Busulfan (Generic Name)

Other Names: Myleran®

Busulfan is a drug used to treat cancer. This drug is given orally.

Possible Side Effects (More Common)

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. Bone marrow depression occurs 10 days after the drug is given and may increase your risk of infection, fatigue, and bleeding.
  • Nausea and vomiting. These symptoms may occur within a few hours after you receive the drug.
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.
  • Diarrhea that may last for several days
  • Decreased appetite
  • Darkening of the skin

Possible Side Effects (Less Common)

  • Lung tissue changes may occur with high amounts of this drug. These changes may not be permanent, and your lung tissue may return to normal. Sometimes these changes may not be seen for many years. You may develop a cough or have difficulty catching your breath.
  • Seizures especially if you have had a seizure or head injury in the past.
  • Rash
  • Usually hair loss is temporary; your hair should grow back when treatment is completed.
  • Hepatitis (rare)
  • Cataracts (rare)
  • Swollen veins in your esophagus (rare)
  • Development of secondary leukemia (rare)
  • You could experience a decrease in the amount of steroids your body makes.

Sexual Problems and Reproductive Concerns

  • In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. 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 receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may experience signs of menopause like vaginal dryness or itching.
    • 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.
    • Speak with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
    • Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.
    • Breast feeding warning; Women are advised not to breast feed during treatment because this drug could enter the breast milk and seriously harm a breast feeding infant.
    • Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

Treating Side Effects

  • Ask your doctor or nurse about medication that is available to help prevent or lessen nausea, vomiting, or diarrhea.
  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
  • Mouth care is very important. Your mouth care should consist of regular, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of ½ teaspoon of salt in 8 ounces of water or 1/2 teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water. This should be done at least after every meal and at bedtime.
  • Avoid mouthwash that contains alcohol. Avoid alcohol and smoking because they can irritate your mouth and throat.
  • Speak with your nurse about obtaining 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 undergoing chemotherapy 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 medication to prevent them from occurring.
  • Your doctor may decide to put you on steroid replacing medications.
  • 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 medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly 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 advice.

Other Instructions

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

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Unusual bleeding or bruising
  • Headache
  • Changes in vision
  • Seizures
  • Cough
  • Swelling of legs, ankles, or feet
  • Abdominal or stomach pain
  • Confusion
  • Persistent cough or difficulty catching your breath
  • Diarrhea of more than five stools in one day

Call your doctor or nurse as soon as possible if you have the following symptom:

  • Painful mouth or throat that makes it difficult to eat or drink

Revised November 2011

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