Busulfan | Side Effects, Dosage, Uses & More
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Generic Name:

busulfan, Oral tablet

All Brands

  • Myleran
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Highlights for busulfan

Oral tablet
1

Busulfan is used to treat pain due to chronic myelogenous leukemia. This is a type of blood cancer.

2

This drug comes in the form of a tablet you take by mouth. It’s also available in an intravenous (IV) form, which is only given by a healthcare provider.

3

Busulfan is available as the brand-name drug called Myleran. It isn’t available as a generic drug.

4

The more common side effects of this drug include weight loss, fatigue, loss of appetite, nausea, and vomiting. Your doctor will give you medications to help prevent nausea and vomiting.

5

In some cases, busulfan can cause serious side effects. These include bone marrow suppression, damage and scarring to your lungs, or fluid buildup around your heart.

IMPORTANT INFORMATION

Damage to your lung tissues

This drug can cause damage and scarring to your lung tissue. This is called pulmonary fibrosis. This may occur at any time during treatment with this drug.

Tumors and leukemias

Because of how this drug works to damage cancer cells, it may also harm some of your body’s normal non-cancerous cells. In rare cases, this may lead to tumors or leukemias.

Heart problems

Busulfan may cause a condition called cardiac tamponade. This happens when your heart becomes compressed by fluid that accumulates in the sac that protects your heart. Tell your doctor right away if you have abdominal pain or vomiting. These may be symptoms of this condition.

What is busulfan?

Busulfan is a prescription drug. It’s available as an oral tablet. It’s also available in an intravenous (IV) form, which is only given by a healthcare provider.

The oral tablet is only available as the brand-name drug called Myleran. It isn’t available as a generic drug.

Busulfan may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Busulfan is used to treat pain due to chronic myelogenous leukemia. This is a type of blood cancer.

How it works

Busulfan belongs to a class of drugs called alkylating agents.

More Details

How it works

Busulfan belongs to a class of drugs called alkylating agents. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Busulfan works by adding a roadblock to the DNA of cancer cells. This stops them from replicating and keeps them from growing larger.

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busulfan Side Effects

Oral tablet

More Common Side Effects

The more common side effects of busulfan can include:

  • weight loss

  • fatigue

  • loss of appetite

  • nausea

  • vomiting

  • bone marrow suppression. Symptoms may include:

    • fever
    • infection
    • bruising or bleeding more easily than normal
  • skin discoloration

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Cardiac tamponade. This condition happens when your heart becomes compressed by fluid that accumulates in the sac that protects your heart. Symptoms can include:

    • chest pain
    • shortness of breath
    • fainting or dizziness
    • abdominal pain
  • Pulmonary fibrosis (damage and scarring to your lung tissue). Symptoms can include:

    • shortness of breath
    • a dry cough
    • fatigue
    • unexplained weight loss
    • muscle and joint aches
  • Bone marrow suppression. Symptoms can include:

    • fever
    • infection. Symptoms can include:
      • fever
      • chills
      • sore throat
      • cough
      • pain throughout your body
    • bruising or bleeding more easily than normal
  • Stops menstruation in women who have a menstrual cycle

Pharmacist's Advice
Healthline Pharmacist Editorial Team

Busulfan may cause drowsiness.

This drug can also cause weight loss, weakness, fatigue, nausea, and vomiting the first few hours after you take it. This is more likely when you first start taking busulfan or when your doctor increases your dose. Your doctor will also give you medications to help prevent nausea and vomiting.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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busulfan May Interact with Other Medications

Oral tablet

Busulfan can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that might interact with this drug

Interactions that increase your risk of side effects
  • Side effects from busulfan: Taking busulfan with certain medications raises your risk of side effects from busulfan. This is because the amount of busulfan in your body is increased. Examples of these drugs include:
    • Itraconazole, fluconazole, ketoconazole, posaconazole, and voriconazole. These drugs reduce your body’s ability to remove busulfan from your body.

Interactions that can make your drugs less effective
  • When busulfan is less effective: When busulfan is used with certain drugs, it may not work as well to treat your condition. This is because the amount of busulfan in your body may be decreased. Examples of these drugs include:
    • Phenytoin. This drug may cause you to remove busulfan from your body more quickly.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Busulfan warnings
People with lung problems

If you have a lung condition, you may be at greater risk for lung damage and scarring from busulfan. Tell your doctor about your lung problems before you start taking this drug.

People with weakened immune systems

If you have a suppressed immune system, this drug may weaken your immune system more. Tell your doctor if you have a weakened immune system before you take this drug.

Pregnant women

Busulfan is a category D pregnancy drug. That means two things:

  1. Research in humans has shown adverse effects to the fetus when the mother takes the drug.
  2. This drug should only be used during pregnancy in serious cases where it's needed to treat a dangerous condition in the mother.

Talk to your doctor if you’re pregnant or planning to become pregnant. Ask your doctor to tell you about the specific harm that may be done to the fetus. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefit.

Women who are breast-feeding

Busulfan may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

Contact with drug

This drug can be transferred to other people if they touch the medication. Talk to your doctor about how to prevent this from happening.

When to call the doctor

Call your doctor right away if you become pregnant while taking this drug.

Allergies

Busulfan can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take busulfan (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Pain due to chronic myelogenous leukemia

Brand: Myleran

Form: Oral tablet
Strengths: 2 mg
Adult dosage (ages 18–64 years)

Usual dosage: 4–8 mg taken one time per day

Child dosage (ages 0–17 years)

Your doctor will decide their dose based on their weight or body surface area (BSA). BSA is calculated from height and weight. It’s measured in squared meters (m2).

  • Usual dosage: 60 mcg/kg of body weight or 1.8 mg/m2 of body surface area taken one time per day

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Busulfan comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your cancer may grow or spread.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • nausea
  • vomiting
  • diarrhea
  • swelling in your throat, stomach, or intestines

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away. 

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

You likely won’t be able to tell if this drug is working. You won’t feel better after starting this drug, and may even feel worse due to side effects. Your doctor will do blood tests to check if this drug is working to treat your cancer.

Busulfan is used for long-term treatment.

Important considerations for taking busulfan
take with or without food
You can take busulfan with or without food
timing
Take this drug at the time(s) recommended by your doctor
do not crush
Don’t cut or crush the tablet
See Details
storage
Store this drug carefully
See Details
refillable
A prescription for this medication is refillable
See Details
travel
Travel
See Details
clinical monitoring
Clinical monitoring
See Details
not usually stocked
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead.
insurance
Insurance
See Details

Store this drug carefully

  • Store busulfan at room temperature. Keep it between 59°F and 86°F (15°C and 30°C). Keep it away from light.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor will monitor your blood cell counts during treatment with this drug. This will help make sure that it’s working to reduce the growth and spread of your cancer, but not harming the normal cells in your body.

This monitoring may be done using this test:

  • Complete blood cell counts. Your doctor may take blood samples to check the number of cancerous and normal cells in your body.

If you’re at risk of pulmonary fibrosis from busulfan treatment, your doctor may check your lung function during treatment.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.


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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on December 8, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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