Do not receive Treanda if you are pregnant. It could harm the unborn baby. Use effective birth control while you are using this medicine and for at least 3 months after your treatment ends.
It is not known whether bendamustine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
How is Treanda given?
Treanda is injected into a vein through an IV. A healthcare provider will give you this injection.
Treanda is usually given for 2 days in a row every 21 to 28 days. You may receive up to 8 treatments total, depending on the condition being treated. Follow your doctor's instructions.
You may be given other medications to help prevent certain side effects of Treanda.
Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when the medicine is injected.
Treanda can lower blood cells that help your body fight infections and help your blood to clot. Your blood will need to be tested often. Your cancer treatments may be delayed based on the results of these tests.
If you have ever had hepatitis B, Treanda can cause this condition to come back or get worse. You will need frequent blood tests to check your liver function during treatment and for several months after you stop using this medicine.
Treanda dosing information
Usual Adult Dose for Chronic Lymphocytic Leukemia:
Recommended dose: 100 mg/m2 administered intravenously on days 1 and 2 of a 28 day cycle, up to 6 cycles. Treanda is intended for administration as an intravenous infusion over 30 minutes.
Consider using allopurinol as prevention for patients at high risk of tumor lysis syndrome for the first few weeks of treatment.
Treanda administration should be delayed in the event of grade 4 hematologic toxicity or clinically significant greater than or equal to grade 2 nonhematologic toxicity. Once nonhematologic toxicity has recovered to less than or equal to grade 1 and/or the blood counts have improved [Absolute Neutrophil Count (ANC) greater than or equal to 1 x 10^9/L, platelets greater than or equal 75 x 10^9/L], Treanda can be reinitiated at the discretion of the treating physician. Dose delays may be warranted.
Dose modifications for hematologic toxicity: for grade 3 or greater toxicity, reduce the dose to 50 mg/m2 on days 1 and 2 of each cycle; if grade 3 or greater toxicity recurs, reduce the dose to 25 mg/m2 on days 1 and 2 of each cycle.
Dose modifications for nonhematologic toxicity: for clinically significant grade 3 or greater toxicity, reduce the dose to 50 mg/m2 on days 1 and 2 of each cycle.
Dose reescalation in subsequent cycles may be considered at the discretion of the treating physician.
Usual Adult Dose for non-Hodgkin's Lymphoma:
Recommended dose: 120 mg/m2 intravenously on days 1 and 2 of a 21 day cycle for up to 8 cycles. Treanda is intended for administration as an intravenous infusion over 60 minutes.
Treanda administration should be delayed in the event of a grade 4 hematologic toxicity or clinically significant greater than or equal to grade 2 nonhematologic toxicity. Once nonhematologic toxicity has recovered to less than or equal to grade 1 and/or the blood counts have improved [Absolute Neutrophil Count (ANC) greater than or equal to 1 x 10^9/L, platelets greater than or equal 75 x 10^9/L], Treanda can be reinitiated at the discretion of the treating physician. In addition, dose reduction may be warranted.
Dose modifications for hematologic toxicity: for grade 4 or greater toxicity, reduce the dose to 90 mg/m2 on days 1 and 2 of each cycle; if grade 4 or greater toxicity recurs, reduce the dose to 60 mg/m2 on days 1 and 2 of each cycle.
Dose modifications for nonhematologic toxicity: for grade 3 or greater toxicity, reduce the dose to 90 mg/m2 on days 1 and 2 of each cycle; if grade 3 or greater toxicity recurs, reduce the dose to 60 mg/m2 on Days 1 and 2 of each cycle.
See also: Dosage Information (in more detail)
What happens if I miss a dose?
Call your doctor for instructions if you miss an appointment for your Treanda injection.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while receiving Treanda?
Treanda may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Bendamustine can pass into body fluids (urine, feces, vomit). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.
Treanda side effects
Get emergency medical help if you have any signs of an allergic reaction to Treanda: (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).
Seek medical treatment if you have a serious drug reaction that can affect many parts of your body.Symptoms may include: skin rash, fever, swollen glands, flu-like symptoms, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. This reaction may occur several weeks after you began using Treanda.
Tell your caregivers at once if you have:
fever, chills, or itching during or shortly after the injection;pain, swelling, redness, skin changes, or signs of infection where the medicine was injected;severe ongoing nausea, vomiting, or diarrhea;pain or burning when you urinate;cough, chest pain, trouble breathing;liver problems - upper stomach pain, itching, tiredness, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);low blood cell counts - fever, flu symptoms, mouth sores, skin sores, pale skin, easy bruising, unusual bleeding;low potassium - leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling; or;signs of tumor cell breakdown - confusion, fast or slow heart rate, fluttering in your chest, vomiting, diarrhea, tingling in your hands or feet, tingling around your mouth.
Common Treanda side effects may include:
fever, cough, mouth sores, trouble breathing;nausea, vomiting, diarrhea, constipation;headache, tiredness, dizziness;swelling in your hands or feet;loss of appetite, weight loss; ormild skin rash.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Treanda?
Tell your doctor about all your current medicines and any you start or stop using, especially:
allopurinol;ciprofloxacin;fluvoxamine;lansoprazole; oromeprazole.
This list is not complete. Other drugs may interact with bendamustine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
