Other Brands/Names

Busulfex.

How It Works

Busulfan is an anticancer medicine of the alkylating-agent class. It works by disrupting the processes of DNA replication and RNA chain formation. In malignant cells, this action slows or halts the proliferation of cancer cells in the body.

Indications

Busulfan injection is indicated to treat chronic myelogenous leukemia (CML), a cancer in which the bone marrow produces excessive white blood cells. Busulfan is also combined with other medicines as part of conditioning before a bone marrow transplant.

Contraindication

Use reliable contraception to prevent pregnancy. If pregnancy occurs during treatment with busulfan, contact a doctor immediately. Busulfan can harm the fetus. It is not known whether this medicine passes into breast milk. Because of the potential for serious adverse effects in infants, breastfeeding is not recommended while using this medicine.

Side Effects

Possible adverse effects include:

• Nausea

• Vomiting

• Diarrhea

• Constipation

• Loss of appetite

• Mouth sores

• Abdominal pain

• Dizziness

• Swelling of ankles/hands

• Skin redness

• Headache

• Difficulty sleeping 

Seek urgent medical help if you experience serious reactions, such as:

• Persistent nausea/vomiting

• Severe chest or lung pain

• Yellowing of skin or eyes

• Dark urine

• Mental/mood changes (depression, hallucinations, restlessness, confusion)

• Muscle cramps

• Increased thirst

• Frequent urination

• Fast or irregular heartbeat

• Coughing up blood

• Blood in the urine

• Seizures

• Pain/redness/swelling at injection site

• Fainting

• Chest pain

• Shortness of breath

Types

Bulufan is available as injection solution in a 6 mg/mL vial.

Dosage

Adults

• 0.8 mg/kg every 6 hours by intravenous infusion over 2 hours, then via a central venous catheter for 4 consecutive days.
• Begin 7 days prior to bone marrow transplantation.

Children Dosage Based on Body Weight

• < 9 kg: 1 mg/kg
• 9 - <16 kg: 1.2 mg/kg
• 16-23 kg: 1.1 mg/kg
• >23-34 kg: 0.95 mg/kg
• >34kg: 0.8 mg/kg
• All doses are administered every 6 hours by intravenous infusion over 2 hours for 4 days

Safety

• This medicine may cause dizziness.
• Busulfan can increase susceptibility to infections or worsen existing infections.
• Inform your healthcare professional that you are receiving busulfan before any immunization or vaccination.
• This medicine may affect fertility in both males and females; consult your doctor for detailed advice.

Drug Interactions

• Co-administration with live vaccines may raise the risk of infection.
• Use with the antifungal itraconazole or the antibiotic metronidazole may increase busulfan blood concentrations and raise toxicity risk.
• Concomitant use with thioguanine may lead to esophageal varices.

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