Busulfan

By Medically reviewed by hellodoktor

Generic Name: Busulfan Brand Name(s): Generics only. No brands available.

Uses

What is Busulfan used for?

Busulfan is commonly used to treat chronic myelogenous leukemia (CML). It does not cure the disease but helps to control it so that your quality of life is improved.

How should I take Busulfan?

Take this medication by mouth with or without food, usually once daily or as directed by your doctor.

Dosage is based on your weight, medical condition, laboratory test results, and response to treatment. Your treatment may be stopped for a short time if your blood counts are too low. Keep all medical and laboratory appointments.

Do not increase your dose or take this medication more often than prescribed. Your condition will not improve any faster, and the risk of serious side effects may be increased.

Since this drug can be absorbed through the skin and lungs, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the tablets.

Tell your doctor if your condition does not improve or if it worsens.

How do I store Busulfan?

Busulfan is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Busulfan in the bathroom or the freezer. There may be different brands of Busulfan that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Busulfan down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Busulfan?

Before taking busulfan, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood/bone marrow disorders (such as bone marrow suppression, neutropenia, thrombocytopenia, anemia), brain disorders (such as seizures, head injury).

Busulfan can make you more likely to get infections or may worsen any current infections. Therefore, wash your hands well to prevent the spread of infection. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.

Do not have immunizations/vaccinations without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

In female children, this medication may prevent puberty. Contact the doctor for more information.

This medication may make it harder for females to become pregnant or for males to father children. Discuss with your doctor for more details.

Busulfan is not recommended for use during pregnancy. It may harm an unborn baby. Discuss the use of reliable forms of birth control with your doctor. If you become pregnant or think you may be pregnant, tell your doctor right away.

It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Busulfan during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this Busulfan. This Busulfan is pregnancy risk category D according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Busulfan?

Darkening skin or dry mouth may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Many people using this medication develop serious side effects. However, your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk.

Tell your doctor right away if you have any serious side effects, including: signs of liver disease (such as persistent nausea/vomiting, severe stomach/abdominal pain, yellowing skin/eyes, dark urine), seizures, unusual/extreme tiredness, painful urination, toe/joint pain, fainting, fast/pounding heartbeat, cloudy/blurred vision.

Busulfan has rarely caused very serious (possibly fatal) lung disease. This may occur after months to years of using busulfan. Tell your doctor right away if you develop symptoms of lung disease, including chest pain, shortness of breath, persistent cough.

Busulfan may cause other cancers (such as acute leukemia, tumors). Consult your doctor for more details. Tell your doctor right away if you notice any symptoms of cancer, including unusual lumps, sudden weight loss.

This medication may affect the ovaries, possibly reducing fertility and causing hormone changes (such as missed menstrual periods). Talk to your doctor for more details.

This medication can decrease sperm production and shrink the testicles, effects that may lower male fertility. Talk to your doctor for more details.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Busulfan?

Some products that may interact with this drug include: acetaminophen, itraconazole, nalidixic acid, thioguanine.

Busulfan may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Busulfan?

Busulfan may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Busulfan?

Busulfan may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Busulfan.

What is the dose of Busulfan for an adult?

Usual Adult Dose for Chronic Myelogenous Leukemia

Initial dose: 60 mcg/kg or 1.8 mg/m2 orally once a day. The usual dosage range for remission induction is 4 to 8 mg/day.

Usual Adult Dose for Bone Marrow Transplantation

2 to 4 mg/kg (up to 560 mg) orally every 6 hours for 4 days. High dose cyclophosphamide has been used in combination with busulfan to prepare patients for bone marrow transplantation.

Dose Adjustments

Obesity has been reported to increase busulfan clearance. Dosing based on body surface area or adjusted ideal bodyweight (defined by Gibbs as an ideal body weight plus 25% of the difference between actual and ideal body weight) should be considered in obese patients.

Dosages of busulfan may depend upon the specific indication for use and protocol. When combined with other myelosuppressive drugs, dosages may need to be decreased.

What is the dose of Busulfan for a child?

Usual Pediatric Dose for Chronic Myelogenous Leukemia

Initial Dose:

Less than or equal to 12 kg : 1.1 mg/kg (based on actual body weight.)

Greater than 12 kg: 0.8 mg/kg (based on actual body weight.)

Doses are administered every 6 hours as 2 hour infusions over 4 days for a total of 16 doses.

Therapeutic drug monitoring and dose adjustment following the first dose is recommended.

Adjust subsequent doses to achieve the desired target AUC (1125 uM/min) using the formula below:

Adjusted Dose (mg) = Actual Dose (mg) x Target AUC (uM/min) / Actual AUC (uM/min)

Usual Pediatric Dose for Bone Marrow Transplantation

Marrow-ablative conditioning regimen:

0.5 mg/kg to 1 mg/kg orally every 6 hours for 4 days.

Hematopoetic stem cell transplant program:

Less than or equal to 6 years:

40 mg/m2/dose every 6 hours for 4 days.

How is Busulfan available?

Busulfan is available in the following dosage forms and strengths:

  • Tablet

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Busulfan, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: January 15, 2018 | Last Modified: September 12, 2019

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