Busulfan

Brand Names

Myleran® (There may be other brand names for this medication)

How is Busulfan Administered?

This drug may be taken by mouth or it can be given as an infusion into a vein (intravenous or IV).

What is it Used For?

This drug is used to treat chronic myelogenous leukemia and to prepare the body for stem cell/bone marrow transplants.

How Does Busulfan Work?

Cancer is a group of diseases in which abnormal cells divide without control.    Both normal and cancer cells go through cycles that include a resting phase, active growing phases, and division. Your chemotherapy schedule is based upon the type of cancer you have, the rate at which they divide, and the times when each drug is the most likely to be effective. This is why chemotherapy is typically given in cycles.

Busulfan is in a class of drugs known as alkalyting agents. Specifically, it is an alkylsulfonate drug and is most active in the resting phase of the cell.

What Should I Tell My Doctor Before I Begin Receiving Busulfan?

Tell your doctor if you:

  • have had an allergic reaction to busulfan
  • have taken any medications in the week before you receive (IV) busulfan
  • are pregnant or breastfeeding
  • have had thalassemia, seizures, or a head injury
  • are taking aspirin, itraconazole (Sporanox), thioguanine, or vitamins
  • have ever received radiation treatments, other stem cell transplants, or other types of chemotherapy

This drug may interact with other medications, increasing or decreasing their effectiveness or causing harmful side effects. Tell your doctor and pharmacist about any prescription or over-the- counter medications, vitamins, herbal or diet supplements that you are taking.

What Are Some Possible Side Effects I May Experience?

  • Nausea, vomiting, or decreased appetite
  • Mouth and/or throat soreness or blistering
  • Diarrhea (may last several days)
  • Darkened and/or dry skin, rash
  • Fatigue
  • Decreased fertility (both men and women). May be temporary or permanent.
  • Menstrual irregularity and/or vaginal dryness or itching in women
  • Thin or brittle hair

How Can I Manage These Side Effects?

  • Ask your doctor about medication to help prevent or lessen nausea, vomiting, and diarrhea.
  • Mouth care is very important while taking this drug. Rinse your mouth with a mixture of 1⁄2 tsp of baking soda in 8 oz of water after every meal and at bedtime. Brush your teeth and gums often with a soft toothbrush. (Soften it further by running it under warm water before brushing.)
  • Avoid smoking, alcohol, and mouthwashes that contain alcohol.
  • Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during intercourse.
  • Speak with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.
  • Do not put any creams, lotions, or gels on a rash without first getting your doctor’s permission.
  • Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.

When Should I Call the Doctor?

Call your doctor immediately if you experience:

  • any sign of infection: fever of 100.5F (38C) or higher, chills, cough, sore throat, pain or burning upon urination; redness or tenderness along a vein, or at an IV site or wound of any kind
  • any sign of an allergic reaction: itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing, dizziness, or palpitations
  • unusual bruising or bleeding: bleeding lasts more than10-15 minutes or that causes dizziness; black or bloody stools; vomit that is bloody or that looks like coffee grounds; blood in your urine or phlegm/mucus, unusually heavy menstrual bleeding, spontaneous bleeding from your gums or nose, or superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae)
  • headache, changes in vision, confusion and/or seizures
  • swelling of legs, ankles, or feet
  • abdominal or stomach pain

Call your doctor as soon as possible if you experience:

  • painful mouth or throat that makes it difficult to eat or drink 
  • cough
  • change in menstrual periods
  • dry mouth, nose, or eyes
  • skin rash
  • trouble sleeping
  • feelings of anxiety
  • diarrhea of more than 5 stools in 1 day

What Else Should I Know About Busulfan?

  • This drug may cause bone marrow depression, usually about 10 days after a treatment, which can increase your risk for infection, fatigue, and bleeding. To help avoid infections, stay away from crowds or people with colds, flu, or other infections. Wash your hands often. Be careful when handling sharp objects. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Use an electric razor. Talk to your doctor before you have any vaccinations. Do not breastfeed while you are taking this medicine.
  • You should know that busulfan may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men but do not assume that you cannot get pregnant or that you cannot get someone else pregnant. Use birth control while on this medication, as it may harm the fetus.
  • You should not plan to have children while receiving chemotherapy or for a while after treatments. (Talk to your doctor for further details). Genetic counseling is available to you to discuss the effect of this drug therapy on future pregnancies.
  • Do not breastfeed while receiving busulfan.
  • Busulfan may cause ovarian failure and may stop girls from reaching puberty. Talk to your doctor about the risk of infertility.
  • Your doctor will need to check your blood at regular times during your treatment. Be sure to keep all your appointments.
  • Receiving busulfan may increase your risk of developing other types of cancer or a recurrence of leukemia. Talk to your doctor about this risk.
  • If taking by mouth: Swallow the tablet whole. Do not crush, break, or chew it. If you miss a dose, take it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
  • Drink plenty of fluids and urinate frequently during your treatment.
  • If you would like more information about busulfan, talk to your doctor.