Treanda is a brand-name prescription medication. It’s a chemotherapy drug that’s FDA-approved to treat certain forms of these types of cancer:*

* For details on these conditions, please see the “Treanda uses” section below.

Treanda drug class and forms

Treanda contains the active drug bendamustine. Bendamustine is part of a specific kind of chemotherapy drug class called alkylating agents. (A drug class is a group of medications that work in a similar way.)

Treanda comes in two forms. One is a single-dose vial of liquid solution that’s available in two strengths: 45 mg/0.5 mL and 180 mg/2 mL.

The other form is a single-dose vial of powder that’s mixed with a liquid solution. The powder is available in two strengths: 25 mg and 100 mg.

Treanda is given as an intravenous (IV) infusion by a healthcare provider. An infusion is an injection into your vein that’s given over a period of time. You’ll typically have Treanda infusions on 2 days every 3 or 4 weeks.

Effectiveness

For information about the effectiveness of Treanda, see the “Treanda uses” section below.

Treanda 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. Generics usually cost less than brand-name drugs.

Both Treanda and Bendeka (bendamustine) contain the same active drug, bendamustine. This means bendamustine is the ingredient that makes Treanda and Bendeka work.

Also, the Food and Drug Administration (FDA) has approved both Treanda and Bendeka to treat certain forms of these types of cancer:*

* For details on these conditions, please see the “Treanda uses” section below.

Infusion times

Both Treanda and Bendeka are given as an intravenous (IV) infusion by a healthcare provider. An infusion is an injection into your vein that’s given over a period of time. You’ll typically have Treanda and Bendeka infusions on 2 days every 3 or 4 weeks.

Treanda infusions take 30 minutes when treating CLL and 60 minutes when treating B-cell NHL.

Bendeka infusions take only 10 minutes for either CLL or NHL.

Infusion devices

Like Treanda and Bendeka, the medication Belrapzo contains bendamustine as its active drug. Belrapzo is also given as an infusion.

Treanda contains an ingredient called N,N-dimethylacetamide (DMA) that won’t work with some devices used to infuse drugs. That means Treanda can’t be used with certain infusion devices. Bendeka and Belrapzo, on the other hand, don’t contain this ingredient. So Bendeka and Belrapzo can be used with more infusion devices than Treanda.

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

For more information on the possible side effects of Treanda, 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 Treanda, you can do so through MedWatch.

Mild side effects

Mild side effects of Treanda can include:*

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 Treanda. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Treanda’s package instructions.

Serious side effects

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:

  • Infections, such as pneumonia. Symptoms can include:
    • chills
    • sweating
    • fever
    • cough
    • stuffy nose
  • Infusion reactions. Symptoms can include:
    • chills
    • fever
    • itchiness
    • rash
    • anaphylaxis (severe allergic reaction that makes it hard to swallow and breathe)
  • Tumor lysis syndrome (a condition in which cancer cells release harmful chemicals into your blood). Symptoms can include:
    • diarrhea
    • feeling restless or irritable
    • muscle cramps
    • nausea, vomiting, or both
    • urinating less often
    • weakness or fatigue
  • Severe skin reactions, such as Stevens-Johnson Syndrome and toxic epidermal necrolysis. Symptoms can include:
    • blisters
    • body aches
    • trouble swallowing
    • fever
    • peeling or shedding skin
    • rash that’s red or purple
    • widespread skin pain
  • Liver damage. Symptoms can include:
    • dark-colored urine
    • fatigue
    • loss of appetite
    • nausea, vomiting, or both
    • stomach pain
    • jaundice (yellowing of the skin and the white of the eyes)
  • Other cancers, such as myelodysplastic syndrome (certain cancers of the bone marrow and blood) and acute myeloid leukemia (a kind of blood cell cancer). Symptoms can include:
    • fatigue
    • feeling short of breath
    • bruising or bleeding easily

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

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.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Treanda. In clinical trials of people with chronic lymphocytic leukemia (CLL), about 5% who received Treanda had an allergic reaction. In comparison, 2% of people who received chlorambucil had an allergic reaction.

How often allergic reactions occur with B-cell non-Hodgkin lymphoma (NHL) that’s indolent (slow growing) wasn’t reported and may vary.

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. About 2% of people with CLL who took Treanda in clinical trials reported having a severe allergic reaction. Treanda wasn’t compared with a different medication or a placebo.

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 or talking

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

Blood disorders

Treanda may cause a number of blood disorders, which occur when your blood cells don’t work properly. Clinical studies of CLL and NHL have looked at certain blood disorders, including:

  • Anemia. With this condition, the number of red blood cells in your body is too low.
    • CLL: About 89% of people who received Treanda had anemia. In comparison, 82% of people who received a different chemotherapy drug (chlorambucil) had anemia.
    • NHL: In the studies, 88% of people who received Treanda had anemia. The drug wasn’t compared with a different medication or a placebo (treatment with no active drug).
  • Leukopenia. With leukopenia, the number of white blood cells in your body is too low.
    • CLL: In the studies, 61% of people who received Treanda had leukopenia. In comparison, 18% of people who received chlorambucil had leukopenia.
    • NHL: In the studies, 94% of people who received Treanda had leukopenia. The drug wasn’t compared with a different medication or a placebo.
  • Lymphopenia. With lymphopenia (also called lymphocytopenia), the number of lymphocytes in your body becomes too low. A lymphocyte is a type of white blood cell.
    • CLL: In the studies, 68% of people who received Treanda had lymphopenia. In comparison, 19% of people who received chlorambucil had lymphopenia.
    • NHL: In the studies, 99% of people who received Treanda had lymphopenia. The drug wasn’t compared with a different medication or a placebo.
  • Neutropenia. This condition occurs when the number of neutrophils (a type of white blood cell) in your body becomes too low.
    • CLL: In the studies, 75% of people who received Treanda had neutropenia. In comparison, 61% of people who received chlorambucil had neutropenia.
    • NHL: In the studies, 86% of people who received Treanda had neutropenia. The drug wasn’t compared with a different medication or a placebo.
  • Thrombocytopenia. Withthrombocytopenia, the number of platelets in your body becomes too low. Platelets are a type of blood cell that helps your body form clots to stop bleeding.
    • CLL: Thrombocytopenia occurred in 77% of people who received Treanda. In comparison, 78% of people who received chlorambucil had low platelet levels as well.
    • NHL: In the studies, 86% of people who received Treanda had thrombocytopenia. The drug wasn’t compared with a different medication or a placebo.

While you take Treanda, your doctor will monitor your blood work to see whether you have a blood disorder. Depending on your results, they may delay one of your doses, or they may switch you to a different medication.

If you have questions about blood disorders while taking Treanda, talk with your doctor.

Fever

Fever may occur with Treanda. In clinical studies, 24% to 34% of people who received Treanda reported having a fever, depending on the cancer being treated.

  • About 2% to 4% of these people had a severe fever. (A severe fever is a fever that’s higher than 104.0°F [40.0°C] for 24 hours or longer.)
  • And 1% of people who received Treanda in these studies stopped their treatment due to fever.

One of these studies compared Treanda with chlorambucil in people with CLL.

  • Of the people who received Treanda, 24% had a fever. And 4% had a severe fever.
  • In comparison, only 6% of people who received chlorambucil had a fever, and 1% had a severe fever.

If you develop a fever while taking Treanda, tell your doctor. A fever can be a sign of an infection or an allergic reaction. For a mild fever that isn’t severe and there isn’t any infection present, your doctor may want you to keep using Treanda. For a severe fever, they may pause or stop your treatment, or switch you to a different drug.

Nausea and vomiting

Nausea and vomiting are common with Treanda use. In a clinical study of people with chronic lymphocytic leukemia (CLL), 20% of people who took Treanda had nausea and 16% experienced vomiting. In the same study, 15% of people who received chlorambucil had nausea and 6% experienced vomiting.

Rates of nausea and vomiting were much higher in a study of people with B-cell non-Hodgkin lymphoma (NHL) that’s indolent (slow growing). Of the people who received Treanda, 75% had nausea and 40% experienced vomiting. Treanda wasn’t compared with a placebo or different drug.

If you experience nausea or vomiting while taking Treanda, tell your doctor. They’ll help determine the cause. If the nausea and vomiting aren’t bothersome, your doctor may recommend that you keep using Treanda. In other instances, they may pause your treatment or switch you to a different drug.

Fatigue

A lack of energy known as fatigue is another common side effect of Treanda. In a clinical study of people with CLL, 9% of people who received Treanda reported fatigue. In comparison, 6% of people who received chlorambucil had fatigue.

Fatigue was much more common in a study of people with B-cell NHL that’s indolent. Of the people who took Treanda, 57% reported having fatigue. Treanda wasn’t compared with a placebo or different drug.

If you feel fatigued during Treanda treatment, tell your doctor. They’ll help determine the cause. If the fatigue isn’t bothersome, they may recommend that you keep using the drug. In other instances, they may pause your treatment or switch you to a different medication.

Here are answers to some frequently asked questions about Treanda.

Is Treanda a type of chemotherapy?

Yes, Treanda is a type of chemotherapy. Chemotherapy drugs work by destroying rapidly growing cells in the body. Because cancer cells grow and divide faster than normal healthy cells, chemotherapy is effective at killing cancer cells.

Treanda is a kind of chemotherapy known as an alkylating agent. It works by interfering with the DNA of cancer cells to stop them from dividing and growing.

Can Treanda cause hair loss?

Hair loss wasn’t reported as a side effect of Treanda in clinical studies.

Hair loss is a common side effect of some chemotherapy drugs. But it doesn’t appear to occur very often with Treanda.

If you’re concerned about hair loss during your Treanda treatment, talk with your doctor.

Are older adults able to take Treanda?

Yes. Older adults can take Treanda. But it’s important to note that in clinical studies of chronic lymphocytic leukemia (CLL), cancers in older adults didn’t respond quite as well to Treanda as cancers in people younger than age 65 years. But that doesn’t mean Treanda doesn’t work in older adults.

The overall response rate for people ages 65 years and older was 47%. In comparison, the rate was 70% for people younger than age 65 years. The overall response rate is the percentage of people who had fewer or no signs of cancer after treatment.

Researchers also looked at how long Treanda kept people’s CLL from progressing (getting worse). For at least half of the younger people, their CLL didn’t progress for at least 19 months. For at least half of the older adults, their CLL didn’t progress for at least 12 months.

Studies also looked at B-cell non-Hodgkin lymphoma (NHL) that’s indolent (slow growing). Treanda was equally effective in people older and younger than age 65 years. The overall response rate for all people with NHL was 74%. And for at least half of the people, their NHL didn’t progress for at least 9.2 months.

If you’re an older adult and have questions about Treanda, talk with your doctor.

Do I need any tests before I start can taking Treanda?

Yes, you’ll need to have tests that determine your liver function before you start taking Treanda. This is because the drug can cause liver damage, which has been fatal in rare cases. To make sure Treanda isn’t harming your liver, your doctor will keep monitoring your liver function during your Treanda treatment.

And if you’re able to become pregnant, your doctor will likely want you to take a pregnancy test before you start using Treanda. The drug can harm a developing baby, so it’s important that you’re not pregnant when you take the drug. (See the “Treanda and pregnancy” section below for more information.)

If you have questions about tests you may need before your Treanda treatment, talk with your doctor.

Will Treanda cure my cancer?

No. Treanda doesn’t cure cancer. The drug works to help prevent your cancer from worsening and help you reach remission. This is a stage in which test results show that there aren’t any cancer cells in your body and you no longer have symptoms. It’s possible that you could stay in remission or the cancer could come back later on.

If you have questions about how Treanda can treat your cancer, talk with your doctor.

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 Treanda, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for chronic lymphocytic leukemia

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

  • other chemotherapy drugs, such as:
    • other brands of bendamustine, including Bendeka and Belrapzo
    • chlorambucil
    • cyclophosphamide
  • targeted therapies, such as:
    • rituximab (Rituxan, Truxima)
    • ofatumumab (Arzerra)
    • obinutuzumab (Gazyva)
  • immunotherapies, such as:
    • CAR T-cell therapy

For more information on medications used to treat CLL, refer to the National Cancer Institute (NCI) website, which maintains a list of drugs approved for treating leukemias, including CLL.

Alternatives for non-Hodgkin lymphoma

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

  • other chemotherapy drugs, such as:
    • other brands of bendamustine, including Bendeka and Belrapzo
    • chlorambucil
    • cyclophosphamide
    • doxorubicin
    • vincristine
  • targeted therapies, such as:
    • copanlisib (Aliqopa)
    • idelalisib (Zydelig)
    • rituximab (Rituxan, Truxima)
    • obinutuzumab (Gazyva)
    • ibritumomab tiuxetan (Zevalin)
  • immunotherapies, such as:
    • lenalidomide (Revlimid) in combination with rituximab (Rituxan, Truxima)
    • CAR T-cell therapy

For more information on medications used to treat B-cell NHL that’s indolent, refer to the NCI website, which maintains a list of drugs approved for treating lymphomas, including NHL.

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

Ingredients

Treanda contains the active drug bendamustine.

Venclexta contains the active drug venetoclax.

Uses

The Food and Drug Administration (FDA) has approved Treanda to treat certain forms of these types of cancer:*

* For details on these conditions, please see the “Treanda uses” section below.

Venclexta is FDA-approved to treat:

So both Treanda and Venclexta are FDA-approved for treating CLL.

Drug forms and administration

Here’s some information about the forms of Treanda and Venclexta and how they’re given.

Treanda

Treanda comes in two forms. One is a single-dose vial of liquid solution.

The other form is a single-dose vial of powder that’s mixed with a liquid solution.

Treanda is given as an intravenous (IV) infusion by a healthcare provider. An infusion is an injection into your vein that’s given over a period of time.

Venclexta

Venclexta comes as a tablet that you swallow.

Side effects and risks

Treanda and Venclexta are both used to treat CLL. Therefore, these medications can cause some similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Treanda, with Venclexta, or with drugs (when taken individually).

Serious side effects

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

Effectiveness

The use of bendamustine (the active ingredient in Treanda) and Venclexta in treating CLL has been directly compared in a clinical study.

Researchers looked at people with CLL who had previously received at least one treatment for CLL. In the study, some people received bendamustine with another drug called rituximab for 6 months. Other people received Venclexta and rituximab for 6 months.

The researchers found that the people who took Venclexta and rituximab had a lower risk of their cancer spreading or getting worse, compared with people who received bendamustine and rituximab.

The overall response rate (people whose cancer had a complete or partial response to treatment) was 72% for people who took bendamustine and rituximab. This was compared with 92% for people who took Venclexta and rituximab. The overall response rate is the percentage of people who had fewer or no signs of cancer after treatment.

Costs

Treanda and Venclexta are both brand-name drugs. Treanda is available as a generic drug called bendamustine. There are currently no generic forms of Venclexta. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, the costs of Treanda infusions and Venclexta tablets will vary depending on your prescribed dose. The actual price you’ll pay for either drug depends on your insurance plan and your location.

Like Venclexta (above), the drug Zevalin (ibritumomab tiuxetan) has uses similar to those of Treanda. Here’s a comparison of how Treanda and Zevalin are alike and different.

Ingredients

Treanda contains the active drug bendamustine.

Zevalin contains the active drug ibritumomab tiuxetan.

Uses

The Food and Drug Administration (FDA) has approved Treanda to treat certain forms of these types of cancer:*

* For details on these conditions, please see the “Treanda uses” section below.

Zevalin is approved by the FDA to treat:

  • B-cell NHL that’s low-grade or follicular as well as relapsed or refractory in adults.
  • NHL that’s follicular and was previously untreated. The drug is for adults who have had a partial or complete response to chemotherapy.

Drug forms and administration

Here’s some information about the forms of Treanda and Venclexta and how they’re given.

Treanda

Treanda comes in two forms. One is a single-dose vial of liquid solution.

The other form is a single-dose vial of powder that’s mixed with a liquid solution.

Treanda is given as an intravenous (IV) infusion by a healthcare provider. An infusion is an injection into your vein that’s given over a period of time.

Zevalin

Zevalin comes as a single-dose vial of liquid solution.

Zevalin is also given as an IV infusion by a healthcare provider.

Before you receive Zevalin, you’ll need an infusion of rituximab (Rituxan).

Side effects and risks

Treanda and Zevalin are both used to treat forms of B-cell NHL. Therefore, these medications can cause some similar side effects, but some different ones as well. Below are examples of these side effects when used to treat B-cell NHL.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Treanda and Zevalin (when taken individually).

Serious side effects

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

* Zevalin has boxed warnings for these side effects. A boxed warning is the most serious warning from the FDA.

Effectiveness

These drugs haven’t been directly compared in clinical studies, but studies have found both Treanda and Zevalin to be effective for treating B-cell NHL.

Costs

Treanda and Zevalin are both brand-name drugs. Treanda is available as a generic drug called bendamustine. There are currently no generic forms of Zevalin. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Treanda costs significantly less than Zevalin. The actual price you’ll pay for either drug depends on your insurance plan and your location.

The Food and Drug Administration (FDA) approves prescription drugs such as Treanda to treat certain conditions. Treanda 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.

Treanda for chronic lymphocytic leukemia

Leukemia” refers to cancers of the blood cells or bone marrow. Treanda is FDA-approved to treat chronic lymphocytic leukemia (CLL), a specific type of leukemia that affects lymphocytes. These are a kind of white blood cell. Normal lymphocytes flow through your blood, helping your body fight infections.

Cancerous lymphocytes don’t work like normal lymphocytes. They don’t help fight infections. As the number of cancerous lymphocytes increases, they start crowding out normal lymphocytes.

What Treanda does

Treanda works by stopping cells from growing and dividing. This stops cancer cells from expanding and spreading. But Treanda doesn’t affect just cancer cells. The drug attacks all multiplying cells in the body, which can cause serious side effects. (See the “Treanda side effects” section above to learn more.)

Treanda hasn’t been compared with first-line treatments for CLL other than the drug chlorambucil. (“First-line” refers to the first treatment used for a condition.)

Effectiveness

In clinical trials, Treanda has been shown to extend the time until people’s cancer progressed (got worse).

One clinical study looked at people with CLL who took Treanda or chlorambucil.

  • For at least half of the people who took Treanda, their CLL didn’t progress for at least 18 months.
  • In comparison, for at least half of the people who took chlorambucil, their CLL didn’t progress for at least 6 months.
  • The overall response rate for people who received Treanda was 59%, compared with only 26% for people who received chlorambucil. The overall response rate is the percentage of people who had fewer or no signs of cancer after treatment.

It’s important to note that this study included only adults.

Treanda for non-Hodgkin lymphoma

Treanda is used to treat non-Hodgkin lymphoma (NHL) that has grown or spread while you’ve taken (or within 6 months of taking):

  • a drug called rituximab, or
  • a treatment that includes rituximab

Lymphoma” refers to a type of cancer of the lymphatic system. Specifically, the cancer develops from lymphocytes, which are a kind of white blood cell.

Treanda is approved to treat a type of lymphoma called B-cell NHL that’s indolent. “B-cell” means that the cancer begins in B cells, which are a specific kind of lymphocyte. “Indolent” means that the cancer grows and spreads slowly and may not cause any symptoms.

What Treanda does

Treanda works by keeping cells from growing and dividing. This stops cancer cells from expanding and spreading. But Treanda doesn’t affect just cancer cells. The drug attacks all multiplying cells in the body, which can cause serious side effects. (See the “Treanda side effects” section above to learn more.)

Effectiveness

In a Treanda study of people with B-cell NHL that’s indolent, everyone had previously tried rituximab or a treatment that included rituximab. But the rituximab or related treatment stopped working for them. Everyone in the Treanda study received Treanda. No one received a different medication or a placebo (treatment with no active drug).

The researchers found that 74% of people responded to Treanda. A response meant that their cancer either shrank or disappeared. Half of the people in the study had not had progression of disease at about 9 months.

It’s important to note that this study included only adults.

Off-label uses for Treanda

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

Treanda for non-Hodgkin lymphoma, in combination with Rituxan

Treanda isn’t FDA-approved to treat NHL with the drug Rituxan (rituximab). However, bendamustine (the active drug in Treanda) may be used for this purpose according to National Comprehensive Cancer Network guidelines.

A clinical study looked at people with NHL that was indolent or mantle cell. They received one of two treatments:

  • bendamustine and Rituxan
  • Rituxan, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)

The bendamustine and Rituxan treatment was more effective and had fewer side effects than R-CHOP.

If you have any questions about the use of bendamustine and Rituxan in treating NHL, talk with your doctor.

Treanda for Hodgkin lymphoma

Treanda isn’t approved by the FDA to treat Hodgkin lymphoma. But the drug may sometimes be used off-label for this condition.

In one study, researchers found that a treatment of bendamustine and a drug called brentuximab vedotin was effective in treating Hodgkin lymphoma that had stopped responding to treatment.

If you have any questions about the use of Treanda in treating Hodgkin lymphoma, talk with your doctor.

Treanda for multiple myeloma

Treanda isn’t FDA-approved to treat multiple myeloma, but the drug may be used off-label for this condition.

One clinical study looked at people with multiple myeloma. Researchers found that more people who received bendamustine and prednisone achieved complete remission than people who received melphalan and prednisone.

With complete remission, test results show that there aren’t any cancer cells in your body and you no longer have symptoms.

If you have any questions about the use of Treanda in treating multiple myeloma, talk with your doctor.

Treanda and children

It’s not known if Treanda is safe and effective in treating children.

Treanda 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 the number of side effects or make them more severe.

Treanda and other medications

Below is a list of medications that can interact with Treanda. This list doesn’t contain all drugs that may interact with Treanda.

Before taking Treanda, 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.

Treanda and certain medications that may increase the level of Treanda in your body

Treanda gets metabolized (broken down) in the body by an enzyme called CYP1A2. Enzymes are proteins that aid chemical changes in your body.

Certain medications keep your body from making CYP1A2, so they may stop your body from breaking down Treanda. This can result in the Treanda level in your body becoming too high, which may increase your risk for side effects. (For more about side effects, see the “Treanda side effects” section above.)

Examples of medications that can keep your body from making CYP1A2 include:

  • fluvoxamine (Luvox, Luvox CR)
  • ciprofloxacin (Cipro)
  • oral contraceptives containing ethinyl estradiol, such as Yaz and Lo Loestrin Fe
  • allopurinol* (Zyloprim, Aloprim)

Before you take Treanda, ask your doctor if any medications that you use can interact with Treanda. They may suggest different treatments.

* The use of Treanda and allopurinol together may also cause severe skin reactions such as Stevens-Johnson syndrome.

Treanda and herbs and supplements

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

Treanda and foods

There aren’t any foods that have been specifically reported to interact with Treanda. If you have any questions about eating certain foods with Treanda, talk with your doctor.

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

  • the type and severity of the condition you’re using Treanda to treat
  • your age
  • your body size
  • other medical conditions you may have
  • whether you’ve previously had side effects from Treanda

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Treanda comes in two forms. One is a single-dose vial of liquid solution that’s available in two strengths: 45 mg/0.5 mL and 180 mg/2 mL.

The other form is a single-dose vial of powder that’s mixed with a liquid solution. The powder is available in two strengths: 25 mg and 100 mg.

Treanda is given as an intravenous (IV) infusion by a healthcare provider. An infusion is an injection into your vein that’s given over a period of time.

Dosage for chronic lymphocytic leukemia

The recommended dose of Treanda for chronic lymphocytic leukemia (CLL) is 100 mg per meter squared (m2) of body surface area. Your doctor will determine your body surface area by using your height and weight.

The dose will be split between two infusions, which last 30 minutes each. You’ll receive them on days 1 and 2 of a 28-day cycle. You can receive up to six cycles of Treanda for CLL.

If you have side effects from Treanda, your doctor may lower your dose to help you better tolerate the drug. (For more about side effects, see the “Treanda side effects” section above.)

If you have questions about the Treanda dosage that’s right for you, talk with your doctor.

Dosage for non-Hodgkin lymphoma

The recommended dose of Treanda for B-cell non-Hodgkin lymphoma (NHL) that’s indolent (slow growing) is 120 mg per meter squared (m2) of body surface area. Your doctor will determine your body surface area by using your height and weight.

The dose will be split between two infusions, which last 60 minutes each. You’ll receive them on days 1 and 2 of a 21-day cycle. You can receive up to eight cycles of Treanda for this type of NHL.

If you have side effects from Treanda, your doctor may lower your dose to help you better tolerate the drug. (For more about side effects, see the “Treanda side effects” section above.)

If you have questions about the Treanda dosage that’s right for you, talk with your doctor.

What if I miss an infusion appointment?

If you miss an appointment for an infusion, call your doctor’s office right away. The staff will work with you to reschedule you as soon as possible. It’s important not to miss a dose.

To help make sure that you don’t miss an appointment, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Treanda is meant to be used as a long-term treatment. If you and your doctor determine that Treanda is safe and effective for you, you’ll likely take it long term. You can receive up to six cycles of Treanda for CLL, and up to eight cycles for B-cell NHL that’s indolent.

There aren’t any known interactions between Treanda and alcohol at this time.

If you have questions about drinking alcohol while taking Treanda, talk with your doctor.

As with all medications, the cost of Treanda can vary. To find current prices for Treanda 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 and your location.

Your insurance plan may require you to get prior authorization before approving coverage for Treanda. 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 prior authorization request and decide if the drug will be covered.

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

Financial assistance

If you need financial support to pay for Treanda, help is available.

NeedyMeds lists programs that may provide assistance in lowering the cost of Treanda. For more information and to find out if you’re eligible for support, visit the website.

Treanda comes in two forms. One is a single-dose vial of liquid solution. The other form is a single-dose vial of powder that’s mixed with a liquid solution.

Treanda is given as an intravenous (IV) infusion by a healthcare provider. An infusion is an injection into your vein that’s given over a period of time. The length of the infusion depends on the type of cancer that Treanda is being used to treat.

Infusions for chronic lymphocytic leukemia (CLL) last about 30 minutes.

Infusions for B-cell non-Hodgkin lymphoma (NHL) that’s indolent last 60 minutes. “B cells” are a certain type of white blood cell. And “indolent” means slow growing.

How often Treanda is given

How often Treanda is given depends on the type of cancer it’s being used to treat:

  • CLL: You’ll receive an infusion on days 1 and 2 of a 28-day cycle. You can receive up to six cycles of Treanda for CLL.
  • B-cell NHL that’s indolent: You’ll receive an infusion on days 1 and 2 of a 21-day cycle. You can receive up to eight cycles of Treanda for NHL.

Here’s some information on what occurs with chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL), and how Treanda works to treat them.

What happens in chronic lymphocytic leukemia (CLL)

Leukemia” refers to a type of cancer of blood cells or bone marrow. Different kinds of leukemia affect different blood cells. CLL affects a kind of white blood cell known as a lymphocyte. Normally, lymphocytes help your body fight infection. But cancerous lymphocytes don’t fight infections. As the number of cancerous lymphocytes grows, your body begins to lose its ability to fight infection.

What happens in non-Hodgkin lymphoma (NHL)

Lymphomas are cancers of the lymphatic system. These cancers begin in the lymph tissue and develop from lymphocytes, a type of white blood cell. Normally, these cells help your body fight infection. But cancerous lymphocytes don’t fight infections. As the number of cancerous lymphocytes grows, your body begins to lose its ability to fight infection.

How Treanda works

Treanda is a kind of chemotherapy drug. “Chemotherapy” refers to drugs that attack and destroy rapidly growing cells in the body. This includes cancer cells because they grow and divide at a faster rate than noncancerous cells.

Treanda works by keeping cells from growing and dividing. This stops cancer cells from expanding and spreading. But Treanda doesn’t affect just cancer cells. The drug attacks all growing cells in the body, which can cause serious side effects. (For more about side effects, see the “Treanda side effects” section above.)

How long does it take to work?

Treanda begins working as soon as it enters your bloodstream to stop cancer cells from growing and dividing, even if you don’t feel different. Your doctor will help set up a plan to monitor your progress.

Using Treanda while you’re pregnant may cause birth defects and miscarriage.

There haven’t been studies of pregnant women who used Treanda. But animal studies showed that when the drug was given to pregnant females, the babies had an increased risk of birth defects or death.

If you’re pregnant or are planning to become pregnant, talk with your doctor before using Treanda. They may suggest a different treatment for you.

Using Treanda while you’re pregnant may cause birth defects and miscarriage. So women will likely need to take a pregnancy test to make sure they aren’t pregnant before starting to use the drug.

For more information about taking Treanda during pregnancy, see the “Treanda and pregnancy” section above.

For women using Treanda

If you’re a woman who can become pregnant, you should use an effective form of birth control while taking Treanda. You should keep using birth control for at least 6 months after your last dose of the drug.

For men using Treanda

If you’re a man and have a female sexual partner who can become pregnant, you should use an effective method of birth control while you take Treanda. You should keep using the birth control for at least 3 months after your last dose of the drug.

If you’re sexually active and you or your partner can become pregnant, talk with your doctor. They can review your birth control needs and help answer any questions you have.

You shouldn’t breastfeed while taking Treanda and for up to 1 week after your last dose.

If you’re breastfeeding or plan to breastfeed, talk with your doctor before using Treanda. They can recommend the best ways to feed your child and what cancer treatments are right for you.

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

  • Pregnancy. Using Treanda while you’re pregnant may cause birth defects and miscarriage. For more information, please see the “Treanda and pregnancy” section above.
  • Breastfeeding. You shouldn’t breastfeed while taking Treanda and for at least 1 week after your last dose of the drug. For more information, please see the “Treanda and breastfeeding” section above.
  • Past infections. Using Treanda may cause past infections to become active again. These infections include hepatitis B, cytomegalovirus (a type of herpes virus), herpes zoster, herpes simplex, and tuberculosis (TB). If you’ve had an infection, tell your doctor before you use Treanda. They’ll need to treat the infection before you can start taking the drug.
  • Allergic reaction. If you’ve had an allergic reaction to Treanda or any of its ingredients, you shouldn’t receive the drug. Ask your doctor what other treatments are better choices for you.

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

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

Indications

The Food and Drug Administration (FDA) approved Treanda (bendamustine hydrochloride) for the treatment of chronic lymphocytic leukemia. The drug is also indicated for treating indolent B-cell non-Hodgkin lymphoma that has progressed either during treatment or within 6 months of treatment with rituximab, or with a regimen containing rituximab.

Mechanism of action

Although the exact mechanism of action is unknown, Treanda contains a purine-like benzimidazole ring and is able to form electrophilic alkyl groups. This allows Treanda to form covalent bonds within the cell nucleus with both single- and double-stranded DNA, resulting in DNA crosslinks between strands. This leads to cell death in both inactive and dividing cells.

Pharmacokinetics and metabolism

After intravenous infusion, the parent compound bendamustine has a half-life of approximately 40 minutes. Treanda forms two active metabolites, gamma-hydroxybendamustine (M3) and N desmethylbendamustine (M4), primarily via hepatic CYP1A2 metabolism. M3 has a half-life of around 3 hours; M4 has a half-life of approximately 30 minutes.

Treanda isn’t recommended for use in people with moderate or severe hepatic impairment.

Approximately 50% of the Treanda dose is eliminated renally. It isn’t recommended for use in patients with a creatine clearance below 30 mL/min.

Contraindications

Treanda should not be used in patients with known hypersensitivity to Treanda or any components of the drug product.

Treanda can cause harm to a developing fetus. Pregnant women should be advised of this risk.

Storage

Treanda is a cytotoxic drug with special handling and disposal procedures. See the drug package for details.

Treanda solution should be stored in a refrigerator from 36°F to 46°F (2°C to 8°C). The medication should be kept in the original packaging until it is to be used in order to protect it from light.

Treanda lyophilized powder for injection can be stored at room temperature, up to 77°F (25°C). Deviations are allowed up to 86°F (30°C). The medication should be kept in the original packaging until it is to be used in order to protect it from light.

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.