Bendeka is a brand-name prescription medication. It’s approved to treat specific types of cancers in adults. These cancers, which affect certain blood cells, include:

  • Chronic lymphocytic leukemia (CLL).* CLL is a type of blood cancer that affects certain blood cells called lymphocytes.
  • Indolent B-cell non-Hodgkin lymphoma (NHL). Indolent B-cell NHL is a type of blood cancer that’s slow growing (indolent). It affects certain immune cells called B cells. For this use, Bendeka is given to people whose indolent B-cell NHL worsened either during or within 6 months after treatment with another drug called rituximab (Rituxan).

Bendeka contains the active drug bendamustine. It’s a chemotherapy drug that belongs to a class of drugs called alkylating agents. (A class of drugs is a group of medications that work in same way.)

Bendeka comes as a solution that’s available in one strength: 100 mg/4 mL. It’s given as an intravenous (IV) infusion by healthcare providers. (With an IV infusion, the drug is injected into your vein over a period of time.) Each Bendeka infusion takes about 10 minutes.

You’ll be given Bendeka on 2 days during each of your prescribed treatment cycles. (For CLL, each treatment cycle lasts 28 days. For NHL, each treatment cycle lasts 21 days.)

* For this use, Bendeka hasn’t been compared with first-line treatments for CLL other than the drug chlorambucil. First-line treatment is the first treatment used for a condition.

FDA approval

The active drug in Bendeka, called bendamustine, was first approved by the Food and Drug Administration (FDA) in 2008. But at that time, it was approved under the brand-name drug Treanda.

Treanda was originally available as both a solution and a powder that could be made into a solution. Both of these forms were approved to treat the same types of cancer as Bendeka is approved to treat.

In December 2015, the FDA approved the brand-name drug Bendeka. Compared with Treanda, Bendeka has a shorter IV infusion time. And it’s given in much smaller volumes than Treanda is given. In addition, the solution form of Treanda isn’t able to be administered using certain types of IV tubing.*

In 2016, Treanda solution was taken off the market. However, the powder form of Treanda is still available.

* IV tubing is used to deliver drugs or fluids that are given to you by IV infusion.

Effectiveness

In a clinical study of people with CLL, treatment with bendamustine (the active drug in Bendeka) was compared to treatment with a different chemotherapy drug called chlorambucil. In this study, 59% of people taking bendamustine had improvement in their condition. In comparison, 26% of people taking chlorambucil had the same result.

In addition, half of the people taking bendamustine went at least 18 months without their cancer getting worse. In comparison, half of the people taking chlorambucil went at least 6 months without their cancer getting worse.

Bendamustine was also studied as a treatment for indolent B-cell NHL that either worsened or didn’t improve during or within 6 months after treatment with another drug called rituximab (Rituxan).

During one clinical study, 74% of people taking bendamustine saw improvement or no worsening of their condition with treatment. And half of the people taking Bendeka kept this response for at least 9.2 months. In this study, there weren’t any people who took treatment other than bendamustine.

Bendeka is available only as a brand-name medication. It’s not currently available in generic form. (A generic drug is an exact copy of the active drug in a brand-name medication.)

Bendeka contains the active drug bendamustine.

Bendeka can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Bendeka. These lists don’t include all possible side effects.

For more information on the possible side effects of Bendeka, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Bendeka, you can do so through MedWatch.

Depending on the condition you’re using Bendeka to treat, your side effects may vary from those listed below.

Mild side effects

Mild side effects of Bendeka can include:*

  • constipation
  • pain in your abdomen (belly)
  • tiredness
  • weight loss
  • chills
  • headache
  • shortness of breath
  • cough
  • trouble sleeping
  • fever
  • nausea
  • vomiting
  • rash

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Bendeka. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Bendeka’s package instructions.

Serious side effects

Serious side effects from Bendeka aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Severe skin reactions. Symptoms can include:
    • fever
    • rash
    • itching
    • blistering and peeling of your skin
    • painful red patches that can spread into your mouth and eyes
  • Infections, such as pneumonia or shingles (infection caused by the herpes zoster virus). Symptoms will vary depending on the type of infection you have, but they can include:
    • cough
    • fever or chills
    • shortness of breath
    • weakness
    • tiredness
    • chest pain
    • confusion
  • Liver damage. Symptoms can include:
    • nausea and vomiting
    • loss of appetite
    • tiredness
    • dark colored urine
    • yellowing of your skin or the whites of your eyes
  • Infusion injury (injury that can occur when a drug given by intravenous infusion leaks into the skin or tissue surrounding your vein). Symptoms can include:
    • redness of the skin affected
    • swelling at the infusion site
    • pain
  • Tumor lysis syndrome (a condition that occurs when many cancer cells quickly die and release substances into your blood). Symptoms can include:
    • nausea and vomiting
    • diarrhea
    • muscle cramps
    • joint pain
    • tiredness
  • Other cancers,* such as a blood cancer called acute myeloid leukemia (AML). Symptoms may include:
    • shortness of breath
    • tiredness
    • bruising or bleeding more easily than usual

* It’s not known for sure whether bendamustine (the active drug in Bendeka) actually causes certain types of cancer. However, the manufacturer of Bendeka has placed a warning on the drug for this possible side effect.

Other serious side effects, which are explained in more detail below in “Side effect details,” include:

  • allergic reaction
  • blood disorders, such as low levels of all blood cell types

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on several of the side effects this drug may cause.

Note: In the side effects described below, information about people taking Bendeka in clinical studies is included. In these studies, people were taking Bendeka to treat the following blood cancers: chronic lymphocytic leukemia (CLL) and indolent B-cell non-Hodgkin lymphoma (NHL).

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Bendeka. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

A small study compared bendamustine (the active drug in Bendeka) to chlorambucil (a different chemotherapy drug) for CLL treatment. In this study, 5% of people taking bendamustine had an allergic reaction. In comparison, 2% of people using chlorambucil had an allergic reaction.

Call your doctor right away if you have a severe allergic reaction to Bendeka. But call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Blood disorders

If you’re taking Bendeka to treat either NHL or CLL, you likely don’t have enough healthy blood cells in your body. (These conditions lower the level of certain blood cells.) Bendeka can also decrease the level of your blood cells. This can increase your risk of complications, such as bleeding and infection.

For example, Bendeka may cause lymphocytopenia in some people. With this condition, you have a low level of white blood cells called lymphocytes. Lymphocytopenia can lead to serious or even fatal infections.

In clinical studies, 68% to 99% of people with CLL or NHL had some degree of lymphocytopenia while using bendamustine (the active drug in Bendeka). In comparison, lymphocytopenia occurred in 19% people with CLL who took chlorambucil (a different chemotherapy drug).

In addition, other blood disorders also occurred in people using bendamustine during clinical studies. (The percentages of people affected varied depending on whether they had CLL or NHL.) These disorders included:

  • Anemia. With anemia, you have a low level of red blood cells. This side effect occurred in 88% to 89% of people taking bendamustine. In comparison, 82% of people with CLL who took chlorambucil had anemia.
  • Thrombocytopenia. With thrombocytopenia, you have a low level of platelets. This side effect occurred in 77% to 86% of people taking bendamustine. In comparison, 78% of people with CLL who took chlorambucil had thrombocytopenia.
  • Leukopenia. With leukopenia, you have low levels of white blood cells. This side effect occurred in 61% to 94% of people taking bendamustine. In comparison, 18% of people with CLL who took chlorambucil had leukopenia.
  • Neutropenia. With neutropenia, you have a low level of neutrophils. (Neutrophils are a type of white blood cell that kills bacteria and fungus in your body.) This side effect occurred in 75% to 86% of people taking bendamustine. In comparison, 61% people of people with CLL who took chlorambucil had neutropenia.

While you’re taking Bendeka, you’ll have blood tests regularly to monitor your blood cell levels. If your levels are abnormal, your doctor may adjust your dosage of Bendeka.

Symptoms of blood disorders

Symptoms of low blood cell levels will vary, depending on which blood disorder you’re affected by. But they may include:

  • unusual bleeding
  • fever or chills
  • tiredness
  • dizziness
  • pale-colored skin or gums
  • cough
  • shortness of breath
  • sore throat

If you have any symptoms of low blood counts, call your doctor right away. They’ll recommend whether you need medical treatment.

Nausea and vomiting

It’s very common to have nausea or vomiting while you’re using Bendeka.

But if you have nausea or vomiting that doesn’t improve or becomes worse while you’re taking Bendeka, talk with your doctor right away. They may be able to recommend ways to help you feel better.

Nausea

In clinical trials, 20% to 75% of people using bendamustine (the active drug in Bendeka) had nausea. (This percentage varied depending on the condition being treated.)

One clinical study of people with CLL compared treatment with bendamustine to treatment with chlorambucil (a different chemotherapy drug). In this study, 15% of people using chlorambucil had nausea, compared with 20% of people using Bendeka.

In some cases, you may feel nauseous very quickly after receiving Bendeka. In clinical studies, 8.2% of people felt nauseous just 1 hour after receiving their dose. And 10.9% of people felt nauseous within the first 24 hours after receiving their dose. About 1.2% of people had to stop using Bendeka because of nausea.

Vomiting

In clinical studies, 16% to 40% of people taking bendamustine had vomiting. (This percentage varied depending on the condition being treated.) And about 1.2% of people had to stop taking Bendeka because of vomiting.

In the same clinical study of people with CLL that compared treatment with bendamustine to treatment with chlorambucil, 6% of people using chlorambucil had vomiting. In comparison, 16% of people using bendamustine had vomiting.

Fever

You may have a fever while you’re taking Bendeka. In clinical trials, 24% to 34% of people using bendamustine (the active drug in Bendeka) had a fever. (This percentage varied depending on what condition the drug was being used to treat.)

One clinical study of people with CLL compared treatment with bendamustine to treatment with chlorambucil (a different chemotherapy drug). In this study, 6% of people using chlorambucil had fever. In comparison, 24% of people using bendamustine had a fever.

In fact, fever was one of the most common side effects that caused people to stop using Bendeka. About 1% to 1.2% of people using the drug had to stop taking it due to fever.

But keep in mind that fever can also be a symptom of infection, which is also a possible side effect of Bendeka.

While taking Bendeka, if you have a fever that doesn’t go away, call your doctor right away. They may need to check to see what’s causing your fever. And they’ll recommend whether or not you need medical treatment.

Diarrhea

It’s very common to have diarrhea while you’re using Bendeka. In clinical trials, between 9% and 37% of people using bendamustine (the active drug in Bendeka) had diarrhea. (This percentage varied depending on what condition the drug was being used to treat.)

One clinical study of people with CLL compared treatment with bendamustine to treatment with chlorambucil (a different chemotherapy drug). In this study, 3% of people using chlorambucil had diarrhea. In comparison, 9% of people using bendamustine had diarrhea.

Diarrhea can sometimes be serious and lead to weight loss and dehydration. (With dehydration, you have a low level of fluids in your body.)

If you’re having severe or worsening diarrhea (with 10 or more loose stools per day) while you’re taking Bendeka, call your doctor right away. They may be able to prescribe medication or suggest other ways to improve your symptoms.

Fatigue

Fatigue (lack of energy) is a very common side effect of Bendeka. In fact, in clinical studies, fatigue occurred in about 9% to 57% of people taking bendamustine (the active drug in Bendeka). (This percentage varied depending on the condition being treated.)

One small study compared treatment with bendamustine to treatment with chlorambucil (a different chemotherapy drug) in people with untreated CLL. In this study, 9% of people taking bendamustine had fatigue. In comparison, 6% of people taking chlorambucil had fatigue.

And of the people affected by fatigue:

  • 5.5% felt fatigued as soon as 1 hour after receiving their dose of bendamustine
  • 8.2% felt fatigued within 24 hours after receiving their dose of bendamustine
  • 1.2% had to stop taking bendamustine because of fatigue

It’s important that you don’t drive or use other machinery if you’re feeling tired while you’re taking Bendeka. And check with doctor about whether it’s safe for you to drive after you’ve received a dose of Bendeka.

If you feel tired or fatigued while using Bendeka, talk with your doctor. They may be able to recommend ways to improve your energy levels and help you feel better.

Bendeka, Treanda, and Belrapzo are all brand-name medications that contain the same active drug: bendamustine. Below, we briefly describe how these drugs are alike and different.

If you have questions about which drug is right for you, talk with your doctor.

About Bendeka, Treanda, and Belrapzo

All three of these medications have been approved to treat both:

  • Chronic lymphocytic leukemia (CLL). CLL is a type of blood cancer that affects certain blood cells called lymphocytes.
  • Indolent B-cell non-Hodgkin lymphoma (NHL). Indolent B-cell NHL is a type of blood cancer that’s slow growing (indolent). It affects certain immune cells called B cells.

Treanda was the first of these brand-name drugs to be approved by the Food and Drug Administration (FDA). It was approved back in 2008.

Treanda was originally available as both a solution and a powder that could be made into a solution. Both of forms of Treanda were approved to treat the same types of cancer as Bendeka is approved to treat.

In December 2015, the FDA approved the brand-name drug Bendeka. Compared with Treanda, Bendeka has a shorter intravenous (IV) infusion* time. And it’s given in much smaller volumes than Treanda is given. In addition, the solution form of Treanda isn’t able to be given with certain types of IV tubing.**

In 2016, Treanda solution was taken off the market and replaced with Bendeka. However, the powder form of Treanda is still available.

Later, in 2018, Belrapzo was approved by the FDA for use.

* With an IV infusion, a needle is inserted into your vein and a small tube is connected to the needle. Certain drugs or fluids are then injected into your vein through the needle over a period of time.

** IV tubing is used to deliver drugs or fluids that are given to you by IV infusion.

Dosages for Bendeka, Treanda, and Belrapzo

Bendeka and Belrapzo each come as a solution that’s available in one strength: 100 mg/4 mL. Treanda comes as a powder that can be made into a solution. It’s available in two strengths: 25 mg and 100 mg.

Bendeka, Treanda, and Belrapzo are each given as IV infusions by healthcare providers.

However, Bendeka is given in smaller volumes than either Belrapzo or Treanda. And it can be infused much more quickly than either Belrapzo or Treanda. For example, it usually takes around 10 minutes to receive a Bendeka infusion. In comparison, infusions of Belrapzo and Treanda can take 30 to 60 minutes, depending on the drug used and the condition being treated.

Here are answers to some frequently asked questions about Bendeka.

Is Bendeka a chemotherapy drug?

Yes, Bendeka is a chemotherapy drug. These drugs are used to treat certain types of cancer.

Bendeka belongs to a class of drugs called alkylating agents. (A class of drugs is a group of medications that work in same way.) It’s not known for sure how Bendeka works, but it may work by stopping cancer cells in your body from multiplying. (Cells that multiply are making more cells.)

Your doctor will recommend whether Bendeka is right for you based on the type of cancer you have. They’ll also consider any other therapies or medications you’ve used in the past when recommending treatment for your condition.

How can I lower my risk of infections while I’m receiving Bendeka?

Because both cancer and certain cancer treatments can weaken your immune system, it’s important to try to avoid getting infections while you’re being treated for cancer. You can do this by following these tips:

  • Wash your hands frequently with soap and warm water.
  • Stay away from anyone who is ill or has a fever.
  • Be aware of possible symptoms of infection, and let your doctor know right away if you have any symptoms, which may include:
    • fever
    • chills
    • cough

If you’d like to know about other ways to help lower your risk of infection during Bendeka treatment, talk with your doctor.

Does Bendeka cause hair loss?

No, hair loss isn’t a common side effect of Bendeka. However, it’s possible that other cancer drugs you’ve used in the past, such as cyclophosphamide or vincristine, may cause hair loss. (Cyclophosphamide and vincristine are drugs used in a chemotherapy regimen called R-CHOP. This regimen is sometimes used to treat non-Hodgkin lymphoma [NHL].)

If you have hair loss while you’re receiving Bendeka, let your doctor know. They may be able to recommend ways to reduce this side effect.

Will I need any tests during Bendeka treatment?

Yes, you’ll need to have blood tests done while you’re using Bendeka. This is because Bendeka can lower the level of all your blood cell types.

Your doctor will order blood tests to check your blood cell levels before you receive each dose of Bendeka. For example, your doctor may order a complete blood count (CBC), which shows the levels of your white blood cells, red blood cells, and platelets. If your blood cell counts are too low, your doctor may adjust your treatment schedule or your dosage of Bendeka.

In addition, checking your blood cell counts allows your doctor to see if Bendeka is working for you. For example, with the blood cancers that Bendeka is used to treat, certain blood cell counts are abnormal. If your condition is improving with Bendeka treatment, your blood cell counts may become more normal during or after treatment.

Your doctor may also check other blood tests to monitor your kidney and liver function during Bendeka treatment. This can be done by ordering a blood test called a comprehensive metabolic panel (CMP). Results from a CMP will show your doctor how well your liver and kidneys are working. The results from this test will also help your doctor to know whether they need to adjust your Bendeka dosage.

If you’d like to know more about the lab tests you’ll need during Bendeka treatment, talk with your doctor.

The Bendeka dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Bendeka to treat
  • your age
  • other medical conditions you may have

Your doctor will likely start you on a standard dosage of Bendeka. Then they’ll adjust your dose over time to reach the amount that’s right for you.

The following information describes dosages that are commonly used or recommended. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Bendeka comes as a solution that’s available in one strength: 100 mg/4 mL.

It’s given as an intravenous (IV) infusion by healthcare providers. (With an IV infusion, the drug is injected into your vein over a period of time.) Each Bendeka infusion takes about 10 minutes.

Dosage for chronic lymphocytic leukemia

The typical dosage of Bendeka for chronic lymphocytic leukemia (CLL)* is calculated based on your body surface area.

A typical dose of Bendeka for CLL is 100 milligrams of drug per meters squared of body surface area (mg/m²). This dose is given by IV infusion over a period of 10 minutes. It’s infused on days 1 and 2 of a 28-day treatment cycle.

For example, a man who weighs 180 pounds (about 82 kilograms) and is 6 feet tall (about 1.8 meters) has a body surface area of about 2.04 m2. He would receive 100 mg of drug per m² of body surface area. So his dosage would be 204 mg of Bendeka.

* CLL is a type of blood cancer that affects certain blood cells called lymphocytes.

Dosage for non-Hodgkin lymphoma

The typical dosage of Bendeka for indolent B-cell non-Hodgkin lymphoma (NHL)* is calculated based on your body surface area.

A typical dose of Bendeka for NHL is 120 milligrams of drug per meters squared of body surface area (mg/m²). This dose is given by IV infusion over a period of 10 minutes. It’s infused on days 1 and 2 of a 21-day treatment cycle.

For example, a man who weighs 180 pounds (about 82 kilograms) and is 6 feet tall (about 1.8 meters) has a body surface area of about 2.04 m2. He would receive 120 mg of drug per m² of body surface area. His dosage would be 244.8 mg of Bendeka.

* Indolent B-cell NHL is a type of blood cancer that’s slow growing (indolent) and affects certain immune cells called B cells.

What if I miss an infusion appointment?

If you miss an appointment for a Bendeka infusion, call your doctor’s office right away. The medical staff can recommend when you should have your next dose of the drug.

To help make sure that you don’t miss an appointment for your Bendeka dose, try setting a reminder on your phone.

The Food and Drug Administration (FDA) approves prescription drugs such as Bendeka to treat certain conditions. Bendeka may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Bendeka for chronic lymphocytic leukemia

Bendeka is FDA-approved to treat chronic lymphocytic leukemia (CLL). This condition is a type of cancer that affects white blood cells called lymphocytes.

White blood cells are made in your bone marrow. With CLL, your bone marrow makes too many white blood cells, and they’re abnormal or immature. These abnormal blood cells prevent healthy white blood cells from being made.

White blood cells are part of your immune system, and they help your body fight off infections. But with CLL, your immune system isn’t able to fight off infections as easily as normal.

Effectiveness for CLL

In a clinical study of people with CLL, treatment with bendamustine (the active drug in Bendeka) was compared to treatment with a different chemotherapy drug called chlorambucil. In this study, 59% of people taking bendamustine had improvement in their condition. In comparison, 26% of people taking chlorambucil had the same result.

In addition, half of the people taking bendamustine went at least 18 months without their cancer getting worse. In comparison, half of the people taking chlorambucil went at least 6 months without their cancer getting worse.

Bendeka for non-Hodgkin lymphoma

Bendeka is FDA-approved to treat a certain form of non-Hodgkin lymphoma (NHL). Lymphoma is a type of cancer that starts in white blood cells called lymphocytes.

White blood cells are made in your bone marrow. With NHL, your bone marrow makes too many white blood cells, and they’re abnormal or immature. These abnormal blood cells prevent healthy white blood cells from being made.

White blood cells are part of your immune system, and they help your body fight off infections. But with NHL, your immune system isn’t able to fight off infections as easily as normal.

Because there are many types of white blood cells that can be affected by cancer, there are also many types of lymphomas. (The cancers are named based on which type of cell they affect.) Bendeka is specifically approved to treat a form of lymphoma called indolent B-cell NHL. This form of cancer affects your B cells (a certain type of lymphocyte). And the cancer is called “indolent” because it grows slowly in your body.

For this use, Bendeka is used to treat indolent B-cell NHL that worsened either during or within 6 months after treatment with another drug called rituximab (Rituxan).

Effectiveness for NHL

Bendamustine has been studied as a treatment for indolent B-cell NHL that either worsened or didn’t improve during or within 6 months after treatment with another drug called rituximab (Rituxan).

During one clinical study, 74% of people taking bendamustine saw improvement or no worsening of their condition with treatment. And half of the people taking Bendeka kept this response for at least 9.2 months. In this study, there weren’t any people who took treatment other than bendamustine.

Off-label uses for Bendeka

In addition to the uses listed above, Bendeka may be used off-label. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. Below are examples of off-label uses for Bendeka.

Bendeka for untreated non-Hodgkin lymphoma, used in combination with Rituxan

Bendeka is FDA-approved to be used alone to treat certain forms of non-Hodgkin lymphoma (NHL) that worsened either during or within 6 months after treatment with rituximab (Rituxan). (NHL is a type of cancer that affects certain white blood cells called lymphocytes.)

But sometimes Bendeka is used in combination with Rituxan in people with untreated NHL. This use is considered off-label because Bendeka is only FDA-approved for use after rituximab treatment.

Treatment with a combination of Bendeka plus rituximab has been studied in people with untreated NHL. In one clinical trial, some people with untreated NHL were given bendamustine (the active drug in Bendeka) with rituximab. Other people were given a well-known chemotherapy regimen called R-CHOP. (Chemotherapy describes traditional drugs used to treat cancer.)

The study showed that at least half of the people taking bendamustine plus rituximab went twice as many months without their cancer getting worse compared with people receiving R-CHOP. And fewer people taking bendamustine plus rituximab had side effects compared with people using R-CHOP.

More studies are needed to better understand the safety and effectiveness of using bendamustine plus rituximab to treat NHL.

If you’d like to know more about treatment options for NHL, talk with your doctor.

Bendeka for multiple myeloma

Bendeka isn’t FDA-approved to treat multiple myeloma. But sometimes it’s used off-label for this condition. Multiple myeloma is a type of cancer that affects certain white blood cells called plasma cells. These cells are made in your bone marrow and help your body fight off infections.

In a clinical study, bendamustine (the active drug in Bendeka) lengthened survival time in people with relapsed or refractory multiple myeloma. With relapsed multiple myeloma, the cancer has come back after a period of remission (when most or all signs of cancer have disappeared). With refractory multiple myeloma, the cancer didn’t respond to past treatment.

However, more clinical studies are needed to know about the effectiveness of bendamustine in treating multiple myeloma.

If you’d like to know more about treatment options for multiple myeloma, talk with your doctor.

Bendeka for Hodgkin lymphoma

Bendeka isn’t FDA-approved to treat Hodgkin lymphoma. But sometimes it’s used off-label for this condition.

Lymphoma is a type of cancer that affects certain white blood cells called lymphocytes. There are different types of lymphoma, including non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma. While Bendeka is approved to treat certain forms of NHL, the drug isn’t approved to treat Hodgkin lymphoma.

In one study, bendamustine (the active drug in Bendeka) was given to 41 people with recurrent Hodgkin lymphoma. (With recurrent cancer, the cancer improved with past treatment, but it came back after a period of time.)

In this study, at least half of the people had used at least 4 other therapies in the past, but their condition didn’t improve with those therapies. More than half of the people using bendamustine had their condition improve with treatment.

This study showed promising results. However, studies with more people are needed to confirm how safe and effective bendamustine is for treating Hodgkin lymphoma.

If you’d like to know more about treatment options for Hodgkin lymphoma, talk with your doctor.

Bendeka and children

Bendeka isn’t approved for use in children. This drug hasn’t been studied in people younger than 18 years of age for either NHL or CLL treatment.

Bendeka hasn’t been studied in combination with alcohol, so it’s not known if the drug interacts with alcohol. However, alcohol is known to cause some of the same side effects that Bendeka causes. These side effects include nausea, vomiting, and diarrhea. Consuming alcohol during Bendeka treatment may worsen these side effects.

Alcohol can also weaken the activity of your immune system and cause inflammation in your body. This makes it harder for both your body and Bendeka to fight off cancer.

If you drink alcohol, talk with your doctor about whether it’s safe for you to drink while you’re using Bendeka.

Bendeka can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Bendeka and other medications

Below we describe certain medications that can interact with Bendeka. However, not all the drugs that may interact with Bendeka are discussed below.

Before taking Bendeka, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Bendeka and certain medications that may decrease Bendeka levels in your body

Bendeka is broken down in your body by an enzyme called CYP1A2. (Enzymes are certain types of proteins.) Certain medications increase the level of CYP1A2 in your body. If taken with Bendeka, these medications may lower the level of Bendeka in your body. This may make Bendeka less effective in treating your condition.

Examples of drugs that may decrease levels of Bendeka in your body include:

  • carbamazepine (Tegretol, Equetro, Epitol, and others), a seizure drug
  • rifampin (Rifadin), an antibiotic

Let your doctor know about all the medications you’re taking before you begin using Bendeka. Your doctor can recommend whether it’s safe for you to take certain drugs with Bendeka.

Bendeka and certain medications that may increase Bendeka levels in your body

Bendeka is broken down in your body by an enzyme called CYP1A2. (Enzymes are certain types of proteins.) Certain medications decrease the level of CYP1A2 in your body. If taken with Bendeka, these medications may increase the level of Bendeka in your body. This can lead to increased side effects from Bendeka.

Examples of drugs that may increase levels of Bendeka in your body include:

  • ciprofloxacin (Cipro), an antibiotic
  • cimetidine (Tagamet), a heartburn medication
  • atazanavir (Reyataz), an antiviral

Let your doctor know about the medications you’re taking before you begin using Bendeka. Your doctor can recommend whether it’s safe for you to take certain drugs with Bendeka.

Bendeka and allopurinol

Taking Bendeka with allopurinol (Zyloprim and Lopurin) may increase your risk of severe skin reactions. (Allopurinol is a drug that’s used to treat gout and kidney stones.)

Before starting Bendeka, talk with your doctor if you’re taking allopurinol. Your doctor may recommend that you stop taking allopurinol or that you use a different medication.

Bendeka and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Bendeka. However, you should still check with your doctor or pharmacist before using any of these products while taking Bendeka.

As with all medications, the cost of Bendeka can vary. To find current prices for Bendeka in your area, check out WellRx.com. The cost you find on WellRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the medical office where you receive this drug.

Your insurance plan may require you to get prior authorization before approving coverage for Bendeka. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Bendeka.

If you’re not sure if you’ll need to get prior authorization for Bendeka, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Bendeka, or if you need help understanding your insurance coverage, help is available.

Teva Pharmaceuticals USA, Inc., the manufacturer of Bendeka, offers the following cost savings programs:

  • Comprehensive Oncology Reimbursement Expertise (CORE). Through this program, you can speak to someone about ways to lower the cost of Bendeka. To talk with someone about CORE, call 888-587-3263.
  • Teva Cares Foundation Patient Assistance Program. Through this program, you may be able to get Bendeka free of charge, if you’re eligible. To talk with someone about this program, call 877-237-4881.

For more information and to find out if you’re eligible for support, call the numbers above or visit the manufacturer’s website.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Bendeka, talk with your doctor. They can tell you about other medications that may work well for you.

Alternatives for chronic lymphocytic leukemia

Examples of other drugs that may be used to treat chronic lymphocytic leukemia (CLL)* include:

  • medications other than Bendeka that contain bendamustine, such as:
    • Treanda
    • Belrapzo
  • kinase inhibitors, such as:
    • acalabrutinib (Calquence)
    • idelalisib (Zydelig)
  • monoclonal antibodies, such as:
    • alemtuzumab (Campath, Lemtrada)
    • rituximab (Rituxan, Truxima, and others)
    • obinutuzumab (Gazyva)
  • alkylating agents, such as:
    • chorambucil (Leukeran)
    • cyclophosphamide (Procytox and others)
  • chemotherapy drugs other than Bendeka, such as:
    • fludarabine
  • targeted therapies, such as:
  • immunomodulators, such as:

* CLL is a type of blood cancer that affects certain blood cells called lymphocytes.

Alternatives for indolent B-cell non-Hodgkin lymphoma

Examples of other drugs that may be used to treat indolent B-cell non-Hodgkin lymphoma (NHL)* include:

  • medications other than Bendeka that contain bendamustine, such as:
    • Treanda
    • Belrapzo
  • rituximab (Rituxan, Truxima and others)
  • chemotherapy drugs other than Bendeka, such as:
    • doxorubicin (Adriamycin)
    • fludarabine
    • vincristine (Marqibo)
    • cyclophosphamide (Procytox and others)

* Indolent B-cell NHL is a type of blood cancer that’s slow growing (indolent) and affects certain immune cells called B cells.

You may wonder how Bendeka compares with other medications that are prescribed for similar uses. Here we look at how Bendeka and Venclexta are alike and different.

Ingredients

Bendeka contains the active drug bendamustine, while Venclexta contains the active drug venetoclax.

Bendeka is a chemotherapy drug. (Chemotherapy describes traditional drugs used to treat cancer.) Venclexta, on the other hand, is a targeted therapy for cancer. These drugs work in different ways in your body to treat cancer.

Uses

Bendeka is approved for use in adults to treat:

  • Chronic lymphocytic leukemia (CLL). For this use, Bendeka hasn’t been compared with first-line treatments for CLL other than the drug chlorambucil. (First-line treatment is the first treatment used for a condition.)
  • Indolent B-cell non-Hodgkin lymphoma (NHL). For treatment of this type of NHL, the condition must have worsened during or within 6 months after treatment with another drug called rituximab (Rituxan).

Venclexta is also approved for use in adults with CLL. In addition, Venclexta is approved for use in adults to treat:

* Venclexta received accelerated approval from the FDA for this use. Accelerated approval is based on information from early clinical trials. The FDA’s decision for full approval will be made after additional clinical trials are completed.

Drug forms and administration

Bendeka comes as a solution that’s given as an intravenous (IV) infusion by a healthcare provider. (With an IV infusion, the drug is injected into your vein over a period of time.) Each infusion takes about 10 minutes.

You’ll be given Bendeka on 2 days during each of your prescribed treatment cycles. (For CLL, each treatment cycle lasts 28 days. For NHL, each treatment cycle lasts 21 days.)

Venclexta comes as tablets. It’s taken by mouth, typically once daily. It should be taken with a meal and a full glass of water.

Your dosage of either Bendeka or Venclexta will vary based on the condition you’re using the drug to treat. It will also depend on how your body is tolerating the drug and on whether you’re taking other medications with either Bendeka or Venclexta.

Side effects and risks

Bendeka and Venclexta are both used to treat certain types of cancer. Therefore, these medications can cause very similar side effects. Below are examples of these side effects.

Depending on the condition you’re using either drug to treat, your side effects may vary from those listed below.

Mild side effects

These lists contain examples of mild side effects that have been reported in people with CLL who took Bendeka or Venclexta.

  • Can occur with Bendeka:
    • no unique side effects
  • Can occur with Venclexta:
    • edema (swelling) in your hands, ankles, or feet
    • belly pain
  • Can occur with both Bendeka and Venclexta:
    • nausea
    • vomiting
    • tiredness
    • headache
    • rash
    • fever

Serious side effects

These lists contain examples of serious side effects that can occur with Bendeka, with Venclexta, or with both drugs (when taken individually).

  • Can occur with Bendeka:
    • infusion reactions, such as fever or rash
    • severe skin reactions
    • liver damage
  • Can occur with Venclexta:
    • few unique serious side effects
  • Can occur with both Bendeka and Venclexta:
    • severe allergic reaction
    • blood disorders, such as anemia (low level of red blood cells) and leukopenia (low level of white blood cells)
    • tumor lysis syndrome (a condition that occurs when many cancer cells quickly die and release substances into your blood)

* It’s not known for sure whether bendamustine (the active drug in Bendeka) actually causes certain types of cancer. However, the manufacturer of Bendeka has placed a warning on the drug for this possible side effect.

Effectiveness

These drugs haven’t been directly compared in clinical studies. But separate studies have found both Bendeka and Venclexta to be effective in treating CLL.

Costs

Bendeka and Venclexta are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, the cost of Bendeka and Venclexta will vary depending on your recommended dosage of either drug. And the actual price you’ll pay for either drug also depends on your insurance plan, your location, and the pharmacy or medical office where you receive the drug.

Like Venclexta (discussed above), the drug Revlimid has uses similar to those of Bendeka. Here’s a comparison of how Bendeka and Revlimid are alike and different.

Ingredients

Bendeka contains the active drug bendamustine, while Revlimid contains the active drug lenalidomide.

Bendeka is a chemotherapy drug. (Chemotherapy describes traditional drugs used to treat cancer.) Revlimid, on the other hand, is an immunomodulator therapy for cancer. These drugs work in different ways in your body to treat cancer.

Uses

Bendeka is approved for use in adults to treat:

  • Chronic lymphocytic leukemia (CLL). For this use, Bendeka hasn’t been compared with first-line treatments for CLL other than the drug chlorambucil. (First-line treatment is the first treatment used for a condition.)
  • Indolent B-cell non-Hodgkin lymphoma (NHL). For treatment of this type of NHL, the condition must have worsened during or within 6 months after treatment with another drug called rituximab (Rituxan).

Revlimid is approved for use in adults to treat the following types of NHL:

  • Follicular lymphoma that’s been treated in the past. For this use, Revlimid is given with chemotherapy that’s made with rituximab (Rituxan).
  • Mantle cell lymphoma that’s been treated in the past with at least two therapies. But one of the therapies must have included bortezomib (Velcade). For this use, Revlimid is given to people whose cancer either came back or worsened after their past treatments.
  • Marginal zone lymphoma that’s been treated in the past. For this use, Revlimid is given with rituximab (Rituxan).

In addition, Revlimid is approved to treat:

Both Bendeka and Revlimid are approved to treat certain types of NHL. In addition, Revlimid is currently being studied as a treatment option for CLL. However, Revlimid isn’t yet approved to treat CLL.

Drug forms and administration

Bendeka comes as a solution that’s given as intravenous (IV) infusions by healthcare providers. (With an IV infusion, the drug is injected into your vein over a period of time.) Each infusion takes about 10 minutes.

You’ll be given Bendeka on 2 days during each of your prescribed treatment cycles. (For CLL, each treatment cycle lasts 28 days. For NHL, each treatment cycle lasts 21 days.)

Revlimid comes as capsules. It’s usually taken once daily, during certain days of your treatment cycle.

Your dosage of either Bendeka or Revlimid will vary based on the condition you’re using the drug to treat. It will also depend on how your body is tolerating the drug and on whether you’re taking other medications with either Bendeka or Revlimid.

Side effects and risks

Bendeka and Revlimid are both used to treat certain types of cancer. Therefore, these medications can cause very similar side effects. Below are examples of these side effects.

Depending on the condition you’re using either drug to treat, your side effects may vary from those listed below.

Mild side effects

These lists contain examples of mild side effects that have been reported in people with NHL who took Bendeka or Revlimid.

  • Can occur with Bendeka:
    • no unique side effects
  • Can occur with Revlimid:
    • muscle spasms
  • Can occur with both Bendeka and Venclexta:
    • nausea
    • vomiting
    • constipation
    • tiredness
    • belly pain
    • headache
    • dizziness
    • fever
    • weight loss
    • rash
    • back pain

Serious side effects

These lists contain examples of serious side effects that can occur with Bendeka, with Revlimid, or with both drugs (when taken individually).

  • Can occur with Bendeka:
    • severe skin reactions
    • liver damage
    • infusion injury (injury that can occur when a drug given by intravenous infusion leaks into the skin or tissue surrounding your vein)
  • Can occur with Revlimid:
  • Can occur with both Bendeka and Revlimid:
    • harm to developing embryos and fetuses if used during pregnancy**
    • tumor lysis syndrome. (a condition that occurs when many cancer cells quickly die and release substances into your blood)
    • severe allergic reaction

* It’s not known for sure whether bendamustine (the active drug in Bendeka) actually causes certain types of cancer. However, the manufacturer of Bendeka has placed a warning on the drug for this possible side effect.

** Revlimid has a boxed warning regarding the risk of blood clots, low levels of certain blood cells, and risk to developing pregnancies. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Effectiveness

Bendeka and Revlimid have different approved uses, but they’re both approved to treat certain types of non-Hodgkin lymphoma (NHL). Additionally, Bendeka is approved to treat CLL, while Revlimid is still being studied for this use. And currently, Revlimid is only given to people with CLL who are involved in studies.

Costs

Bendeka and Revlimid are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Revlimid generally costs more than Bendeka. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy or medical office where you receive the drug.

Bendeka is given by intravenous (IV) infusion by healthcare providers. With an IV infusion, the drug is injected into your vein over a period of time. Each Bendeka infusion takes about 10 minutes.

How often Bendeka is given

Bendeka is given on days 1 and 2 of your treatment cycle. Depending on which condition you’re using Bendeka to treat, your treatment cycle lengths will vary.

The typical length of Bendeka treatment for the conditions it’s approved to treat is as follows:

  • Chronic lymphocytic leukemia (CLL).* For this condition, Bendeka is given on a 28-day treatment cycle. And the drug can be continued for up to six cycles.
  • Indolent B-cell non-Hodgkin lymphoma (NHL) that worsened during or within 6 months of treatment with another drug called rituximab (Rituxan).** For this condition, Bendeka is given on a 21-day treatment cycle. And the drug can be continued for up to eight cycles.

To help make sure that you don’t miss an appointment for your Bendeka dose, try setting a reminder on your phone.

* CLL is a type of blood cancer that affects certain blood cells called lymphocytes.

**Indolent B-cell NHL is a type of blood cancer that’s slow growing [indolent]. It affects certain immune cells called B cells.

Bendeka is approved to treat certain forms of blood cancer. It contains the drug bendamustine, which is a chemotherapy drug. Bendeka belongs to a class of drugs called alkylating agents. (A drug class describes a group of medications that work in the same way.)

It’s not known exactly how Bendeka works. But one suggestion is that the drug disturbs the DNA (genetic material) of multiplying cells. (Cells that multiply are making more cells.)

Because cancer cells are quickly multiplying, they’re affected by Bendeka. The drug prevents the cells from multiplying, which also prevents them from growing and spreading.

By doing this, Bendeka kills cancer cells and slows the growth of cancer in your body.

How long does it take to work?

Several factors can affect how quickly Bendeka will start to work in your body. Your treatment results will vary depending on the type of cancer you have and on your age. But there are many other factors that can affect your treatment and determine how well Bendeka works for you.

During Bendeka treatment, your doctor will order blood tests to help monitor whether Bendeka is working. Your doctor can also discuss with you how quickly you can expect the drug to start working for your condition.

There haven’t been any studies in pregnant women to know whether Bendeka is safe to use during pregnancy.

However, animal studies have shown that serious birth defects and even miscarriages occurred in pregnant females who were given the drug. But keep in mind that the results of animal studies don’t always predict what will happen in people.

Because of the possible risks, it’s recommended that you don’t use Bendeka if you’re pregnant. In fact, the manufacturer of Bendeka recommends that both men and women taking the drug use birth control to prevent pregnancy. For information on these recommendations, see the next section, “Bendeka and birth control.”

If you become pregnant during Bendeka treatment, call your doctor right away. They can help you decide how to manage your treatment.

Bendeka may cause harm if it’s used during pregnancy. Because of this, it’s recommended that if you’re sexually active and you or your partner can become pregnant, you use birth control during Bendeka treatment.

Recommendations for both men and women using the drug are described below. Be sure to discuss birth control options with your doctor before starting Bendeka.

Females using Bendeka

If you’re a woman taking Bendeka and you’re able to become pregnant, you should use birth control during treatment with the drug. And you should continue to use birth control for at least 6 months after your last dose of Bendeka.

Males using Bendeka

If you’re a man taking Bendeka and you’re sexually active with a female who can become pregnant, you should use birth control during treatment with the drug. And you should continue to use birth control for at least 3 months after your last dose of Bendeka.

It’s not known whether Bendeka is passed into breast milk. It’s also not known what effect the drug may have on a child who’s breastfed.

But because of possible risks, it’s recommended that breastfeeding be avoided during Bendeka treatment. And you should continue to avoid breastfeeding for at least 1 week after your last dose of the drug.

If you have questions about the risks of breastfeeding during Bendeka treatment, talk with your doctor.

This drug comes with several precautions. Before taking Bendeka, talk with your doctor about your health history. Bendeka may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Allergy to Bendeka. If you’ve had an allergic reaction in the past to Bendeka or to any of its ingredients, you should avoid taking this drug. If you’re not sure about your medication allergies, talk with your doctor.
  • Kidney disease. If you havekidney disease, it may not be safe for you to use Bendeka. Before starting Bendeka, talk with your doctor about any history of kidney problems. Your doctor can recommend whether it’s safe for you to use Bendeka.
  • Liver disease. Bendeka may cause new or worsening liver problems. If you already have liver disease, it may not be safe for you to use Bendeka. Before starting Bendeka, talk with your doctor about any history of liver problems. Your doctor can recommend whether it’s safe for you to use the drug.
  • Pregnancy. Bendeka may cause serious harm if used during pregnancy. For more information, please see the “Bendeka and pregnancy” section above.
  • Breastfeeding. Breastfeeding should be avoided during Bendeka treatment. For more information, please see the “Bendeka and breastfeeding” section above.

Note: For more information about the potential negative effects of Bendeka, see the “Bendeka side effects” section above.

The following information is provided for clinicians and other healthcare professionals.

Indications

Bendeka is approved to treat both:

  • indolent B-cell non-Hodgkin’s lymphoma (NHL) that worsened during or after 6 months of treatment with either rituximab or a rituximab-containing agent
  • chronic lymphoid leukemia (CLL)*

* For this use, Bendeka hasn’t been compared with first-line treatments for CLL other than chlorambucil.

Mechanism of action

Bendeka is an alkylating agent. Its exact mechanism of action is unknown, but the drug is thought to form covalent bonds within nucleophilic moieties, leading to inhibition of cell division and induction of cell death.

Pharmacokinetics and metabolism

Bendeka is highly (94% to 96%) protein bound and extensively metabolized by the liver. The drug is excreted by both renal (approximately 50%) and fecal (approximately 25%) routes. Its elimination half-life is 40 minutes; however, it does have active metabolites.

Contraindications

Bendeka is contraindicated for use in people who have had a past hypersensitivity reaction to a product containing bendamustine. This includes medications such as Treanda, Bendeka, and Belrapzo.

Storage

Bendeka solution should be stored in the refrigerator, at a temperature of 36°F to 46°F (2°C to 8°C). It should be kept in its original container and protected from light exposure.

Once Bendeka is diluted with normal saline or other diluents, it is stable for up to 24 hours if kept in the refrigerator.

Bendeka is available in both individual and multidose vials. The multidose vials are stable in the refrigerator for up to 28 days after their initial use, and they can be punctured for use up to 6 times.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.