Bendamustine is a parenterally administered alkylating agent used alone and in combination with other antineoplastic agents in the treatment of chronic lymphocytic leukemia and refractory forms of non-Hodgkin lymphoma. Bendamustine therapy is associated with minor transient serum enzyme elevations during treatment and with rare instances of clinically apparent liver injury, with jaundice generally arising as a part of a generalized hypersensitivity syndrome. Bendamustine also has potent immunosuppressive activity and can cause reactivation of chronic hepatitis B which can be severe and even fatal.
Bendamustine is a bifunctional mechlorethamine derivative with alkylating and antimetabolite activities. Although the exact mechanism of action of bendamustine is unknown, this agent appears to alkylate and crosslink macromolecules, resulting in DNA, RNA, and protein synthesis inhibition, and eventually the induction of apoptosis.
Bendamustine Hydrochloride is the hydrochloride salt of bendamustine, a bifunctional mechlorethamine derivative with alkylator and antimetabolite activities. Bendamustine possesses three active moieties: an alkylating group; a benzimidazole ring, which may act as a purine analogue; and a butyric acid side chain. Although its exact mechanism of action is unknown this agent appears to act primarily as an alkylator. Bendamustine metabolites alkylate and crosslink macromolecules, resulting in DNA, RNA and protein synthesis inhibition, and, subsequently, apoptosis. Bendamustine may differ from other alkylators in that it may be more potent in activating p53-dependent stress pathways and inducing apoptosis; it may induce mitotic catastrophe; and it may activate a base excision DNA repair pathway rather than an alkyltransferase DNA repair mechanism. Accordingly, this agent may be more efficacious and less susceptible to drug resistance than other alkylators.
Mechanism of Action
Bendamustine is a bifunctional mechlorethamine derivative capable of forming electrophilic alkyl groups that covalently bond to other molecules. Through this function as an alkylating agent, bendamustine causes intra- and inter-strand crosslinks between DNA bases resulting in cell death. It is active against both active and quiescent cells, although the exact mechanism of action is unknown.
Multiple myeloma is a fatal hematological disease caused by the malignant transformation of plasma cells. Bendamustine has been proven to be a potent alternative to melphalan in phase 3 studies, yet its molecular mode of action is still poorly understood. The four-myeloma cell lines NCI-H929, OPM-2, RPMI-8226, and U266 were cultured in vitro. Apoptosis was measured by flow cytometry after annexin V FITC and propidium iodide staining. The cell cycle distribution of cells was determined by DNA staining with propidium iodide. Intracellular levels of (phosphorylated) proteins were determined by western blot. /It was shown/ that bendamustine induces apoptosis with an IC50 of 35-65 mg/ml and with cleavage of caspase 3. Incubation with 10-30 mg/ml results in G2 cell cycle arrest in all four-cell lines. The primary DNA-damage signaling kinases ATM and Chk2, but not ATR and Chk1, are activated. The Chk2 substrate Cdc25A phosphatase is degraded and Cdc2 is inhibited by inhibitory phosphorylation of Tyr15 accompanied by increased cyclin B levels. Additionally, p53 activation occurs as phosphorylation of Ser15, the phosphorylation site for ATM. p53 promotes Cdc2 inhibition by upregulation of p21. Targeting of p38 MAPK by the selective inhibitor SB202190 significantly increases bendamustine-induced apoptosis. Additionally, SB202190 completely abrogates G2 cell cycle arrest. Bendamustine induces ATM-Chk2-Cdc2-mediated G2 arrest and p53-mediated apoptosis. Inhibition of p38 MAPK augments apoptosis and abrogates G2 arrest and can be considered a new therapeutic strategy in combination with bendamustine.
Indications
- Bendamustine is indicated for use in the treatment of chronic lymphocytic leukemia (CLL) and indolent B-cell non-Ho
- Bendamustine is a parenterally administered alkylating agent used alone and in combination with other antineoplastic agents in the treatment of chronic lymphocytic leukemia and refractory forms of non-Hodgkin lymphoma.
- B-cellnon-Hodgkin lymphoma (NHL) is indolent (slow-growing) and got worse during or within 6 months after treatment with rituximab.
- Chronic lymphocytic leukemia (CLL).
- Bendamustine hydrochloride is used for the treatment of chronic lymphocytic leukemia (CLL) and is designated an orphan drug by the US Food and Drug Administration (FDA) for use in this condition.
- Bendamustine administered as monotherapy is active in rituximab-refractory indolent non-Hodgkin’s lymphoma, predominantly in patients with nontransformed or with sensitive disease characteristics. Therefore, bendamustine may be considered a reasonable choice for rituximab-refractory, indolent non-Hodgkin’s lymphoma; bendamustine may also may be considered an alternative in patients who are not candidates for radioimmunotherapy due to either patient selection (i.e., a clinical contraindication) or accessibility issues.
- Chronic Lymphocytic Leukemia (CLL)
- Follicular Non-Hodgkin’s Lymphoma Refractory
- Refractory Hodgkin Lymphoma
- Refractory Mantle Cell Lymphoma
- Waldenström’s Macroglobulinemia (WM)
- Recurrent multiple myeloma
- Refractory indolent B cell non-hodgkin lymphoma
Use in Cancer
Bendamustine hydrochloride is approved to treat:
- B-cell non-Hodgkin lymphoma (NHL) is indolent (slow-growing) and got worse during or within 6 months after treatment with rituximab.
- Chronic lymphocytic leukemia (CLL).
Bendamustine hydrochloride is also being studied in the treatment of other types of cancer.
Contraindications
- are allergic to bendamustine hydrochloride or any ingredients of this medication, including mannitol
- a bad infection
- malignant melanoma, a type of skin cancer
- dehydration
- high levels of potassium in the blood
- anemia
- decreased blood platelets
- low levels of a type of white blood cell called neutrophils
- abnormal liver function tests
- pregnancy
- a patient who is producing milk and breastfeeding
- tobacco smoking
- progressive multifocal leukoencephalopathy, a type of brain infection
Dosage
Strengths: 25 mg/mL; 25 mg; 100 mg; 90 mg/mL
Chronic Lymphocytic Leukemia
- 100 mg/m2 IV on Days 1 and 2 of a 28-day cycle
- Duration of Therapy: Up to 6 cycles
- Administer this drug via IV infusion over 30 minutes; consult the manufacturer’s product information for a specific IV infusion time period.
- Efficacy of this drug relative to first-line therapies other than chlorambucil has not been established.
- This drug is available in two formulations, a solution and a lyophilized powder; do not mix or combine the two formulations.
Non-Hodgkin’s Lymphoma
- 120 mg/m2 IV on Days 1 and 2 of a 21-day cycle
- Duration of Therapy: Up to 8 cycles
- Administer this drug via IV infusion over 60 minutes; consult the manufacturer product information for specific IV infusion time period.
- This drug is available in two formulations, a solution and a lyophilized powder; do not mix or combine the two formulations.
Renal Dose Adjustments
- Mild to Moderate Renal Dysfunction: Use with caution.
- Severe Renal Dysfunction (CrCl less than 30 mL/min): Not recommended.
Liver Dose Adjustments
- Mild Liver Dysfunction: Use with caution.
- Moderate Liver Dysfunction (AST or ALT 2.5 to 10 x Upper Limit of Normal and Total Bilirubin 1.5 to 3 x ULN): Not recommended.
- Severe Liver Dysfunction (Total Bilirubin greater than 3 x ULN): Not recommended.
Dose Adjustments
Chronic Lymphocytic Leukemia (CLL) or Non-Hodgkin Lymphoma (NHL):
- Grade 4 Hematologic Toxicity or Clinically Significant Grade 2 or Greater Non-Hematologic Toxicity: Delay treatment; reinitiate therapy at a physician’s discretion once non-hematologic toxicity has recovered to Grade 1 or less and/or absolute neutrophil count (ANC) 1 x 10(9)/L or greater and platelets 75 x 10(9)/L or greater; dose reduction may be warranted.
CLL:
Grade 3 or Greater Hematologic Toxicity: Reduce dose to 50 mg/m2 on Days 1 and 2 of each cycle.
- If Grade 3 or greater toxicity recurs, reduce dose to 25 mg/m2 on Days 1 and 2 of each cycle.
- Dose re-escalation in subsequent cycles may be considered per physician discretion.
Clinically Significant Grade 3 or Greater Non-Hematologic Toxicity: Reduce dose to 50 mg/m2 on Days 1 and 2 of each cycle.
- Dose re-escalation in subsequent cycles may be considered per physician discretion.
NHL:
Grade 4 Hematologic Toxicity or Grade 3 or Greater Non-Hematologic Toxicity: Reduce dose to 90 mg/m2 on Days 1 and 2 of each cycle.
- If Grade 4 hematologic or Grade 3 or greater non-hematologic toxicity recurs, reduce dose to 60 mg/m2 on Days 1 and 2 of each cycle.
Side Effects
The Most Common
- nausea
- vomiting
- diarrhea
- heartburn
- constipation
- stomach pain or swelling
- sores or white patches in the mouth
- dry mouth
- bad taste in the mouth or difficulty tasting food
- loss of appetite
- weight loss
- headache
- anxiety
- depression
- difficulty falling asleep or staying asleep
- back, bone, joint, arm or leg pain
- dry skin
- sweating
- night sweats
More common
- pain in the place where the medication was injected
- hives
- rash
- itching
- blistering or peeling skin
- difficulty breathing or swallowing
- swelling of the eyes, face, lips, tongue, arms, hands, feet, ankles, or lower legs
- shortness of breath
- chest pain
- fast heartbeat
- excessive tiredness or weakness
- pale skin
- fever, chills, cough, or other signs of infection
- nausea; vomiting; unusual bleeding or bruising; yellowing of the skin or eyes, dark urine, or light colored stool; tenderness on the right upper side of the stomach
Rare
- dehydration (thirst, dizziness, dry mouth, less urine output)
- difficulty breathing
- fever (over 38°C, or as instructed by your physician or clinic)
- lumps or discoloured patches on the skin
- signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
- signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
- signs of increased uric acid in the body (gout; e.g., joint pain, swelling and warmth of joints)
- signs of heart problems (e.g., fast, irregular heartbeat or pulse, chest pain, sudden weight gain, difficulty breathing, leg swelling)
- signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine, change of urine colour)
- signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
- skin growths or changes to existing skin growths or sores
- skin rash
- symptoms of extravasation (leakage of drug from the veins; redness, pain, swelling or infection at the site of infusion)
- symptoms of an infection such as fever, chills, or painful and difficult urination
- symptoms of a new cancer (e.g., weight loss, fatigue, night sweats, loss of appetite, coughing up blood, persistent cough, fever, frequent infections, bone pain)
- symptoms of irregular heartbeat (e.g., chest pain, dizziness, rapid, pounding heartbeat, shortness of breath)
- symptoms of low potassium levels in the blood (e.g., weakness, fatigue, muscle cramps, irregular heartbeat)
- symptoms of a lung infection (e.g., shortness of breath, cough, chest pain)
- symptoms of scarring of the lung (e.g., shortness of breath, fatigue, fever, infection)
- symptoms of severely increased blood pressure (e.g., chest pain, blurred vision, dizziness, excessive tiredness, headache, stronger or faster heart beat)
Seek immediate medical attention if any of the following occur:
- signs of bleeding in the stomach (e.g., bloody, black, or tarry stools, spitting up of blood, vomiting blood or material that looks like coffee grounds)
- signs of a heart attack (e.g., chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating)
- symptoms of a serious allergic reaction, such as hives, difficulty breathing, or swelling of the eyelids, throat, and mouth
- signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
- symptoms of progressive multifocal leukoencephalopathy (PML) (e.g., memory loss, trouble thinking, difficulty walking, loss of sight)
- symptoms of tumor lysis syndrome (e.g., producing less urine, cloudy urine, kidney problems, muscle spasms, nausea, shortness of breath)
Bendamustine therapy is associated with minor transient serum enzyme elevations during treatment and to rare instances of clinically apparent liver injury, with jaundice generally arising as a part of a generalized hypersensitivity syndrome. Bendamustine also has potent immunosuppressive activity and can cause reactivation of chronic hepatitis B that can be severe and even fatal.
Drug Interaction
| DRUG | INTERACTION |
|---|---|
| Abametapir | The serum concentration of Bendamustine can be increased when it is combined with Abametapir. |
| Abatacept | The metabolism of Bendamustine can be increased when combined with Abatacept. |
| Abciximab | The risk or severity of bleeding can be increased when Abciximab is combined with Bendamustine. |
| Abiraterone | The serum concentration of Bendamustine can be increased when it is combined with Abiraterone. |
| Abrocitinib | The serum concentration of Bendamustine can be increased when it is combined with Abrocitinib. |
| Acenocoumarol | The metabolism of Bendamustine can be decreased when combined with Acenocoumarol. |
| Acetaminophen | The metabolism of Bendamustine can be decreased when combined with Acetaminophen. |
| Acetylsalicylic acid | The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Bendamustine. |
| Acyclovir | The metabolism of Bendamustine can be decreased when combined with Acyclovir. |
| Adalimumab | The metabolism of Bendamustine can be increased when combined with Adalimumab. |
| Adenovirus | The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Bendamustine. |
| Afatinib | The serum concentration of Bendamustine can be increased when it is combined with Afatinib. |
| Agomelatine | The metabolism of Bendamustine can be decreased when combined with Agomelatine. |
| Albendazole | The serum concentration of Bendamustine can be increased when it is combined with Albendazole. |
| Aldesleukin | The risk or severity of adverse effects can be increased when Aldesleukin is combined with Bendamustine. |
| Alefacept | The risk or severity of adverse effects can be increased when Alefacept is combined with Bendamustine. |
| Alemtuzumab | The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Bendamustine. |
| Allogeneic processed | The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Bendamustine. |
| Allopurinol | The risk or severity of rash, hypersensitivity reaction, Stevens-Johnson syndrome, and Cutaneous drug reaction can be increased when Allopurinol is combined with Bendamustine. |
| Alosetron | The metabolism of Bendamustine can be decreased when combined with Alosetron. |
| Alteplase | The risk or severity of bleeding can be increased when Alteplase is combined with Bendamustine. |
| Altretamine | The risk or severity of adverse effects can be increased when Altretamine is combined with Bendamustine. |
| Ambrisentan | The serum concentration of Bendamustine can be increased when it is combined with Ambrisentan. |
| Aminophenazone | The metabolism of Bendamustine can be decreased when combined with Aminophenazone. |
| Aminophylline | The metabolism of Bendamustine can be decreased when combined with Aminophylline. |
| Amiodarone | The serum concentration of Bendamustine can be increased when it is combined with Amiodarone. |
| Amitriptyline | The metabolism of Bendamustine can be decreased when combined with Amitriptyline. |
| Amsacrine | The risk or severity of adverse effects can be increased when Amsacrine is combined with Bendamustine. |
| Anagrelide | The metabolism of Bendamustine can be decreased when combined with Anagrelide. |
| Anakinra | The metabolism of Bendamustine can be increased when combined with Anakinra. |
| Ancrod | The risk or severity of bleeding can be increased when Ancrod is combined with Bendamustine. |
| Anifrolumab | The risk or severity of adverse effects can be increased when Bendamustine is combined with Anifrolumab. |
| Anistreplase | The risk or severity of bleeding can be increased when Anistreplase is combined with Bendamustine. |
| Anthrax immune globulin | The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Bendamustine. |
| Anthrax vaccine | The risk or severity of infection can be increased when Anthrax vaccine is combined with Bendamustine. |
| Antilymphocyte | The risk or severity of adverse effects can be increased when Bendamustine is combined with Antilymphocyte immunoglobulin (horse). |
| Antipyrine | The metabolism of Bendamustine can be decreased when combined with Antipyrine. |
| Antithrombin Alfa | The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Bendamustine. |
| Antithrombin III human | The risk or severity of bleeding can be increased when Antithrombin III human is combined with Bendamustine. |
| Antithymocyte | The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Bendamustine. |
| Apalutamide | The serum concentration of Bendamustine can be decreased when it is combined with Apalutamide. |
| Apixaban | The serum concentration of Bendamustine can be increased when it is combined with Apixaban. |
| Apremilast | The metabolism of Bendamustine can be increased when combined with Apremilast. |
| Ardeparin | The risk or severity of bleeding can be increased when Ardeparin is combined with Bendamustine. |
| Argatroban | The risk or severity of bleeding can be increased when Argatroban is combined with Bendamustine. |
| Armodafinil | The metabolism of Bendamustine can be increased when combined with Armodafinil. |
| Arsenic trioxide | The serum concentration of Bendamustine can be increased when it is combined with Arsenic trioxide. |
| Articaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Articaine. |
| Asciminib | The serum concentration of Bendamustine can be increased when it is combined with Asciminib. |
| Asenapine | The metabolism of Bendamustine can be decreased when combined with Asenapine. |
| COVID-19 Vaccine | The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Bendamustine. |
| Asunaprevir | The serum concentration of Bendamustine can be increased when it is combined with Asunaprevir. |
| Atazanavir | The metabolism of Bendamustine can be decreased when combined with Atazanavir. |
| Avanafil | The serum concentration of Bendamustine can be increased when it is combined with Avanafil. |
| Avatrombopag | The serum concentration of Bendamustine can be increased when it is combined with Avatrombopag. |
| Axitinib | The metabolism of Bendamustine can be decreased when combined with Axitinib. |
| Azacitidine | The risk or severity of adverse effects can be increased when Azacitidine is combined with Bendamustine. |
| Azathioprine | The risk or severity of adverse effects can be increased when Azathioprine is combined with Bendamustine. |
| Azelastine | The metabolism of Bendamustine can be decreased when combined with Azelastine. |
| Bacillus calmette-guerin | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Bendamustine. |
| Bacillus calmette-guerin | The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Bendamustine. |
| Bacillus calmette-guerin | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Bendamustine. |
| Baricitinib | The risk or severity of adverse effects can be increased when Bendamustine is combined with Baricitinib. |
| Basiliximab | The risk or severity of adverse effects can be increased when Basiliximab is combined with Bendamustine. |
| BCG vaccine | The risk or severity of infection can be increased when BCG vaccine is combined with Bendamustine. |
| Beclomethasone dipropionate | The risk or severity of adverse effects can be increased when Beclomethasone dipropionate is combined with Bendamustine. |
| Belantamab mafodotin | The serum concentration of Bendamustine can be increased when it is combined with Belantamab mafodotin. |
| Belatacept | The risk or severity of adverse effects can be increased when Belatacept is combined with Bendamustine. |
| Belimumab | The risk or severity of adverse effects can be increased when Bendamustine is combined with Belimumab. |
| Belinostat | The risk or severity of adverse effects can be increased when Belinostat is combined with Bendamustine. |
| Belumosudil | The serum concentration of Bendamustine can be increased when it is combined with Belumosudil. |
| Bemiparin | The risk or severity of bleeding can be increased when Bemiparin is combined with Bendamustine. |
| Bendroflumethiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Bendamustine. |
| Benzocaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Benzocaine. |
| Benzthiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Bendamustine. |
| Benzyl alcohol | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Benzyl alcohol. |
| Berotralstat | The serum concentration of Bendamustine can be increased when it is combined with Berotralstat. |
| Betamethasone | The risk or severity of adverse effects can be increased when Betamethasone is combined with Bendamustine. |
| Betaxolol | The metabolism of Bendamustine can be decreased when combined with Betaxolol. |
| Betrixaban | The serum concentration of Bendamustine can be increased when it is combined with Betrixaban. |
| Bexarotene | The risk or severity of adverse effects can be increased when Bexarotene is combined with Bendamustine. |
| Bimekizumab | The metabolism of Bendamustine can be increased when combined with Bimekizumab. |
| Binimetinib | The metabolism of Binimetinib can be decreased when combined with Bendamustine. |
| Bisoprolol | The serum concentration of Bendamustine can be increased when it is combined with Bisoprolol. |
| Bivalirudin | The risk or severity of bleeding can be increased when Bivalirudin is combined with Bendamustine. |
| Bleomycin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Bendamustine. |
| Blinatumomab | The risk or severity of adverse effects can be increased when Bendamustine is combined with Blinatumomab. |
| Bordetella pertussis | The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Bendamustine. |
| Bortezomib | The risk or severity of adverse effects can be increased when Bortezomib is combined with Bendamustine. |
| Bosutinib | The risk or severity of adverse effects can be increased when Bosutinib is combined with Bendamustine. |
| Brentuximab vedotin | The risk or severity of adverse effects can be increased when Bendamustine is combined with Brentuximab vedotin. |
| Brodalumab | The risk or severity of adverse effects can be increased when Bendamustine is combined with Brodalumab. |
| Bromazepam | The metabolism of Bendamustine can be decreased when combined with Bromazepam. |
| Bromotheophylline | The metabolism of Bromotheophylline can be decreased when combined with Bendamustine. |
| Budesonide | The risk or severity of adverse effects can be increased when Budesonide is combined with Bendamustine. |
| Bupivacaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Bupivacaine. |
| Busulfan | The risk or severity of adverse effects can be increased when Busulfan is combined with Bendamustine. |
| Butacaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Butacaine. |
| Butamben | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Butamben. |
| Cabazitaxel | The risk or severity of adverse effects can be increased when Bendamustine is combined with Cabazitaxel. |
| Canagliflozin | The serum concentration of Bendamustine can be increased when it is combined with Canagliflozin. |
| Canakinumab | The metabolism of Bendamustine can be increased when combined with Canakinumab. |
| Cangrelor | The risk or severity of bleeding can be increased when Cangrelor is combined with Bendamustine. |
| Cannabidiol | The metabolism of Bendamustine can be decreased when combined with Cannabidiol. |
| Capecitabine | The risk or severity of adverse effects can be increased when Capecitabine is combined with Bendamustine. |
| Caplacizumab | The risk or severity of bleeding can be increased when Caplacizumab is combined with Bendamustine. |
| Capmatinib | The serum concentration of Bendamustine can be increased when it is combined with Capmatinib. |
| Capsaicin | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Capsaicin. |
| Carbamazepine | The serum concentration of Bendamustine can be increased when it is combined with Carbamazepine. |
| Carboplatin | The risk or severity of adverse effects can be increased when Carboplatin is combined with Bendamustine. |
| Carfilzomib | The serum concentration of Bendamustine can be increased when it is combined with Carfilzomib. |
| Carmustine | The risk or severity of adverse effects can be increased when Carmustine is combined with Bendamustine. |
| Carvedilol | The serum concentration of Bendamustine can be increased when it is combined with Carvedilol. |
| Ceritinib | The serum concentration of Bendamustine can be increased when it is combined with Ceritinib. |
| Certolizumab pegol | The metabolism of Bendamustine can be increased when combined with Certolizumab pegol. |
| Chlorambucil | The risk or severity of adverse effects can be increased when Chlorambucil is combined with Bendamustine. |
| Chloramphenicol | The risk or severity of adverse effects can be increased when Chloramphenicol is combined with Bendamustine. |
| Chloroprocaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Chloroprocaine. |
| Chlorothiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Bendamustine. |
| Chlorpromazine | The metabolism of Bendamustine can be decreased when combined with Chlorpromazine. |
| Chlorzoxazone | The metabolism of Bendamustine can be decreased when combined with Chlorzoxazone. |
| Ciclesonide | The risk or severity of adverse effects can be increased when Ciclesonide is combined with Bendamustine. |
| Cilostazol | The metabolism of Bendamustine can be decreased when combined with Cilostazol. |
| Cimetidine | The metabolism of Bendamustine can be decreased when combined with Cimetidine. |
| Cinacalcet | The metabolism of Bendamustine can be decreased when combined with Cinacalcet. |
| Cinchocaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Cinchocaine. |
| Cinnarizine | The metabolism of Bendamustine can be decreased when combined with Cinnarizine. |
| Cinoxacin | The metabolism of Bendamustine can be decreased when combined with Cinoxacin. |
| Ciprofloxacin | The serum concentration of Bendamustine can be increased when it is combined with Ciprofloxacin. |
| Cisplatin | The risk or severity of adverse effects can be increased when Cisplatin is combined with Bendamustine. |
| Citalopram | The metabolism of Bendamustine can be decreased when combined with Citalopram. |
| Cladribine | The risk or severity of adverse effects can be increased when Cladribine is combined with Bendamustine. |
| Clarithromycin | The serum concentration of Bendamustine can be increased when it is combined with Clarithromycin. |
| Clobazam | The serum concentration of Bendamustine can be increased when it is combined with Clobazam. |
| Clobetasol propionate | The risk or severity of adverse effects can be increased when Clobetasol propionate is combined with Bendamustine. |
| Clofarabine | The risk or severity of adverse effects can be increased when Clofarabine is combined with Bendamustine. |
| Clofazimine | The serum concentration of Bendamustine can be increased when it is combined with Clofazimine. |
| Clomifene | The serum concentration of Bendamustine can be increased when it is combined with Clomifene. |
| Clomipramine | The metabolism of Bendamustine can be decreased when combined with Clomipramine. |
| Clonidine | The metabolism of Bendamustine can be decreased when combined with Clonidine. |
| Clopidogrel | The metabolism of Bendamustine can be decreased when combined with Clopidogrel. |
| Clostridium tetani | The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Bendamustine. |
| Clozapine | The risk or severity of neutropenia can be increased when Bendamustine is combined with Clozapine. |
| Cobicistat | The serum concentration of Bendamustine can be increased when it is combined with Cobicistat. |
| Cobimetinib | The serum concentration of Bendamustine can be increased when it is combined with Cobimetinib. |
| Cocaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Cocaine. |
| Colchicine | The serum concentration of Bendamustine can be increased when it is combined with Colchicine. |
| Conivaptan | The serum concentration of Bendamustine can be increased when it is combined with Conivaptan. |
| Conjugated estrogens | The metabolism of Bendamustine can be decreased when combined with Conjugated estrogens. |
| Copanlisib | The serum concentration of Bendamustine can be increased when it is combined with Copanlisib. |
| Corticotropin | The risk or severity of adverse effects can be increased when Corticotropin is combined with Bendamustine. |
| Cortisone acetate | The risk or severity of adverse effects can be increased when Cortisone acetate is combined with Bendamustine. |
| Corynebacterium | The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Bendamustine. |
| Crizotinib | The serum concentration of Bendamustine can be increased when it is combined with Crizotinib. |
| Curcumin | The serum concentration of Bendamustine can be increased when it is combined with Curcumin. |
| Cyanocobalamin | The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Bendamustine. |
| Cyclobenzaprine | The metabolism of Bendamustine can be decreased when combined with Cyclobenzaprine. |
| Cyclopenthiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Bendamustine. |
| Cyclophosphamide | The risk or severity of adverse effects can be increased when Cyclophosphamide is combined with Bendamustine. |
| Cyclosporine | Bendamustine may increase the immunosuppressive activities of Cyclosporine. |
| Cyclothiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Bendamustine. |
| Cyproterone acetate | The metabolism of Bendamustine can be increased when combined with Cyproterone acetate. |
| Cytarabine | The risk or severity of adverse effects can be increased when Cytarabine is combined with Bendamustine. |
| Dabigatran | The risk or severity of bleeding can be increased when Dabigatran is combined with Bendamustine. |
| Dabigatran etexilate | The serum concentration of Bendamustine can be increased when it is combined with Dabigatran etexilate. |
| Dabrafenib | The serum concentration of Bendamustine can be increased when it is combined with Dabrafenib. |
| Dacarbazine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Bendamustine. |
| Daclatasvir | The serum concentration of Bendamustine can be increased when it is combined with Daclatasvir. |
| Dacomitinib | The serum concentration of Bendamustine can be increased when it is combined with Dacomitinib. |
| Dactinomycin | The risk or severity of adverse effects can be increased when Dactinomycin is combined with Bendamustine. |
| Dalteparin | The risk or severity of bleeding can be increased when Dalteparin is combined with Bendamustine. |
| Danaparoid | The risk or severity of bleeding can be increased when Danaparoid is combined with Bendamustine. |
| Dapagliflozin | The metabolism of Bendamustine can be decreased when combined with Dapagliflozin. |
| Daptomycin | The serum concentration of Bendamustine can be increased when it is combined with Daptomycin. |
| Darbepoetin alfa | The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Bendamustine. |
| Darolutamide | The serum concentration of Bendamustine can be increased when it is combined with Darolutamide. |
| Darunavir | The serum concentration of Bendamustine can be increased when it is combined with Darunavir. |
| Dasabuvir | The serum concentration of Bendamustine can be increased when it is combined with Dasabuvir. |
| Dasatinib | The risk or severity of adverse effects can be increased when Dasatinib is combined with Bendamustine. |
| Daunorubicin | The risk or severity of adverse effects can be increased when Daunorubicin is combined with Bendamustine. |
| Decitabine | The risk or severity of adverse effects can be increased when Decitabine is combined with Bendamustine. |
| Deferasirox | The serum concentration of Bendamustine can be increased when it is combined with Deferasirox. |
| Defibrotide | The risk or severity of bleeding can be increased when Defibrotide is combined with Bendamustine. |
| Deflazacort | The risk or severity of adverse effects can be increased when Bendamustine is combined with Deflazacort. |
| Denosumab | The risk or severity of adverse effects can be increased when Denosumab is combined with Bendamustine. |
| Desirudin | The risk or severity of bleeding can be increased when Desirudin is combined with Bendamustine. |
| Desoximetasone | The risk or severity of adverse effects can be increased when Desoximetasone is combined with Bendamustine. |
| Deucravacitinib | The risk or severity of adverse effects can be increased when Bendamustine is combined with Deucravacitinib. |
| Dexamethasone | The risk or severity of adverse effects can be increased when Dexamethasone is combined with Bendamustine. |
| Dexamethasone acetate | The serum concentration of Bendamustine can be decreased when it is combined with Dexamethasone acetate. |
| Dexfenfluramine | The metabolism of Bendamustine can be decreased when combined with Dexfenfluramine. |
| Dexmedetomidine | The metabolism of Bendamustine can be decreased when combined with Dexmedetomidine. |
| Dexrazoxane | The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Bendamustine. |
| Dextran | The risk or severity of bleeding can be increased when Dextran is combined with Bendamustine. |
| Diacerein | The metabolism of Bendamustine can be decreased when combined with Diacerein. |
| Diclofenac | The metabolism of Bendamustine can be decreased when combined with Diclofenac. |
| Dicoumarol | The risk or severity of bleeding can be increased when Dicoumarol is combined with Bendamustine. |
| Difluocortolone | The risk or severity of adverse effects can be increased when Bendamustine is combined with Difluocortolone. |
| Digitoxin | The serum concentration of Bendamustine can be increased when it is combined with Digitoxin. |
| Edetic acid | The risk or severity of bleeding can be increased when Edetic acid is combined with Bendamustine. |
| Edoxaban | The serum concentration of Bendamustine can be increased when it is combined with Edoxaban. |
| Efalizumab | The risk or severity of adverse effects can be increased when Efalizumab is combined with Bendamustine. |
| Efavirenz | The metabolism of Bendamustine can be decreased when combined with Efavirenz. |
| Elagolix | The serum concentration of Bendamustine can be increased when it is combined with Elagolix. |
| Elbasvir | The serum concentration of Bendamustine can be increased when it is combined with Elbasvir. |
| Eliglustat | The serum concentration of Bendamustine can be increased when it is combined with Eliglustat. |
| Eltrombopag | The metabolism of Bendamustine can be decreased when combined with Eltrombopag. |
| Emapalumab | The metabolism of Bendamustine can be increased when combined with Emapalumab. |
| Enasidenib | The serum concentration of Bendamustine can be increased when it is combined with Enasidenib. |
| Enfortumab vedotin | The serum concentration of Bendamustine can be increased when it is combined with Enfortumab vedotin. |
| Enoxacin | The serum concentration of Bendamustine can be increased when it is combined with Enoxacin. |
| Enoxaparin | The risk or severity of bleeding can be increased when Enoxaparin is combined with Bendamustine. |
| Entecavir | The metabolism of Bendamustine can be decreased when combined with Entecavir. |
| Entrectinib | The serum concentration of Bendamustine can be increased when it is combined with Entrectinib. |
| Epirubicin | The risk or severity of adverse effects can be increased when Epirubicin is combined with Bendamustine. |
| Epoprostenol | The risk or severity of bleeding can be increased when Epoprostenol is combined with Bendamustine. |
| Eptifibatide | The risk or severity of bleeding can be increased when Eptifibatide is combined with Bendamustine. |
| Erdafitinib | The serum concentration of Bendamustine can be increased when it is combined with Erdafitinib. |
| Eribulin | The risk or severity of adverse effects can be increased when Bendamustine is combined with Eribulin. |
| Erlotinib | The metabolism of Bendamustine can be decreased when combined with Erlotinib. |
| Ertugliflozin | The serum concentration of Bendamustine can be increased when it is combined with Ertugliflozin. |
| Erythromycin | The serum concentration of Bendamustine can be increased when it is combined with Erythromycin. |
| Erythropoietin | The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Bendamustine. |
| Estradiol | The metabolism of Bendamustine can be decreased when combined with Estradiol. |
| Estradiol acetate | The metabolism of Bendamustine can be decreased when combined with Estradiol acetate. |
| Estradiol benzoate | The metabolism of Bendamustine can be decreased when combined with Estradiol benzoate. |
| Estradiol cypionate | The metabolism of Estradiol cypionate can be decreased when combined with Bendamustine. |
| Estradiol dienanthate | The metabolism of Bendamustine can be decreased when combined with Estradiol dienanthate. |
| Estradiol valerate | The metabolism of Bendamustine can be decreased when combined with Estradiol valerate. |
| Estramustine | The risk or severity of adverse effects can be increased when Estramustine is combined with Bendamustine. |
| Estrone sulfate | The metabolism of Bendamustine can be decreased when combined with Estrone sulfate. |
| Etanercept | The metabolism of Bendamustine can be increased when combined with Etanercept. |
| Ethambutol | The metabolism of Bendamustine can be decreased when combined with Ethambutol. |
| Ethanol | The metabolism of Bendamustine can be decreased when combined with Ethanol. |
| Ethinylestradiol | The metabolism of Bendamustine can be decreased when combined with Ethinylestradiol. |
| Ethyl chloride | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Ethyl chloride. |
| Etidocaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Etidocaine. |
| Etoposide | The risk or severity of adverse effects can be increased when Etoposide is combined with Bendamustine. |
| Etoricoxib | The metabolism of Bendamustine can be decreased when combined with Etoricoxib. |
| Everolimus | The serum concentration of Bendamustine can be increased when it is combined with Everolimus. |
| Famotidine | The metabolism of Bendamustine can be decreased when combined with Famotidine. |
| Favipiravir | The serum concentration of Bendamustine can be increased when it is combined with Favipiravir. |
| Fedratinib | The serum concentration of Bendamustine can be increased when it is combined with Fedratinib. |
| Fenfluramine | The metabolism of Bendamustine can be decreased when combined with Fenfluramine. |
| Fexinidazole | The metabolism of Bendamustine can be decreased when combined with Fexinidazole. |
| Fexofenadine | The serum concentration of Bendamustine can be increased when it is combined with Fexofenadine. |
| Filgotinib | The serum concentration of Bendamustine can be increased when it is combined with Filgotinib. |
| Fingolimod | Bendamustine may increase the immunosuppressive activities of Fingolimod. |
| Flecainide | The metabolism of Bendamustine can be decreased when combined with Flecainide. |
| Flibanserin | The serum concentration of Bendamustine can be increased when it is combined with Flibanserin. |
| Floxuridine | The risk or severity of adverse effects can be increased when Floxuridine is combined with Bendamustine. |
| Fluconazole | The serum concentration of Bendamustine can be increased when it is combined with Fluconazole. |
| Flucytosine | The risk or severity of adverse effects can be increased when Flucytosine is combined with Bendamustine. |
| Fludarabine | The risk or severity of adverse effects can be increased when Fludarabine is combined with Bendamustine. |
| Fludrocortisone | The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Bendamustine. |
| Fluindione | The risk or severity of bleeding can be increased when Fluindione is combined with Bendamustine. |
| Flunarizine | The metabolism of Bendamustine can be decreased when combined with Flunarizine. |
| Flunisolide | The risk or severity of adverse effects can be increased when Flunisolide is combined with Bendamustine. |
| Fluocinolone acetonide | The risk or severity of adverse effects can be increased when Fluocinolone acetonide is combined with Bendamustine. |
| Fluocinonide | The risk or severity of adverse effects can be increased when Fluocinonide is combined with Bendamustine. |
| Fluocortolone | The risk or severity of adverse effects can be increased when Bendamustine is combined with Fluocortolone. |
| Fluorometholone | The risk or severity of adverse effects can be increased when Fluorometholone is combined with Bendamustine. |
| Fluorouracil | The risk or severity of adverse effects can be increased when Fluorouracil is combined with Bendamustine. |
| Fluoxetine | The metabolism of Bendamustine can be decreased when combined with Fluoxetine. |
| Flupentixol | The risk or severity of myelosuppression can be increased when Flupentixol is combined with Bendamustine. |
| Fluprednisolone | The risk or severity of adverse effects can be increased when Bendamustine is combined with Fluprednisolone. |
| Flutamide | The metabolism of Bendamustine can be decreased when combined with Flutamide. |
| Fluticasone | The risk or severity of adverse effects can be increased when Bendamustine is combined with Fluticasone. |
| Fluticasone furoate | The risk or severity of adverse effects can be increased when Bendamustine is combined with Fluticasone furoate. |
| Fluticasone propionate | The risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Bendamustine. |
| Fluvoxamine | The serum concentration of Bendamustine can be increased when it is combined with Fluvoxamine. |
| Fondaparinux | The risk or severity of bleeding can be increased when Fondaparinux is combined with Bendamustine. |
| Fosphenytoin | The metabolism of Bendamustine can be increased when combined with Fosphenytoin. |
| Fostemsavir | The serum concentration of Bendamustine can be increased when it is combined with Fostemsavir. |
| Frovatriptan | The metabolism of Bendamustine can be decreased when combined with Frovatriptan. |
| Futibatinib | The serum concentration of Bendamustine can be increased when it is combined with Futibatinib. |
| Gallium nitrate | The risk or severity of adverse effects can be increased when Gallium nitrate is combined with Bendamustine. |
| Irinotecan | The risk or severity of adverse effects can be increased when Irinotecan is combined with Bendamustine. |
| Isavuconazole | The serum concentration of Bendamustine can be increased when it is combined with Isavuconazole. |
| Isavuconazonium | The serum concentration of Bendamustine can be increased when it is combined with Isavuconazonium. |
| Isoniazid | The metabolism of Bendamustine can be decreased when combined with Isoniazid. |
| Istradefylline | The serum concentration of Bendamustine can be increased when it is combined with Istradefylline. |
| Itraconazole | The serum concentration of Bendamustine can be increased when it is combined with Itraconazole. |
| Ivacaftor | The serum concentration of Bendamustine can be increased when it is combined with Ivacaftor. |
| Ixabepilone | The serum concentration of Bendamustine can be increased when it is combined with Ixabepilone. |
| Ixekizumab | The risk or severity of adverse effects can be increased when Bendamustine is combined with Ixekizumab. |
| Janssen COVID-19 Vaccine | The therapeutic efficacy of Janssen COVID-19 Vaccine can be decreased when used in combination with Bendamustine. |
| Japanese encephalitis | The therapeutic efficacy of Japanese encephalitis virus strain sa 14-14-2 antigen (formaldehyde inactivated) can be decreased when used in combination with Bendamustine. |
| Ketoconazole | The serum concentration of Bendamustine can be increased when it is combined with Ketoconazole. |
| Lapatinib | The serum concentration of Bendamustine can be increased when it is combined with Lapatinib. |
| Larotrectinib | The serum concentration of Bendamustine can be increased when it is combined with Larotrectinib. |
| Lasmiditan | The serum concentration of Bendamustine can be increased when it is combined with Lasmiditan. |
| Ledipasvir | The serum concentration of Bendamustine can be increased when it is combined with Ledipasvir. |
| Lefamulin | The serum concentration of Bendamustine can be increased when it is combined with Lefamulin. |
| Leflunomide | The risk or severity of adverse effects can be increased when Bendamustine is combined with Leflunomide. |
| Lemborexant | The serum concentration of Bendamustine can be increased when it is combined with Lemborexant. |
| Lenalidomide | The risk or severity of adverse effects can be increased when Lenalidomide is combined with Bendamustine. |
| Lenvatinib | The serum concentration of Bendamustine can be increased when it is combined with Lenvatinib. |
| Lepirudin | The risk or severity of bleeding can be increased when Lepirudin is combined with Bendamustine. |
| Levobupivacaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Levobupivacaine. |
| Levoketoconazole | The serum concentration of Bendamustine can be increased when it is combined with Levoketoconazole. |
| Levothyroxine | The serum concentration of Bendamustine can be decreased when it is combined with Levothyroxine. |
| Lidocaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Lidocaine. |
| Linagliptin | The serum concentration of Bendamustine can be increased when it is combined with Linagliptin. |
| Linezolid | The risk or severity of adverse effects can be increased when Linezolid is combined with Bendamustine. |
| Loperamide | The serum concentration of Bendamustine can be increased when it is combined with Loperamide. |
| Lopinavir | The serum concentration of Bendamustine can be increased when it is combined with Lopinavir. |
| Lorcaserin | The metabolism of Bendamustine can be decreased when combined with Lorcaserin. |
| Lorlatinib | The serum concentration of Bendamustine can be decreased when it is combined with Lorlatinib. |
| Loxapine | The serum concentration of Bendamustine can be increased when it is combined with Loxapine. |
| Lumacaftor | The serum concentration of Bendamustine can be decreased when it is combined with Lumacaftor. |
| Lusutrombopag | The serum concentration of Bendamustine can be increased when it is combined with Lusutrombopag. |
| Magnesium | The serum concentration of Magnesium can be decreased when it is combined with Bendamustine. |
| Mannitol | The serum concentration of Bendamustine can be increased when it is combined with Mannitol. |
| Maprotiline | The metabolism of Bendamustine can be decreased when combined with Maprotiline. |
| Maribavir | The serum concentration of Bendamustine can be increased when it is combined with Maribavir. |
| Measles virus vaccine | The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Bendamustine. |
| Mechlorethamine | The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Bendamustine. |
| Mefenamic acid | The metabolism of Bendamustine can be decreased when combined with Mefenamic acid. |
| Mefloquine | The serum concentration of Bendamustine can be increased when it is combined with Mefloquine. |
| Melatonin | The metabolism of Bendamustine can be decreased when combined with Melatonin. |
| Meloxicam | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Meloxicam. |
| Melphalan | The risk or severity of adverse effects can be increased when Melphalan is combined with Bendamustine. |
| Meningococcal | The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Bendamustine. |
| Mephenytoin | The metabolism of Bendamustine can be decreased when combined with Mephenytoin. |
| Mepivacaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Mepivacaine. |
| Mepolizumab | The risk or severity of adverse effects can be increased when Mepolizumab is combined with Bendamustine. |
| Meprednisone | The risk or severity of adverse effects can be increased when Bendamustine is combined with Meprednisone. |
| Mercaptopurine | The risk or severity of adverse effects can be increased when Mercaptopurine is combined with Bendamustine. |
| Methimazole | The risk or severity of adverse effects can be increased when Methimazole is combined with Bendamustine. |
| Methotrexate | The excretion of Methotrexate can be decreased when combined with Bendamustine. |
| Methoxsalen | The metabolism of Bendamustine can be decreased when combined with Methoxsalen. |
| Methoxy polyethylene | The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Bendamustine. |
| Methylene blue | The serum concentration of Bendamustine can be increased when it is combined with Methylene blue. |
| Methylprednisolone | The risk or severity of adverse effects can be increased when Methylprednisolone is combined with Bendamustine. |
| Metoclopramide | The metabolism of Bendamustine can be decreased when combined with Metoclopramide. |
| Mexiletine | The metabolism of Bendamustine can be decreased when combined with Mexiletine. |
| Mianserin | The metabolism of Bendamustine can be decreased when combined with Mianserin. |
| Mifepristone | The serum concentration of Bendamustine can be decreased when it is combined with Mifepristone. |
| Mirabegron | The serum concentration of Bendamustine can be increased when it is combined with Mirabegron. |
| Mirtazapine | The metabolism of Bendamustine can be decreased when combined with Mirtazapine. |
| Mitapivat | The serum concentration of Bendamustine can be increased when it is combined with Mitapivat. |
| Mitomycin | The risk or severity of adverse effects can be increased when Mitomycin is combined with Bendamustine. |
| Mitoxantrone | The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Bendamustine. |
| Moderna COVID-19 Vaccine | The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Bendamustine. |
| Modified vaccinia ankara | The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Bendamustine. |
| Mometasone furoate | The risk or severity of adverse effects can be increased when Bendamustine is combined with Mometasone furoate. |
| Monomethyl fumarate | The risk or severity of adverse effects can be increased when Bendamustine is combined with Monomethyl fumarate. |
| Morphine | The serum concentration of Bendamustine can be increased when it is combined with Morphine. |
| Mosunetuzumab | The metabolism of Bendamustine can be decreased when combined with Mosunetuzumab. |
| Moxifloxacin | The metabolism of Bendamustine can be decreased when combined with Moxifloxacin. |
| Mumps virus strain B | The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Bendamustine. |
| Muromonab | The risk or severity of adverse effects can be increased when Muromonab is combined with Bendamustine. |
| Mycophenolate mofetil | The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Bendamustine. |
| Mycophenolic acid | The risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Bendamustine. |
| Nabumetone | The metabolism of Bendamustine can be decreased when combined with Nabumetone. |
| Nadroparin | The risk or severity of bleeding can be increased when Nadroparin is combined with Bendamustine. |
| Nafcillin | The metabolism of Bendamustine can be increased when combined with Nafcillin. |
| Nalidixic acid | The metabolism of Bendamustine can be decreased when combined with Nalidixic acid. |
| Naproxen | The metabolism of Bendamustine can be decreased when combined with Naproxen. |
| Natalizumab | The risk or severity of adverse effects can be increased when Bendamustine is combined with Natalizumab. |
| Nelarabine | The risk or severity of adverse effects can be increased when Nelarabine is combined with Bendamustine. |
| Neratinib | The serum concentration of Bendamustine can be increased when it is combined with Neratinib. |
| Netupitant | The serum concentration of Bendamustine can be increased when it is combined with Netupitant. |
| Nevirapine | The metabolism of Bendamustine can be decreased when combined with Nevirapine. |
| Niclosamide | The metabolism of Bendamustine can be decreased when combined with Niclosamide. |
| Nifedipine | The metabolism of Bendamustine can be decreased when combined with Nifedipine. |
| Nilotinib | The serum concentration of Bendamustine can be increased when it is combined with Nilotinib. |
| Nimesulide | The risk or severity of bleeding can be increased when Nimesulide is combined with Bendamustine. |
| Nintedanib | The serum concentration of Bendamustine can be increased when it is combined with Nintedanib. |
| Norfloxacin | The metabolism of Bendamustine can be decreased when combined with Norfloxacin. |
| Norgestimate | The serum concentration of Bendamustine can be increased when it is combined with Norgestimate. |
| Nuvaxovid | The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Bendamustine. |
| Obeticholic acid | The risk or severity of adverse effects can be increased when Obeticholic acid is combined with Bendamustine. |
| Obinutuzumab | The risk or severity of adverse effects can be increased when Bendamustine is combined with Obinutuzumab. |
| Ocrelizumab | Ocrelizumab may increase the immunosuppressive activities of Bendamustine. |
| Ofatumumab | The risk or severity of adverse effects can be increased when Ofatumumab is combined with Bendamustine. |
| Olanzapine | The metabolism of Bendamustine can be decreased when combined with Olanzapine. |
| Olaparib | The risk or severity of adverse effects can be increased when Bendamustine is combined with Olaparib. |
| Omadacycline | The serum concentration of Bendamustine can be increased when it is combined with Omadacycline. |
| Ombitasvir | The serum concentration of Bendamustine can be increased when it is combined with Ombitasvir. |
| Omeprazole | The metabolism of Bendamustine can be increased when combined with Omeprazole. |
| Ondansetron | The metabolism of Bendamustine can be decreased when combined with Ondansetron. |
| Orphenadrine | The metabolism of Bendamustine can be decreased when combined with Orphenadrine. |
| Osilodrostat | The serum concentration of Bendamustine can be increased when it is combined with Osilodrostat. |
| Osimertinib | The serum concentration of Bendamustine can be decreased when it is combined with Osimertinib. |
| Oxaliplatin | The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Bendamustine. |
| Oxetacaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Oxetacaine. |
| Oxtriphylline | The metabolism of Bendamustine can be decreased when combined with Oxtriphylline. |
| Oxybuprocaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Oxybuprocaine. |
| Ozanimod | The risk or severity of adverse effects can be increased when Bendamustine is combined with Ozanimod. |
| Paclitaxel | The risk or severity of adverse effects can be increased when Paclitaxel is combined with Bendamustine. |
| Pacritinib | The serum concentration of Bendamustine can be increased when it is combined with Pacritinib. |
| Palbociclib | The serum concentration of Bendamustine can be increased when it is combined with Palbociclib. |
| Palifermin | The therapeutic efficacy of Palifermin can be decreased when used in combination with Bendamustine. |
| Paliperidone | The serum concentration of Bendamustine can be increased when it is combined with Paliperidone. |
| Panobinostat | The risk or severity of adverse effects can be increased when Panobinostat is combined with Bendamustine. |
| Paritaprevir | The serum concentration of Bendamustine can be increased when it is combined with Paritaprevir. |
| Parnaparin | The risk or severity of bleeding can be increased when Parnaparin is combined with Bendamustine. |
| Paroxetine | The metabolism of Bendamustine can be decreased when combined with Paroxetine. |
| Pazopanib | The risk or severity of adverse effects can be increased when Pazopanib is combined with Bendamustine. |
| Pefloxacin | The metabolism of Bendamustine can be decreased when combined with Pefloxacin. |
| Loperamide | The serum concentration of Bendamustine can be increased when it is combined with Loperamide. |
| Lopinavir | The serum concentration of Bendamustine can be increased when it is combined with Lopinavir. |
| Lorcaserin | The metabolism of Bendamustine can be decreased when combined with Lorcaserin. |
| Lorlatinib | The serum concentration of Bendamustine can be decreased when it is combined with Lorlatinib. |
| Loxapine | The serum concentration of Bendamustine can be increased when it is combined with Loxapine. |
| Lumacaftor | The serum concentration of Bendamustine can be decreased when it is combined with Lumacaftor. |
| Lusutrombopag | The serum concentration of Bendamustine can be increased when it is combined with Lusutrombopag. |
| Magnesium | The serum concentration of Magnesium can be decreased when it is combined with Bendamustine. |
| Mannitol | The serum concentration of Bendamustine can be increased when it is combined with Mannitol. |
| Maprotiline | The metabolism of Bendamustine can be decreased when combined with Maprotiline. |
| Maribavir | The serum concentration of Bendamustine can be increased when it is combined with Maribavir. |
| Measles virus vaccine | The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Bendamustine. |
| Mechlorethamine | The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Bendamustine. |
| Mefenamic acid | The metabolism of Bendamustine can be decreased when combined with Mefenamic acid. |
| Mefloquine | The serum concentration of Bendamustine can be increased when it is combined with Mefloquine. |
| Melatonin | The metabolism of Bendamustine can be decreased when combined with Melatonin. |
| Meloxicam | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Meloxicam. |
| Melphalan | The risk or severity of adverse effects can be increased when Melphalan is combined with Bendamustine. |
| Meningococcal | The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Bendamustine. |
| Mephenytoin | The metabolism of Bendamustine can be decreased when combined with Mephenytoin. |
| Mepivacaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Mepivacaine. |
| Mepolizumab | The risk or severity of adverse effects can be increased when Mepolizumab is combined with Bendamustine. |
| Meprednisone | The risk or severity of adverse effects can be increased when Bendamustine is combined with Meprednisone. |
| Mercaptopurine | The risk or severity of adverse effects can be increased when Mercaptopurine is combined with Bendamustine. |
| Methimazole | The risk or severity of adverse effects can be increased when Methimazole is combined with Bendamustine. |
| Methotrexate | The excretion of Methotrexate can be decreased when combined with Bendamustine. |
| Methoxsalen | The metabolism of Bendamustine can be decreased when combined with Methoxsalen. |
| Methoxy polyethylene | The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Bendamustine. |
| Methylene blue | The serum concentration of Bendamustine can be increased when it is combined with Methylene blue. |
| Methylprednisolone | The risk or severity of adverse effects can be increased when Methylprednisolone is combined with Bendamustine. |
| Metoclopramide | The metabolism of Bendamustine can be decreased when combined with Metoclopramide. |
| Mexiletine | The metabolism of Bendamustine can be decreased when combined with Mexiletine. |
| Mianserin | The metabolism of Bendamustine can be decreased when combined with Mianserin. |
| Mifepristone | The serum concentration of Bendamustine can be decreased when it is combined with Mifepristone. |
| Mirabegron | The serum concentration of Bendamustine can be increased when it is combined with Mirabegron. |
| Mirtazapine | The metabolism of Bendamustine can be decreased when combined with Mirtazapine. |
| Mitapivat | The serum concentration of Bendamustine can be increased when it is combined with Mitapivat. |
| Mitomycin | The risk or severity of adverse effects can be increased when Mitomycin is combined with Bendamustine. |
| Mitoxantrone | The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Bendamustine. |
| Moderna COVID-19 Vaccine | The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Bendamustine. |
| Modified vaccinia ankara | The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Bendamustine. |
| Mometasone furoate | The risk or severity of adverse effects can be increased when Bendamustine is combined with Mometasone furoate. |
| Monomethyl fumarate | The risk or severity of adverse effects can be increased when Bendamustine is combined with Monomethyl fumarate. |
| Morphine | The serum concentration of Bendamustine can be increased when it is combined with Morphine. |
| Mosunetuzumab | The metabolism of Bendamustine can be decreased when combined with Mosunetuzumab. |
| Moxifloxacin | The metabolism of Bendamustine can be decreased when combined with Moxifloxacin. |
| Mumps virus | The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Bendamustine. |
| Muromonab | The risk or severity of adverse effects can be increased when Muromonab is combined with Bendamustine. |
| Mycophenolate mofetil | The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Bendamustine. |
| Mycophenolic acid | The risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Bendamustine. |
| Nabumetone | The metabolism of Bendamustine can be decreased when combined with Nabumetone. |
| Nadroparin | The risk or severity of bleeding can be increased when Nadroparin is combined with Bendamustine. |
| Nafcillin | The metabolism of Bendamustine can be increased when combined with Nafcillin. |
| Nalidixic acid | The metabolism of Bendamustine can be decreased when combined with Nalidixic acid. |
| Naproxen | The metabolism of Bendamustine can be decreased when combined with Naproxen. |
| Natalizumab | The risk or severity of adverse effects can be increased when Bendamustine is combined with Natalizumab. |
| Nelarabine | The risk or severity of adverse effects can be increased when Nelarabine is combined with Bendamustine. |
| Neratinib | The serum concentration of Bendamustine can be increased when it is combined with Neratinib. |
| Netupitant | The serum concentration of Bendamustine can be increased when it is combined with Netupitant. |
| Nevirapine | The metabolism of Bendamustine can be decreased when combined with Nevirapine. |
| Niclosamide | The metabolism of Bendamustine can be decreased when combined with Niclosamide. |
| Nifedipine | The metabolism of Bendamustine can be decreased when combined with Nifedipine. |
| Nilotinib | The serum concentration of Bendamustine can be increased when it is combined with Nilotinib. |
| Nimesulide | The risk or severity of bleeding can be increased when Nimesulide is combined with Bendamustine. |
| Nintedanib | The serum concentration of Bendamustine can be increased when it is combined with Nintedanib. |
| Norfloxacin | The metabolism of Bendamustine can be decreased when combined with Norfloxacin. |
| Norgestimate | The serum concentration of Bendamustine can be increased when it is combined with Norgestimate. |
| Nuvaxovid | The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Bendamustine. |
| Obeticholic acid | The risk or severity of adverse effects can be increased when Obeticholic acid is combined with Bendamustine. |
| Obinutuzumab | The risk or severity of adverse effects can be increased when Bendamustine is combined with Obinutuzumab. |
| Ocrelizumab | Ocrelizumab may increase the immunosuppressive activities of Bendamustine. |
| Ofatumumab | The risk or severity of adverse effects can be increased when Ofatumumab is combined with Bendamustine. |
| Olanzapine | The metabolism of Bendamustine can be decreased when combined with Olanzapine. |
| Olaparib | The risk or severity of adverse effects can be increased when Bendamustine is combined with Olaparib. |
| Omadacycline | The serum concentration of Bendamustine can be increased when it is combined with Omadacycline. |
| Ombitasvir | The serum concentration of Bendamustine can be increased when it is combined with Ombitasvir. |
| Omeprazole | The metabolism of Bendamustine can be increased when combined with Omeprazole. |
| Ondansetron | The metabolism of Bendamustine can be decreased when combined with Ondansetron. |
| Orphenadrine | The metabolism of Bendamustine can be decreased when combined with Orphenadrine. |
| Osilodrostat | The serum concentration of Bendamustine can be increased when it is combined with Osilodrostat. |
| Osimertinib | The serum concentration of Bendamustine can be decreased when it is combined with Osimertinib. |
| Oxaliplatin | The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Bendamustine. |
| Oxetacaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Oxetacaine. |
| Oxtriphylline | The metabolism of Bendamustine can be decreased when combined with Oxtriphylline. |
| Oxybuprocaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Oxybuprocaine. |
| Ozanimod | The risk or severity of adverse effects can be increased when Bendamustine is combined with Ozanimod. |
| Paclitaxel | The risk or severity of adverse effects can be increased when Paclitaxel is combined with Bendamustine. |
| Pacritinib | The serum concentration of Bendamustine can be increased when it is combined with Pacritinib. |
| Palbociclib | The serum concentration of Bendamustine can be increased when it is combined with Palbociclib. |
| Palifermin | The therapeutic efficacy of Palifermin can be decreased when used in combination with Bendamustine. |
| Paliperidone | The serum concentration of Bendamustine can be increased when it is combined with Paliperidone. |
| Panobinostat | The risk or severity of adverse effects can be increased when Panobinostat is combined with Bendamustine. |
| Paritaprevir | The serum concentration of Bendamustine can be increased when it is combined with Paritaprevir. |
| Parnaparin | The risk or severity of bleeding can be increased when Parnaparin is combined with Bendamustine. |
| Paroxetine | The metabolism of Bendamustine can be decreased when combined with Paroxetine. |
| Pazopanib | The risk or severity of adverse effects can be increased when Pazopanib is combined with Bendamustine. |
| Pefloxacin | The metabolism of Bendamustine can be decreased when combined with Pefloxacin. |
| Phenindione | The risk or severity of bleeding can be increased when Phenindione is combined with Bendamustine. |
| Phenol | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Phenol. |
| Phenprocoumon | The risk or severity of bleeding can be increased when Phenprocoumon is combined with Bendamustine. |
| Phenylalanine | The risk or severity of adverse effects can be increased when Phenylalanine is combined with Bendamustine. |
| Phenylephrine | The metabolism of Bendamustine can be increased when combined with Phenylephrine. |
| Pibrentasvir | The serum concentration of Bendamustine can be increased when it is combined with Pibrentasvir. |
| Pimecrolimus | The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Bendamustine. |
| Pimozide | The metabolism of Bendamustine can be decreased when combined with Pimozide. |
| Pirfenidone | The risk or severity of adverse effects can be increased when Pirfenidone is combined with Bendamustine. |
| Pitolisant | The metabolism of Bendamustine can be increased when combined with Pitolisant. |
| Polythiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Bendamustine. |
| Pomalidomide | The risk or severity of adverse effects can be increased when Bendamustine is combined with Pomalidomide. |
| Ponatinib | The serum concentration of Bendamustine can be increased when it is combined with Ponatinib. |
| Ponesimod | The risk or severity of adverse effects can be increased when Bendamustine is combined with Ponesimod. |
| Posaconazole | The serum concentration of Bendamustine can be increased when it is combined with Posaconazole. |
| Pralatrexate | The risk or severity of adverse effects can be increased when Bendamustine is combined with Pralatrexate. |
| Pralsetinib | The serum concentration of Bendamustine can be increased when it is combined with Pralsetinib. |
| Pramocaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Pramocaine. |
| Prasugrel | The risk or severity of bleeding can be increased when Prasugrel is combined with Bendamustine. |
| Pravastatin | The serum concentration of Bendamustine can be increased when it is combined with Pravastatin. |
| Praziquantel | The metabolism of Bendamustine can be decreased when combined with Praziquantel. |
| Prednisolone | The risk or severity of adverse effects can be increased when Prednisolone is combined with Bendamustine. |
| Prednisolone phosphate | The serum concentration of Bendamustine can be decreased when it is combined with Prednisolone phosphate. |
| Prednisone | The risk or severity of adverse effects can be increased when Prednisone is combined with Bendamustine. |
| Prilocaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Prilocaine. |
| Primaquine | The metabolism of Bendamustine can be increased when combined with Primaquine. |
| Primidone | The serum concentration of Bendamustine can be increased when it is combined with Primidone. |
| Procaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Procaine. |
| Procarbazine | The risk or severity of adverse effects can be increased when Procarbazine is combined with Bendamustine. |
| Promazine | The metabolism of Bendamustine can be decreased when combined with Promazine. |
| Propafenone | The serum concentration of Bendamustine can be increased when it is combined with Propafenone. |
| Proparacaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Proparacaine. |
| Propoxycaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Propoxycaine. |
| Propranolol | The metabolism of Bendamustine can be decreased when combined with Propranolol. |
| Propylthiouracil | The risk or severity of adverse effects can be increased when Propylthiouracil is combined with Bendamustine. |
| Protein C | The risk or severity of bleeding can be increased when Protein C is combined with Bendamustine. |
| Protein S human | The risk or severity of bleeding can be increased when Protein S human is combined with Bendamustine. |
| Quinidine | The serum concentration of Bendamustine can be increased when it is combined with Quinidine. |
| Quinine | The serum concentration of Bendamustine can be increased when it is combined with Quinine. |
| Rabies immune globulin | The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Bendamustine. |
| Rabies virus antigen | The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Bendamustine. |
| Rabies antigen, B | The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Bendamustine. |
| Raltitrexed | The risk or severity of adverse effects can be increased when Raltitrexed is combined with Bendamustine. |
| Ramelteon | The metabolism of Bendamustine can be decreased when combined with Ramelteon. |
| Ranitidine | The metabolism of Bendamustine can be decreased when combined with Ranitidine. |
| Ranolazine | The serum concentration of Bendamustine can be increased when it is combined with Ranolazine. |
| Rasagiline | The metabolism of Bendamustine can be decreased when combined with Rasagiline. |
| Ravulizumab | The risk or severity of adverse effects can be increased when Bendamustine is combined with Ravulizumab. |
| Regorafenib | The serum concentration of Bendamustine can be increased when it is combined with Regorafenib. |
| Relugolix | The serum concentration of Bendamustine can be increased when it is combined with Relugolix. |
| Reserpine | The serum concentration of Bendamustine can be increased when it is combined with Reserpine. |
| Reteplase | The risk or severity of bleeding can be increased when Reteplase is combined with Bendamustine. |
| Revefenacin | The serum concentration of Bendamustine can be increased when it is combined with Revefenacin. |
| Reviparin | The risk or severity of bleeding can be increased when Reviparin is combined with Bendamustine. |
| Rifampicin | The serum concentration of Bendamustine can be increased when it is combined with Rifampicin. |
| Rifamycin | The serum concentration of Bendamustine can be increased when it is combined with Rifamycin. |
| Rilonacept | The metabolism of Bendamustine can be increased when combined with Rilonacept. |
| Riluzole | The metabolism of Bendamustine can be decreased when combined with Riluzole. |
| Rimegepant | The serum concentration of Bendamustine can be increased when it is combined with Rimegepant. |
| Riociguat | The serum concentration of Bendamustine can be increased when it is combined with Riociguat. |
| Ripretinib | The serum concentration of Bendamustine can be increased when it is combined with Ripretinib. |
| Risankizumab | The risk or severity of adverse effects can be increased when Bendamustine is combined with Risankizumab. |
| Ritonavir | The serum concentration of Bendamustine can be increased when it is combined with Ritonavir. |
| Rituximab | The risk or severity of adverse effects can be increased when Rituximab is combined with Bendamustine. |
| Rivaroxaban | The serum concentration of Bendamustine can be increased when it is combined with Rivaroxaban. |
| Rofecoxib | The serum concentration of Bendamustine can be increased when it is combined with Rofecoxib. |
| Roflumilast | Roflumilast may increase the immunosuppressive activities of Bendamustine. |
| Rolapitant | The serum concentration of Bendamustine can be increased when it is combined with Rolapitant. |
| Romidepsin | The serum concentration of Bendamustine can be increased when it is combined with Romidepsin. |
| Ropeginterferon | The risk or severity of adverse effects can be increased when Bendamustine is combined with Ropeginterferon alfa-2b. |
| Ropivacaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Ropivacaine. |
| Rosoxacin | The metabolism of Bendamustine can be decreased when combined with Rosoxacin. |
| Rotavirus vaccine | The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Bendamustine. |
| Rubella virus vaccine | The risk or severity of infection can be increased when Rubella virus vaccine is combined with Bendamustine. |
| Rucaparib | The metabolism of Bendamustine can be decreased when combined with Rucaparib. |
| Ruxolitinib | The risk or severity of adverse effects can be increased when Bendamustine is combined with Ruxolitinib. |
| Sapropterin | The serum concentration of Bendamustine can be increased when it is combined with Sapropterin. |
| Saquinavir | The serum concentration of Bendamustine can be increased when it is combined with Saquinavir. |
| Sarecycline | The serum concentration of Bendamustine can be increased when it is combined with Sarecycline. |
| Sarilumab | The risk or severity of adverse effects can be increased when Bendamustine is combined with Sarilumab. |
| Satralizumab | The serum concentration of Bendamustine can be decreased when it is combined with Satralizumab. |
| Secukinumab | The metabolism of Bendamustine can be increased when combined with Secukinumab. |
| Selegiline | The metabolism of Bendamustine can be decreased when combined with Selegiline. |
| Selexipag | The serum concentration of Bendamustine can be increased when it is combined with Selexipag. |
| Selumetinib | The metabolism of Selumetinib can be decreased when combined with Bendamustine. |
| Sildenafil | The serum concentration of Bendamustine can be increased when it is combined with Sildenafil. |
| Siltuximab | The metabolism of Bendamustine can be increased when combined with Siltuximab. |
| Simeprevir | The serum concentration of Bendamustine can be increased when it is combined with Simeprevir. |
| Simvastatin | The serum concentration of Bendamustine can be increased when it is combined with Simvastatin. |
| Siponimod | The risk or severity of adverse effects can be increased when Bendamustine is combined with Siponimod. |
| Sipuleucel-T | The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Bendamustine. |
| Sirolimus | The risk or severity of adverse effects can be increased when Sirolimus is combined with Bendamustine. |
| Sitagliptin | The serum concentration of Bendamustine can be increased when it is combined with Sitagliptin. |
| Smallpox | The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Bendamustine. |
| Sodium citrate | The risk or severity of bleeding can be increased when Sodium citrate is combined with Bendamustine. |
| Sofosbuvir | The serum concentration of Bendamustine can be increased when it is combined with Sofosbuvir. |
| Somapacitan | The metabolism of Bendamustine can be increased when combined with Somapacitan. |
| Somatotropin | The metabolism of Bendamustine can be increased when combined with Somatotropin. |
| Somatrem | The metabolism of Bendamustine can be increased when combined with Somatrem. |
| Somatrogon | The metabolism of Bendamustine can be increased when combined with Somatrogon. |
| Sorafenib | The serum concentration of Bendamustine can be increased when it is combined with Sorafenib. |
| Sotagliflozin | The serum concentration of Bendamustine can be increased when it is combined with Sotagliflozin. |
| Sotorasib | The serum concentration of Bendamustine can be increased when it is combined with Sotorasib. |
| Spesolimab | The risk or severity of adverse effects can be increased when Bendamustine is combined with Spesolimab. |
| St. John’s Wort | The serum concentration of Bendamustine can be decreased when it is combined with St. John’s Wort. |
| Stiripentol | The metabolism of Bendamustine can be decreased when combined with Stiripentol. |
| Streptokinase | The risk or severity of bleeding can be increased when Streptokinase is combined with Bendamustine. |
| Streptozocin | The risk or severity of adverse effects can be increased when Streptozocin is combined with Bendamustine. |
| Sulfamethoxazole | The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Bendamustine. |
| Sulfasalazine | The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Bendamustine. |
| Sulfinpyrazone | The risk or severity of bleeding can be increased when Sulfinpyrazone is combined with Bendamustine. |
| Sulodexide | The risk or severity of bleeding can be increased when Sulodexide is combined with Bendamustine. |
| Sunitinib | The risk or severity of adverse effects can be increased when Sunitinib is combined with Bendamustine. |
| Suvorexant | The serum concentration of Bendamustine can be increased when it is combined with Suvorexant. |
| Tacrine | The metabolism of Bendamustine can be decreased when combined with Tacrine. |
| Tacrolimus | Tacrolimus may increase the immunosuppressive activities of Bendamustine. |
| Talazoparib | The serum concentration of Bendamustine can be increased when it is combined with Talazoparib. |
| Tamoxifen | The serum concentration of Bendamustine can be increased when it is combined with Tamoxifen. |
| Tasimelteon | The metabolism of Tasimelteon can be decreased when combined with Bendamustine. |
| Tazemetostat | The serum concentration of Bendamustine can be increased when it is combined with Tazemetostat. |
| Technetium | The serum concentration of Bendamustine can be increased when it is combined with Technetium Tc-99m sestamibi. |
| Tedizolid phosphate | The risk or severity of myelosuppression can be increased when Bendamustine is combined with Tedizolid phosphate. |
| Tegafur | The metabolism of Tegafur can be decreased when combined with Bendamustine. |
| Tegaserod | The metabolism of Bendamustine can be decreased when combined with Tegaserod. |
| Telaprevir | The serum concentration of Bendamustine can be increased when it is combined with Telaprevir. |
| Temozolomide | The risk or severity of adverse effects can be increased when Temozolomide is combined with Bendamustine. |
| Temsirolimus | The serum concentration of Bendamustine can be increased when it is combined with Temsirolimus. |
| Tenecteplase | The risk or severity of bleeding can be increased when Tenecteplase is combined with Bendamustine. |
| Teniposide | The risk or severity of adverse effects can be increased when Teniposide is combined with Bendamustine. |
| Tenofovir disoproxil | The serum concentration of Bendamustine can be increased when it is combined with Tenofovir disoproxil. |
| Tepotinib | The serum concentration of Bendamustine can be increased when it is combined with Tepotinib. |
| Teprotumumab | The risk or severity of adverse effects can be increased when Teprotumumab is combined with Bendamustine. |
| Terbinafine | The metabolism of Bendamustine can be decreased when combined with Terbinafine. |
| Teriflunomide | The serum concentration of Bendamustine can be decreased when it is combined with Teriflunomide. |
| Tetracaine | The risk or severity of methemoglobinemia can be increased when Bendamustine is combined with Tetracaine. |
| Tezacaftor | The serum concentration of Bendamustine can be increased when it is combined with Tezacaftor. |
| Thalidomide | The risk or severity of adverse effects can be increased when Thalidomide is combined with Bendamustine. |
| Theophylline | The metabolism of Bendamustine can be decreased when combined with Theophylline. |
| Thiabendazole | The metabolism of Bendamustine can be decreased when combined with Thiabendazole. |
| Thiotepa | The risk or severity of adverse effects can be increased when Thiotepa is combined with Bendamustine. |
| Thiothixene | The metabolism of Bendamustine can be decreased when combined with Thiothixene. |
| Ticagrelor | The serum concentration of Bendamustine can be increased when it is combined with Ticagrelor. |
| Tick-borne encephalitis | The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Bendamustine. |
| Ticlopidine | The metabolism of Bendamustine can be decreased when combined with Ticlopidine. |
| Tinzaparin | The risk or severity of bleeding can be increased when Tinzaparin is combined with Bendamustine. |
| Tioguanine | The risk or severity of adverse effects can be increased when Tioguanine is combined with Bendamustine. |
| Tipranavir | The serum concentration of Bendamustine can be decreased when it is combined with Tipranavir. |
| Tirofiban | The risk or severity of bleeding can be increased when Tirofiban is combined with Bendamustine. |
| Tivozanib | The serum concentration of Bendamustine can be increased when it is combined with Tivozanib. |
| Tixocortol | The risk or severity of adverse effects can be increased when Bendamustine is combined with Tixocortol. |
| Tizanidine | The metabolism of Bendamustine can be decreased when combined with Tizanidine. |
| Tocainide | The metabolism of Bendamustine can be decreased when combined with Tocainide. |
| Tocilizumab | The metabolism of Bendamustine can be increased when combined with Tocilizumab. |
| Tofacitinib | Bendamustine may increase the immunosuppressive activities of Tofacitinib. |
| Tolvaptan | The serum concentration of Bendamustine can be increased when it is combined with Tolvaptan. |
| Topotecan | The risk or severity of adverse effects can be increased when Topotecan is combined with Bendamustine. |
| Toremifene | The serum concentration of Bendamustine can be increased when it is combined with Toremifene. |
| Tositumomab | The risk or severity of adverse effects can be increased when Tositumomab is combined with Bendamustine. |
| Trabectedin | The risk or severity of adverse effects can be increased when Trabectedin is combined with Bendamustine. |
| Trastuzumab | Trastuzumab may increase the neutropenic activities of Bendamustine. |
| Trastuzumab emtansine | The risk or severity of adverse effects can be increased when Trastuzumab emtansine is combined with Bendamustine. |
| Trazodone | The serum concentration of Bendamustine can be decreased when it is combined with Trazodone. |
| Tretinoin | The risk or severity of adverse effects can be increased when Tretinoin is combined with Bendamustine. |
| Triamcinolone | The risk or severity of adverse effects can be increased when Triamcinolone is combined with Bendamustine. |
| Triamterene | The metabolism of Bendamustine can be decreased when combined with Triamterene. |
| Trichlormethiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Bendamustine. |
| Triclabendazole | The metabolism of Bendamustine can be decreased when combined with Triclabendazole. |
| Trifluoperazine | The metabolism of Bendamustine can be decreased when combined with Trifluoperazine. |
| Trifluridine | The risk or severity of adverse effects can be increased when Trifluridine is combined with Bendamustine. |
| Triflusal | The risk or severity of bleeding can be increased when Triflusal is combined with Bendamustine. |
| Trilaciclib | The metabolism of Bendamustine can be increased when combined with Trilaciclib. |
| Trilostane | The risk or severity of adverse effects can be increased when Trilostane is combined with Bendamustine. |
| Trovafloxacin | The metabolism of Bendamustine can be decreased when combined with Trovafloxacin. |
| Tucatinib | The serum concentration of Bendamustine can be increased when it is combined with Tucatinib. |
| Typhoid vaccine | The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Bendamustine. |
| Typhoid Vaccine Live | The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Bendamustine. |
| Typhoid vaccine | The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Bendamustine. |
| Ubrogepant | The serum concentration of Bendamustine can be increased when it is combined with Ubrogepant. |
| Umbralisib | The serum concentration of Bendamustine can be increased when it is combined with Umbralisib. |
| Umeclidinium | The serum concentration of Bendamustine can be increased when it is combined with Umeclidinium. |
| Upadacitinib | The risk or severity of adverse effects can be increased when Bendamustine is combined with Upadacitinib. |
| Urokinase | The risk or severity of bleeding can be increased when Urokinase is combined with Bendamustine. |
| Valproic acid | The metabolism of Bendamustine can be decreased when combined with Valproic acid. |
| Vandetanib | The serum concentration of Bendamustine can be increased when it is combined with Vandetanib. |
| Vardenafil | The serum concentration of Bendamustine can be increased when it is combined with Vardenafil. |
Pregnancy and Lactation
Pregnancy category D
Pregnancy
There is a possibility of birth defects if either the man or woman is taking bendamustine at the time of conception, or if it is taken during pregnancy. Use effective birth control starting 2 weeks before receiving this medication and for at least 4 weeks after receiving your last dose. If you become pregnant while taking this medication, contact your doctor immediately.
Lactation
No information is available on the use of bendamustine during breastfeeding. Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy, especially alkylating agents such as bendamustine.[1] Based on the half-life of the drug and its metabolites, the drug should be eliminated from the milk by 24 to 48 hours after the last dose. The manufacturer recommends that breastfeeding be discontinued during bendamustine therapy and for at least 1 week after the last dose.
How should this medicine be used?
For chronic lymphocytic leukemia, the usual adult dose is 100 mg per square metre of body surface area. It is given intravenously (directly into a vein) over 30 minutes on Days 1 and 2 of a 28-day cycle, up to 6 cycles.
For non-Hodgkin’s lymphoma, the usual dose is 120 mg per square metre of body surface area. It is given intravenously (directly into a vein) over 60 minutes of Days 1 and 2 of a 21-day cycle, up to 8 cycles.
Bendamustine comes as a solution (liquid) or as a powder to be mixed with liquid and injected intravenously (into a vein) over 10 minutes or infused intravenously over 30 or 60 minutes by a doctor or nurse in a medical office or hospital outpatient clinic. When bendamustine injection is used to treat CLL, it is usually injected once a day for 2 days, followed by 26 days when the medication is not given. This treatment period is called a cycle, and the cycle may be repeated every 28 days for as long as 6 cycles. When bendamustine injection is used to treat NHL, it is usually injected once a day for 2 days, followed by 19 days when the medication is not given. This treatment cycle may be repeated every 21 days for up to 8 cycles.
Your doctor may need to delay your treatment and adjust your dose if you experience certain side effects. Your doctor may also give you other medication(s) to prevent or treat certain side effects. Be sure to tell your doctor how you are feeling during your treatment with bendamustine injection.
What special precautions should I follow?
Before receiving bendamustine injection,
- tell your doctor and pharmacist if you are allergic to bendamustine, any other medications, or any of the ingredients in bendamustine injection. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: ciprofloxacin (Cipro), fluvoxamine (Luvox, and omeprazole (Prilosec). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may interact with bendamustine, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
- tell your doctor if you have or have ever had cytomegalovirus infection (CMV; a viral infection that may cause symptoms in patients with weak immune systems), hepatitis B virus infection (HBV; an ongoing liver infection), tuberculosis (TB; a serious infection that affects the lungs and sometimes other parts of the body), herpes zoster (shingles; a rash that can occur in people who have had chickenpox in the past), or kidney or liver disease.
- tell your doctor if you are pregnant or plan to become pregnant, or if you plan to father a child. You or your partner should not become pregnant while you are receiving bendamustine injection. You should use birth control to prevent pregnancy in yourself or your partner during your treatment with bendamustine injection and for 3 months afterwards. Talk to your doctor about birth control methods that will work for you. If you or your partner becomes pregnant while receiving bendamustine injection, call your doctor. Bendamustine injection can harm the fetus.
- tell your doctor if you are breast-feeding. You should not breastfeed during your treatment with bendamustine.
- you should know that bendamustine injection may make you tired. Do not drive a car or operate machinery until you know how this medication affects you.
- tell your doctor if you use tobacco products. Smoking may decrease the effectiveness of this medication.
Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.
Low red blood cell count: This medication can reduce the number of red blood cells in the blood. Red blood cells help provide oxygen to different tissues in the body. Tell your doctor of any signs that your red blood cell count is low. Such symptoms may include feeling unusually tired, decreased levels of alertness, loss of appetite, paler-than-normal skin, trouble breathing, or rapid heartbeat.
Blood clotting: This medication can reduce the number of platelet cells in the blood. Platelets help the blood to clot, and a shortage could make you bleed more easily. Tell your doctor of any signs that your blood is not clotting as quickly. Such symptoms may include black and tarry stools, blood in the urine, easy bruising, or cuts that won’t stop bleeding.
Blood pressure: Bendamustine can cause increased blood pressure. If you have high blood pressure or are taking medications to control blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Extravasation: When bendamustine leaks into tissue surrounding a vein, symptoms such as redness, swelling, and pain can occur around the place of injection. This is called extravasation. If you develop symptoms of extravasation, tell your doctor or nurse immediately.
Heart problems: Bendamustine can cause heart problems such as heart failure, chest pain, heart attack, and abnormal heart rhythms. If you have heart problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Infection: As well as killing cancer cells, this medication can reduce the number of cells that fight infection in the body (white blood cells). Avoid contact with people who have contagious infections and tell your doctor if you begin to notice signs of an infection such as fever or chills.
Infertility: Men treated with bendamustine may develop infertility that may last for several years after stopping treatment. Talk to your doctor about infertility management options.
Infusion reaction: When bendamustine is given, you may experience an infusion reaction (fever, chills, skin rash or itchiness). If you experience an infusion reaction, your doctor may prescribe medications (e.g., antihistamines, acetaminophen, corticosteroids) to be given before future infusions to prevent another reaction.
Kidney problems: If you have kidney problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver problems: Bendamustine can affect your liver function. If you have severe liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Progressive multifocal leukoencephalopathy (PML): There have been reports of PML after using bendamustine. PML is a rare disorder that causes nerve damage in the brain. If you experience memory loss, vision changes, trouble thinking, personality changes or difficulty walking, contact your doctor immediately.
Secondary cancer: This medication can increase the risk of developing leukemia, lung cancer, or certain types of skin cancer. If you are concerned about this, talk to your doctor about the risks and benefits of using this medication.
Surgery: If you need surgery, tell your doctor or anesthetist that you are taking this medication.
Tumour lysis syndrome: Bendamustine, like many other cancer medications, causes many cancer cells to be suddenly killed when treatment is first started. This can overwhelm the body with waste products from the cells. As a result, the body may not be able to keep up with getting rid of all the waste. When this happens, you may have nausea, shortness of breath, cloudy urine, or joint pain. This is called tumour lysis syndrome. Your doctor may prescribe some medications to help your body get rid of the waste products. Make sure you understand how to use these medications and report any of these signs or symptoms to your doctor immediately.
References
