Alkylating agent (specialist)
Bendamustine hydrochloride
Brand names: Levact
Adult dose
Dose: 90–120mg/m² IV days 1 & 2 q21–28d
Route: IV
Frequency: Per protocol
Clinical pearls
- NICE TA216 / TA243: relapsed indolent NHL, mantle cell lymphoma, multimodal therapy
- BSH lymphoma; ESMO
- HBV screening before initiation; PJP/HSV prophylaxis often given
Contraindications
- Severe hepatic/renal impairment
- Severe myelosuppression
- Pregnancy
- Hypersensitivity
Side effects
- Myelosuppression
- Infections (severe — PJP, hepatitis B reactivation)
- Tumour lysis
- Mucositis
- Peripheral neuropathy
- Skin reactions including SJS/TEN
- Secondary malignancies
Interactions
- Live vaccines
- CYP1A2 inhibitors
Monitoring
- FBC
- HBV
- LFTs
- Renal
- TLS
- Infection signs
Reference: BNF; NICE TA216; NICE TA243; BSH lymphoma; ESMO; SmPC; https://bnf.nice.org.uk/drugs/bendamustine-hydrochloride-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Acute Myeloid Leukaemia Presentation · BSH; NICE — NG146
- Tumour Lysis Syndrome · Cairo-Bishop; BSH; NICE — Best Practice
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158