Busulfan

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Busulfan Brand Names

Busulfex | Myleran

What is Busulfan

Busulfan (1,4-butanediol dimethanesulfonate) is a bifunctional alkylating agent.

The IV formulation is indicated in combination with cyclophosphamide as a conditioning regimen prior to allogeneic hematopoietic stem-cell transplantation in patients with chronic myelogenous leukemia (CML).

The oral tablet formulation is indicated for the palliative treatment of CML. It is less effective in patients with Philadelphia chromosome (Ph)-negative CML and in young children with Ph-negative disease.

It is not effective for the treatment of blast-phase CML, chronic lymphocytic leukemia, or acute leukemias.

Indications

  • chronic myelogenous leukemia (CML)
  • stem cell transplant preparation

For the palliative treatment of chronic myelogenous leukemia (CML)

Side Effects

  1. abdominal pain
  2. acne vulgaris
  3. adrenocortical insufficiency
  4. agitation
  5. alopecia
  6. amenorrhea
  7. anemia
  8. anhidrosis
  9. anorexia
  10. anorexia
  11. anovulation
  12. anxiety
  13. aplastic anemia
  14. arthralgia
  15. asthenia
  16. atrial fibrillation
  17. azoospermia
  18. back pain
  19. bone marrow suppression
  20. bullous rash
  21. cardiac tamponade
  22. cataracts
  23. cheilitis
  24. chest pain (unspecified)
  25. chills
  26. coma
  27. confusion
  28. constipation
  29. cough
  30. delirium
  31. depression
  32. diarrhea
  33. dizziness
  34. drowsiness
  35. dyspepsia
  36. dyspnea
  37. dysuria
  38. edema
  39. elevated hepatic enzymes
  40. enamel hypoplasia
  41. encephalopathy
  42. epistaxis
  43. erythema multiforme
  44. erythema nodosum
  45. esophagitis
  46. fever
  47. flushing
  48. gonadal suppression
  49. graft-versus-host disease (GVHD)
  50. gynecomastia
  51. hallucinations
  52. headache
  53. heart failure
  54. hematemesis
  55. hematuria
  56. hemoptysis
  57. hemorrhagic cystitis
  58. hepatic necrosis
  59. hepatomegaly
  60. hiccups
  61. hot flashes
  62. hyperbilirubinemia
  63. hyperbilirubinemia
  64. hyperglycemia
  65. hypertension
  66. hyperuricemia
  67. hyperventilation
  68. hypervolemia
  69. hypocalcemia
  70. hypokalemia
  71. hypomagnesemia
  72. hyponatremia
  73. hypophosphatemia
  74. hypotension
  75. hypoxia
  76. ileus
  77. infection
  78. infertility
  79. injection site reaction
  80. insomnia
  81. intracranial bleeding
  82. jaundice
  83. lethargy
  84. leukopenia
  85. lymphopenia
  86. maculopapular rash
  87. myalgia
  88. myasthenia
  89. nausea
  90. neutropenia
  91. new primary malignancy
  92. oliguria
  93. pancreatitis
  94. pericardial effusion
  95. pharyngitis
  96. pleural effusion
  97. porphyria
  98. prolonged bleeding time
  99. pruritus
  100. pulmonary fibrosis
  101. rash
  102. rhinitis
  103. seizures
  104. sinus tachycardia
  105. sinusitis
  106. sinusoidal obstruction syndrome (SOS)
  107. skin discoloration
  108. skin hyperpigmentation
  109. stomatitis
  110. testicular atrophy
  111. thrombocytopenia
  112. thrombosis
  113. thrombotic microangiopathy
  114. tumor lysis syndrome (TLS)
  115. urticaria
  116. veno-occlusive disease (VOD)
  117. vesicular rash
  118. vomiting
  119. weakness
  120. weight gain
  121. weight loss
  122. xerosis
  123. xerostomia

Monitoring Parameters

  • CBC with differential
  • LFTs
  • serum bilirubin (total and direct)
  • serum electrolytes
  • serum uric acid

Contraindications

  • bleeding
  • bone marrow suppression
  • breast-feeding
  • children
  • contraception requirements
  • head trauma
  • hepatic disease
  • hepatotoxicity
  • hyperuricemia
  • infants
  • infection
  • infertility
  • leukopenia
  • male-mediated teratogenicity
  • neonates
  • neutropenia
  • new primary malignancy
  • pregnancy
  • radiation therapy
  • reproductive risk
  • seizures
  • sinusoidal obstruction syndrome (SOS)
  • thrombocytopenia
  • tumor lysis syndrome (TLS)
  • vaccination
  • veno-occlusive disease (VOD)

Interactions

  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Aldesleukin, IL-2
  • Amlodipine; Celecoxib
  • Benzhydrocodone; Acetaminophen
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Celecoxib
  • Clozapine
  • Cyclophosphamide
  • Deferasirox
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Digoxin
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Echinacea
  • Esomeprazole; Naproxen
  • Ethotoin
  • Etodolac
  • Famotidine; Ibuprofen
  • Febuxostat
  • Fenoprofen
  • Flucytosine
  • Flurbiprofen
  • Fosphenytoin
  • Hydrocodone; Ibuprofen
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Indomethacin
  • Itraconazole
  • Ketoconazole
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Live Vaccines
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Metronidazole
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nonsteroidal antiinflammatory drugs
  • Oxaprozin
  • Palifermin
  • Pegfilgrastim
  • Penicillamine
  • Pexidartinib
  • Phenytoin
  • Piroxicam
  • Riluzole
  • Rofecoxib
  • Rufinamide
  • Sulindac
  • Thioguanine, 6-TG
  • Tolmetin
  • Tuberculin Purified Protein Derivative, PPD
  • Valdecoxib

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