Keep your regular appointments with your doctor or hospital. You will need to have frequent tests while you are on busulfan.
Swallow the tablets with plenty of water. Do not break, crush or chew the tablets.
If you feel suddenly unwell or experience any worrying symptoms, speak with your doctor or clinic straightaway.
|Type of medicine||Alkylating medicine|
|Used for||To treat chronic myeloid leukaemia and other diseases that affect blood cells|
To prepare for stem cell transplantation
Busulfan is used to treat chronic myeloid leukaemia (CML). This is a cancer of blood-forming cells in the bone marrow. Abnormal cells gradually fill the bone marrow and spill into the bloodstream, which increases the number of white cells in your blood. The disease typically develops very slowly and symptoms such as anaemia, bleeding problems or infections may not occur for many years after the start of the condition.
Busulfan is also used during preparation for stem cell transplantation. This is a procedure in which blood cells growing in a healthy donor's bone marrow are transferred to help produce healthy cells in another person's bone marrow.
Busulfan works by stopping cells from multiplying. It does this by binding to and damaging the DNA in cells. This helps stop the increase in the number of blood cells.
Before taking busulfan
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking busulfan it is important that your doctor or pharmacist knows:
- If you are pregnant, trying for a baby or breastfeeding.
- If you have recently had radiotherapy.
- If you have any problems with the way your liver or kidneys work.
- If you have a breathing problem such as asthma or chronic obstructive pulmonary disease (COPD).
- If you have an infection or feel unwell.
- If you have epilepsy or have ever had a fit (seizure).
- If you have a rare inherited blood disorder called porphyria.
- If you have ever had gout (painful or swollen joints, usually in the toes).
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take busulfan
- Busulfan will be prescribed for you by a specialist doctor who is experienced in treating your condition. Take the tablets exactly as your doctor tells you to. Your dose will depend on the reason why you are taking it. If you are unsure about how to take the tablets, or if you have any other concerns, you should contact your doctor or hospital clinic for advice.
- Swallow the tablets with plenty of water. Do not break, crush or chew them. You can take busulfan tablets before or after meals.
- Before you start this treatment, read any printed information you have been given by your doctor and the leaflet from inside your pack of tablets. The leaflet will give you more information about busulfan and a full list of possible side-effects from taking it.
- You may need to take busulfan for several weeks or months. Do not stop taking busulfan without speaking with your doctor first.
- If you are sick (vomiting) shortly after taking a dose, or if you forget a dose, contact your doctor or clinic for advice on what to do. You will be told whether to take the dose again, or wait until the next dose is due.
Getting the most from your treatment
- You must try to keep your regular appointments with your doctor or hospital. This is so your doctor can check on your progress. You will need to have regular check-ups during your treatment to monitor for unwanted side-effects.
- Busulfan lowers the number of white cells in your blood, increasing the chance of you getting an infection. If possible, avoid people who you know are ill, and let your doctor know if you feel you are getting an infection.
- It is important that you do not get pregnant or father a child while you are taking busulfan. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner.
- If you intend to have children in the future, you should ask your doctor for advice about family planning before you begin taking busulfan. This is particularly important if you are a man, as there is a risk of reduced fertility after busulfan treatment.
- While you are taking busulfan and for a while after you stop treatment, do not have any immunisations (vaccinations) without talking to your doctor first. Busulfan lowers your body's resistance and there is a chance that you may get an infection from some vaccines.
- If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking busulfan.
- If you buy any medicines, check with your doctor or a pharmacist that they are suitable for you to take with your other medicines.
Can busulfan cause problems?
Along with their useful effects, most medicines can cause side-effects although not everyone experiences them. Before you start treatment with busulfan, your doctor will discuss with you the possibility of unwanted side-effects occurring. The table below lists some of the most common ones associated with busulfan. You will find a full list in the manufacturer's information leaflet supplied with your medicine.You should let your doctor or clinic know as soon as possible if you experience any of the following:
|Common busulfan side-effects||What can I do if I experience this?|
|Feeling sick (nausea) or being sick (vomiting)||Stick to simple foods. Let your doctor know about this, as an anti-sickness medicine may help|
|Diarrhoea||Drink plenty of water to replace lost fluids. If this continues, speak with your doctor|
|Mouth ulcers||Brushing your teeth 2-3 times a day with a soft toothbrush and regularly using a mouth rinse may help to prevent this. If mouth ulcers become a problem, speak with your doctor|
|Hair loss||This is not permanent, but speak with your doctor if you are concerned about it|
|Dark patches of colour on your skin, menstrual problems||If troublesome, speak with your doctor|
|Feeling unwell, a high temperature (fever) or symptoms of an infection||Let your doctor know straightaway|
|Unexpected bruising or bleeding||These are symptoms of bone marrow suppression. Let your doctor know about this straightaway|
|Sudden wheeziness or any difficulties breathing||Let your doctor know straightaway|
|Yellowing of your skin or the whites of your eyes (jaundice)||Let your doctor know straightaway|
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store busulfan
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- Return any unused or unwanted tablets to your pharmacy to destroy. They will need special disposal.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Busulfan 2 mg Tablets; Aspen Pharma Trading Ltd, The electronic Medicines Compendium. Dated September 2017.
British National Formulary, 78th Edition (Sep 2019); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.