Busulfan

From Anvita Health Wiki

Contents 1 Introduction 2 Indications 3 Contraindications 4 Dosage 5 Pharmacokinetics 6 Adverse-effects 7 Drug-interactions 8 Test-interactions 9 Mechanism-of-action 10 More General Terms 11 Internet Database 12 References

Introduction

• Tradename: Myleran.

Indications

• chronic myelogenous leukemia
• polycythemia vera
• bone marrow ablation prior to bone marrow transplant

Contraindications

• Caution:
• monitor for signs of bleeding
• excellent oral hygiene is needed to minimize oral discomfort
  

Dosage

• adults 408 mg PO QD
• maintenance dosage: 2-4 mg/week to 4 mg QD
• bone marrow transplant: up to 8-16 mg/kg

• Tabs: 2 mg.

Pharmacokinetics

• well absorbed orally
  

• elimination via liver
• 1/2life = 2.5 hours

Adverse-effects

• common (> 10%)

• pancytopenia
• delayed effect, onset 7-10 days
• nadir 14-21 days
• recovery 28 days
• busulfan affects stem cells

• less common (1-10%)

• amenorrhea, hyperpigmentation, nausea/vomiting, diarrhea, weakness, anorexia, weight loss

• uncommon (< 1%)

• seizures, adrenal suppression (Addison-like syndrome), hepatic dysfunction, blurred vision, pulmonary fibrosis, hemorrhagic cystitis, gynecomastia, hyperuricemia,

• other

• mucositis
• increased serum transaminases
• "Bulsulfan" lung: fever/ chills, rales, dyspnea
  
• drug adverse effects of alkylating agents

Drug-interactions

• thioguanine
• in combination with probenecid results in increased serum & urine uric acid

Test-interactions

• may increase measurements of serum K+

Mechanism-of-action

• alkylating agent

More General Terms

• alkylating agent
• antineoplastic agent (chemotherapeutic agent)

Internet Database

PubChem: 2478

References

1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998

busulfan (Myleran)