PARTNERS WITH
Bendamustine
Non-platinum based Alkylating Agents
MECHANISM OF ACTION
Bendamustine is an alkylating agent (nitrogen mustard derivative) with a benzimidazole ring (purine analog) which demonstrates only partial cross-resistance (in vitro) with other alkylating agents. It leads to cell death via single and double strand DNA cross-linking. Bendamustine is active against quiescent and dividing cells.
Elimination
Feces (~25%); urine (~50%; ~3% as active parent drug).
MECHANISM OF KIDNEY INJURY
increase in serum Cr
CLINICAL KIDNEY SYNDROME
Pseudo AKI (false elevation in Cr), BLE edema, UTI , TLS
CARDIOVASCULAR ADVERSE EFFECTS
edema, HTN exacerbation, tachycardia, chest pain, A fib ( can cause hypotension too)
LYTE ABNORMALITIES
increase Cr
RISK FACTORS
CrCl <30 mL/minute: Use is not recommended
MITIGATION STRATEGIES
CrCl <30 mL/minute: Use is not recommended
SUGGESTIONS
If pseudo AKI, hold drug to see improvement Cr
NOTES/COMMENTS
PHARMACOKINETICS
Molecular Weight
Volume of Distribution
Plasma Protein Binding
Metabolism
Bioavailability
Half-life elimination
Time to peak
Excretion
Dialyzable?
Unknown
REF:
https://www.cdc.gov/niosh/docs/2016-161/.
Treanda (bendamustine) [prescribing information]. North Wales, PA: Teva Pharmaceuticals USA Inc; June 2021.
PATHOLOGY SLIDES:
ENTRY UPDATES:
Kartik Kalra
United States
Sep 25, 2022