Generic drug: busulfan
Brand name: Busulfex
What is Busulfex (busulfan), and how does it work?
What are the side effects of Busulfex?
Common side effects of Busulfex include:
- loss of appetite,
- weight loss,
- mouth sores,
- upset stomach,
- abdominal pain,
- swelling of the ankles/feet/hand,
- flushing (warmth,
- redness, or tingly feeling),
- trouble sleeping,
- swelling or irritation around the IV needle,
- missed menstrual periods,
- hair loss,
- darkened skin color, and
Tell your doctor if you have serious side effects of Busulfex including:
- pale skin,
- shortness of breath,
- trouble concentrating,
- easy bruising,
- unusual bleeding,
- purple or red pinpoint spots under your skin,
- signs of infection (such as fever, chills, sore throat, flu symptoms, loss of appetite, weight loss, unusual weakness, mouth and throat ulcers, rapid and shallow breathing),
- weight gain,
- stomach swelling or tenderness,
- yellowing of the skin or eyes (jaundice),
- coughing up blood,
- stomach pain,
- sharp chest pain,
- trouble breathing,
- lower back pain,
- blood in your urine,
- urinating less than usual or not at all,
- jerking muscle movements,
- muscle tightness or contraction,
- overactive reflexes,
- muscle weakness or limp feeling,
- leg discomfort,
- numbness or tingly feeling around your mouth,
- fast/slow/uneven heart rate,
- weak pulse,
- seizures (convulsions),
- persistent cough,
- congestion, or
- low fever
Busulfex (bus ulfan) Injection causes severe and prolonged myelosuppression at the recommended dos age. Hematopoietic progenitor cell trans plantation is required to prevent potentially fatal complications of the prolonged myelosuppression.
What is the dosage for Busulfex?
Initial Dosing Information
- Administer Busulfex in combination with cyclophosphamide as a conditioning regimen prior to bone marrow or peripheral blood progenitor cell replacement. For patients weighing more than 12 kg, the recommended doses are:
- Busulfex 0.8 mg per kg (ideal body weight or actual body weight, whichever is lower) intravenously via a central venous catheter as a two-hour infusion every six hours for four consecutive days for a total of 16 doses (Days -7, -6, -5 and -4).
- Cyclophosphamide 60 mg per kg intravenously as a one-hour infusion on each of two days beginning no sooner than six hours following the 16th dose of Busulfex (Days -3 and -2).
- Administer hematopoietic progenitor cells on Day 0.
- Premedicate patients with anticonvulsants (e.g., benzodiazepines, phenytoin, valproic acid or levetiracetam) to prevent seizures reported with the use of high dose Busulfex. Administer anticonvulsants 12 hours prior to Busulfex to 24 hours after the last dose of Busulfex.
- Administer antiemetics prior to the first dose of Busulfex and continue on a fixed schedule through Busulfex administration.
- Busulfex clearance is best predicted when the Busulfex dose is administered based on adjusted ideal body weight. Dosing
Busulfex based on actual body weight, ideal body weight or other factors can produce significant differences in
Busulfex clearance among lean, normal and obese patients.
Men: IBW (kg)=50+0.91× (height in cm -152) Women: IBW (kg)=45+0.91× (height in cm -152)
- Calculate ideal body weight (IBW) as follows (height in cm, and weight in kg):
- For obese or severely obese patients, base Busulfex dosing on adjusted ideal body weight (AIBW):
- AIBW= IBW +0.25× (actual weight -IBW).
What drugs interact with Busulfex?
Drugs That Decrease Busulfex Clearance
- Itraconazole decreases busulfan clearance by up to 25%. Metronidazole decreases the clearance of busulfan to a greater extent than does itraconazole; metronidazole coadministration has been associated with increased busulfan toxicity. Fluconazole (200 mg) has been used with Busulfex.
- Decreased clearance of busulfan was observed with concomitant use with deferasirox. The mechanism of this interaction is not fully elucidated. Discontinue iron chelating agents well in advance of administration of Busulfex to avoid increased exposure to busulfan.
- Because busulfan is eliminated from the body via conjugation with glutathione, use of acetaminophen prior to (less than 72 hours) or concurrent with Busulfex may result in reduced busulfan clearance based upon the known property of acetaminophen to decrease glutathione levels in the blood and tissues.
Drugs That Increase Busulfex Clearance
- Phenytoin increases the clearance of busulfan by 15% or more, possibly due to the induction of glutathione-S-transferase. Since the pharmacokinetics of Busulfex were studied in patients treated with phenytoin, the clearance of Busulfex at the recommended dose may be lower and exposure (AUC) higher in patients not treated with phenytoin.
Is Busulfex safe to use while pregnant or breastfeeding?
- Busulfex can cause fetal harm when administered to a pregnant woman based on animal data. Busulfan was teratogenic in mice, rats, and rabbits following administration during organogenesis.
- The solvent, DMA, may also cause fetal harm when administered to a pregnant woman.
- It is not known whether Busulfex is present in human milk. Because many drugs are excreted in human milk and because of the potential for tumorigenicity shown for busulfan in human and animal studies, discontinue breastfeeding during treatment with Busulfex.
- The Predicted 'Tripledemic' Is Here: Why Isn't There an RSV Vaccine?
- 'Tumor Progressing,' 'Positive Findings': Patients Often Confused by Medical Jargon
- Seizures Seem Tied to Faster Decline in People With Dementia
- Few Americans Understand Alcohol's Impact on Cancer Risk: Survey
- Frozen Stuffed Chicken Products & Microwave Ovens: A Recipe for Salmonella
- More Health News »
Busulfex (busulfan) is a cancer (antineoplastic) medication used to treat the symptoms of chronic myelogenous leukemia (a type of blood cancer). Busulfex is not a cure for leukemia. Common side effects of Busulfex include nausea, vomiting, diarrhea, constipation, loss of appetite, weight loss, mouth sores, upset stomach, abdominal pain, dizziness, weakness, swelling of the ankles/feet/hand, and others.
Multimedia: Slideshows, Images & Quizzes
What do you know about leukemia? Did you know there are different types? What are the symptoms? Take the Leukemia Quiz and test...
Cancer: Guide to Leukemia
Learn about the common types and stages of leukemia, who gets it, symptoms, tests, treatments, and more. People with blood cancer...
Related Disease Conditions
Leukemia is a type of cancer of the blood cells in which the growth and development of the blood cells are abnormal. Strictly speaking, leukemia should refer only to cancer of the white blood cells (the leukocytes) but in practice, it can apply to malignancy of any cellular element in the blood or bone marrow, as in red cell leukemia (erythroleukemia).
What Is the Life Expectancy of a Person With Leukemia?
Leukemia is a group of cancers of the blood affecting the white blood cells. White blood cells are the infection-fighting cells of the body. In adults, leukemia is most common in people older than 55 years, with the average age of diagnosis being 66 years. It is also one of the most common cancers in children and adults younger than 20 years. The survival rate is higher for younger people.
How Does Leukemia Kill?
Leukemia is a cancer of the white blood cells of the bone marrow. Patients with leukemia have an over-production of a particular blood cell type in the body, the white blood cells (cells that fight infection, and provide immunity).
Survival Rate for Acute Lymphoblastic Leukemia
The prognosis depends on the type of leukemia, the extent of the disease, age of the patient, and the general condition of the patient. Some patients can go into complete remission. The average five-year survival rate of leukemia is 60-65%.
Leukemia: Signs, Symptoms, And Complications
Leukemia results when the genetic material (DNA) of a single cell in the bone marrow transforms, this is called a mutation. A mutated cell does not perform body function, but it eats away the nutrition meant for the normal cells.
What Are the Stages of Chronic Lymphocytic Leukemia?
Chronic lymphocytic leukemia is a cancer of the blood and bone marrow. With this type of cancer, the marrow creates too many abnormal lymphocytes. There are five stages of chronic lymphocytic leukemia.
Treatment & Diagnosis
- Leukemia FAQs
- Evolution of Treatment for a Rare Type of Leukemia
- Gleevec and Chronic Myeloid Leukemia
- How Familes Cope with a Leukemia Diagnosis
- Coping with a Bad Disease - Community Counts
- A Family's Leukemia Diary - Coping
- Is Multiple Myeloma the Same as Leukemia?
- Does Folic Acid Prevent Leukemia?
- Can Folic Acid Prevent Leukemia?
- Chronic Myelogenous Leukemia (CML)
Medications & Supplements
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.