Busulfan (Generic Name)

Other Names: Myleran®

About This Drug

Busulfan is a drug used to treat cancer. This drug can be given in the vein (IV) or by mouth.

Possible Side Effects (More Common)

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours or many hours after your treatment. Medicines are available to stop or lessen these side effects.
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.
  • Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak)
  • Loose bowel movements (diarrhea) that may last for a few days
  • Decreased appetite (decreased hunger)
  • Darkening of the skin

Possible Side Effects (Less Common) 

  • Changes in lung tissue may happen with large amounts of this drug. These changes may not last forever, and your lung tissue may go back to normal. Sometimes these changes may not be seen for many years. You may get a cough or have trouble catching your breath.
  • Seizures – you are more at risk if you have had a seizure or head injury in the past. You may need medication to prevent seizures while taking this drug.
  • Rash
  • You may notice your hair getting thin. Some patients lose their hair. Your hair often grows back when treatment is done.
  • Changes in your liver function.  Your doctor will check your liver function as needed.
  • Cataracts (rare)
  • Swollen veins in your esophagus (rare)
  • This drug may cause an increased risk of developing a second cancer (rare)
  • This drug may lower the amount of steroids your body normally makes

Allergic Reactions

Allergic reactions, including anaphylaxis are rare but may happen in some patients.  Signs of allergic reactions to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, do not take another dose of this drug. You should get urgent medical treatment.

Treating Side Effects

  • Ask your doctor or nurse about medicine that is available to help stop or lessen nausea, throwing up, or loose bowel movements (diarrhea).
  • Ask your doctor or nurse about medicine that is available to help stop or lessen fever, headache, muscle and joint aches.
  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can bother your mouth and throat.
  • Do not put anything on a rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • Talk with your nurse about getting a wig before you lose your hair.  Also, call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good, Feel Better” program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
  • If you are at high risk for seizures your doctor may give you medicine to stop them from happening.
  • Your doctor may decide to put you on steroid replacing medications.
  • Wear dark sunglasses and use sunscreen with SPF 30 or higher when you are outdoors even for a short time. Cover up when you are out in the sun. Wear wide-brimmed hats, long-sleeved shirts, and pants. Keep your neck, chest, and back covered.

Food and Drug Interactions

Oral Busulfan should be taken one hour before a meal or two to three hours after a meal. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

Important Instructions

It is important that you take all of the capsules. If you drop a capsule, or if you throw up any part of a dose, save the thrown up fluids and call your nurse immediately. All or part of the dose may need to be repeated. You will be getting medication to prevent nausea and throwing up before each dose.

Other Instructions

  • Whenever you tell a doctor or nurse your health history, always tell them that you have received busulfan.
  • This medicine should be kept in a dry place at room temperature

When to Call the Doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or above; chills
  • Bleeding or bruising that is not usual
  • Headache that does not go away
  • Blurred vision or other changes in eyesight
  • Seizures
  • Confusion or agitation
  • Cough or trouble breathing
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired or weak, unusual itching, or yellowing of the eyes or skin
  • Weight gain of 5 pounds in one week (fluid retention)
  • Blood in urine
  • Nausea that stops you from eating and drinking
  • Throwing up more than three times a day.

Call your doctor or nurse as soon as possible if you have any of these symptoms:

  • Pain in the mouth or throat that makes it hard to eat or drink
  • Loose bowel movements (diarrhea) 5-6 times a day or diarrhea with weakness or feeling lightheaded
  • Heavy menstrual bleeding that lasts longer than normal
  • Swelling of legs, ankles, or feet

Sexual Problems and Reproductive Concerns

  • Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your treatment. Talk with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
  • In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.
  • In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
  • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
  • Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

Revised June 2014

©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com