Busulphan

Busulfan or Busulphan is a bifunctional cytotoxic alkylating agent and prototype agent of alkyl sulfonates. Busulfan is a antineoplastic agent, also known as anticancerous drug, unrelated to nitrogen mustards. All alkylating agents have or can form an alkyl group that becomes covalently bound to cellular constituents. Busulfan is used in combination of different types of anticancerous drugs to obtain better therapeutic effects and to reduce the side effects or toxicities.

Busulphan is primarily indicated in conditions like Chronic myeloid leukemia, Granulocytic leukemia, Polycythemia Vera, and can also be given in adjunctive therapy as an alternative drug of choice in Myelofibrosis, Thrombocythemia.

Busulphan is contraindicated in conditions like Anaemia,Thrombocytopenia,Leukopenia.

The severe or irreversible adverse effects of Busulphan, which give rise to further complications include Hyperpigmentation, Addison's disease.Busulphan produces potentially life-threatening effects which include Bone marrow suppression, Thrombocytopenia, which are responsible for the discontinuation of Busulphan therapy.The signs and symptoms that are produced after the acute over dosage of Busulphan include Hematological toxicity, Neutropenia, Nausea, stomatitis, Anorexia, Fever, Insomnia, Lymphopenia, Headache, abdominal pain, Chills, Dyspepsia, Anemia, Asthenia, Dry mouth, Mild epistaxis., Rectal disorder, edema, Thrombosis

Busulphan is not recommended for use during pregnancy or lactation. Immunosuppressant drug should not be given, where possible, to patients with acute infection, dosage reduction or withdrawal should be considered if infection develops, until the infection has been controlled. Blood counts and measurement of hemoglobin concentration should be carried out routinely; it helps to predict the onset of bone marrow depression. It must be handled with great care and avoid contact with skin and eyes and should not be inhaled.

Drug should not be given to Paediatrics, Pregnant Mothers, patients suffering from Kidney dysfunction, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.

0.057 mg/kg (0.057 (0.057)) 24 hourly PO — -

Not used in children ( ) —

No neonatal dosage information is recorded for this medicine yet.

Busulphan is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementCarmustineClozapineADVICE: Avoid concomitant use of cytotoxics with Clozapine. (increased risk of agranulocytosis).MajorCyclophosphamideItraconazoleMetabolism of Busulphan inhibited by Itraconazole (increased risk of toxicity).MetronidazoleParacetamolMetabolism of Intravenous Busulphan possibly inhibited Paracetamol (caution is advised within 72 hours of Paracetamol).Phenytoin (Na)Cytotoxics (e.g Busulphan) reduce absorption of Phenytoin.Rotavirus vaccineThe administration of live, attenuated virus or bacterial vaccines during immunosuppressant or intense antineoplastic therapy may be associated with a risk of disseminated infection due to enhanced replication of vaccine virus or bacteria in the presence of diminished immune competence. Patients may be immunosuppressed if they have recently received Busulphan.MajorIn general, live virus or bacterial vaccines should not be used in patients receiving Busulphan.VORICONAZOLEVoriconazole may increase the serum concentration of busulfan by decreasing its metabolismMonitor for changes in the therapeutic and adverse effects of buprenorphine if voriconazole is initiated, discontinued or dose change These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Tab Store in a well closed container, at room temperature.