Ribomustin (Bendamustine Hydrochloride)
Complete patient guide for uses, dosage, side effects, and safety information
Quick Facts
What Is Ribomustin Used For?
Ribomustin is a chemotherapy medicine that belongs to a group called antineoplastic or cytotoxic medicines. These medicines work by killing cancer cells.
Primary Uses
Ribomustin is used to treat chronic lymphocytic leukaemia, indolent Stage III-IV Non-Hodgkin’s Lymphoma and Stage III-IV Mantle Cell Lymphoma in patients who have not been previously treated, and indolent Non-Hodgkin’s Lymphoma in patients who have received one or more prior treatments and whose cancer is still progressing.
How It Works
Ribomustin works by killing cancer cells. It can be used alone (monotherapy) or in combination with other cancer medicines.
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How to Take Ribomustin
Ribomustin is given only in a specialized medical unit under the supervision of a doctor experienced in cancer treatment. It is administered directly into a vein over 30-60 minutes.
Dosage Instructions
Your doctor will calculate your dose based on your height and weight, as well as your kidney function, liver function, and other medicines you’re taking. For Chronic Lymphocytic Leukaemia: 100mg per square metre of body surface area, repeated every 4 weeks up to 6 times. For progressing Non-Hodgkin’s Lymphoma: 120mg per square metre on days 1 and 2, repeated every 3 weeks up to 6 times. For previously untreated indolent Non-Hodgkin’s Lymphoma and Mantle Cell Lymphoma: 90mg per square metre on days 1 and 2, repeated every 4 weeks up to 6 cycles.
Treatment Schedule
Treatment will not start if your white blood cells fall below 3,000 cells/µL and/or your blood platelets fall below 75,000 cells/µL. Your doctor will check these values regularly and may adjust your dose during treatment based on your response.
Important: Keep all follow-up appointments with your doctor. It’s important to have your doses at the appropriate times to get the best effects from your treatment.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- low counts of white blood cells
- decrease in red blood pigment (haemoglobin)
- low platelet counts
- decreased red blood cells (anaemia)
- infections
- feeling sick (nausea)
- vomiting
- fatigue
- chills, fever, headache or cough
- mucosal inflammation
- increased blood levels of creatinine, glucose or urea
- bleeding
- allergic skin reactions (dermatitis, urticaria)
- rise in liver enzymes
- rise in bile pigment
- rise in alkaline phosphatase enzyme
- low potassium, sodium or calcium blood levels
- disturbed heart function or rhythms
- low or high blood pressure
- diarrhoea, constipation, or stomach pain
- sore mouth
- loss of appetite or weight loss
- hair loss
- missed periods
- insomnia, anxiety, or depression
- dehydration including excessive thirst and urine production
Seek immediate medical attention if you experience:
- infection of the blood (sepsis)
- severe allergic reactions (anaphylactic reactions)
- drowsiness
- loss of voice
- acute circulatory collapse
- skin reddening, inflammation, itching, or rash
- excessive sweating
- pneumonia
- breakdown of red blood cells
- anaphylactic shock
- disturbed sense of taste
- feeling unwell, pain in limbs
- nervous system disorders
- lack of coordination (ataxia)
- brain or vein inflammation
- increased heart rate, heart attack, chest pain, heart failure
- lung tissue formation (fibrosis)
- bleeding inflammation of gullet or stomach
- infertility
- multiple organ failure
Important Warnings
There are several important warnings you need to know before receiving Ribomustin treatment.
Who Should Not Take Ribomustin
Do not use Ribomustin if you are allergic to bendamustine hydrochloride or any ingredients, are breastfeeding, have severe liver dysfunction, have yellowing of skin or eyes (jaundice), have severely disturbed bone marrow function, have had major surgery less than 30 days before treatment, have an infection (especially with reduced white blood cells), or are receiving yellow fever vaccines.
Medical Conditions to Discuss
Tell your doctor if you have reduced bone marrow capability, infections including fever or lung symptoms, skin reactions, heart disease (heart attack, chest pain, severely disturbed heart rhythms), hepatitis B infection, or severe allergic reactions. Pay attention to infusion reactions after your first cycle of treatment.
Pregnancy and Breastfeeding
Do not use Ribomustin if you are pregnant. Women of childbearing potential must use effective contraception before and during treatment. Men receiving treatment should not conceive a child during treatment and for up to 6 months afterwards. Seek advice on storing sperm due to possibility of permanent infertility. Do not breastfeed while using this medicine.
Blood Cell Monitoring: Ribomustin can lower your white blood cells and platelets, increasing your risk of infection and bleeding. Take precautions to avoid infections and injuries.
Drug Interactions
Some medicines may interfere with Ribomustin and affect how it works. Tell your doctor about all medicines you’re taking.
- medicines that may result in excessive immunosuppression (cyclosporine, tacrolimus)
- fluvoxamine (used to treat depression)
- ciprofloxacin and aciclovir (used to treat infections)
- cimetidine (used to treat ulcers)
- viral vaccinations
- medicines that inhibit blood formation in bone marrow
Alcohol & Driving
Ribomustin may affect your ability to drive or operate machinery safely.
Driving and Operating Machinery
Do not drive or use machines until you know how Ribomustin affects you. This medicine may cause sleepiness, dizziness, lack of coordination, or fatigue. If you feel light-headed, dizzy, or faint when getting out of bed or standing up, get up slowly. Standing up slowly will help your body adjust to changes in position and blood pressure.
Storage
Ribomustin should be kept below 25°C, protected from light. Store it in a cool, dry place away from moisture, heat, or sunlight. Do not store in the bathroom or near a sink, in the car, or on window sills. Keep out of reach of children. Healthcare professionals will dispose of any unwanted medicine appropriately.
Overdose Information
Since Ribomustin is given under medical supervision, it’s very unlikely you’ll receive too much. However, if you experience side effects after treatment, you may need urgent medical attention. Immediately phone the Poisons Information Centre (13 11 26), contact your doctor or nurse, or go to the Emergency Department at your nearest hospital, even if there are no signs of discomfort or poisoning.
Frequently Asked Questions
There is no set time limit for Ribomustin treatment. The duration depends on your specific disease and how you respond to treatment. Treatment cycles are typically repeated every 3-4 weeks for up to 6 cycles, but your doctor will determine the best schedule for you.
Ribomustin lowers your white blood cell count, increasing infection risk. Avoid people with infections and check with your doctor immediately if you think you’re getting an infection, or if you develop fever, chills, cough, hoarse throat, or lower back or side pain.
If you’re going to have surgery, tell the surgeon or anaesthetist that you’re taking Ribomustin, as it may affect other medicines used during surgery. Also, you cannot start Ribomustin treatment if you’ve had major surgery less than 30 days before.
Since Ribomustin can lower your platelet count, be careful when using a toothbrush, toothpick, or dental floss. Your healthcare team may recommend other ways to clean your teeth and gums. Also be careful not to cut yourself when using sharp objects like razors or nail cutters.
No, do not use Ribomustin if you’re pregnant. Women of childbearing potential must use effective contraception before and during treatment. Men should not conceive a child during treatment and for up to 6 months afterwards. Seek advice on storing sperm due to possible permanent infertility.
Tell any doctors, dentists, and pharmacists treating you that you’re using Ribomustin. This is important because it may interact with other medicines and affect treatments you receive.
Your doctor will do blood, urine, or other tests regularly to make sure the medicine is working and to prevent unwanted side effects. They’ll check your white blood cell and platelet counts at regular intervals and may adjust your dose based on these results.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.