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Busulfan tablets

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.

At a glance

  • Busulfan is a medicine used to treat chronic myeloid leukaemia and other blood cell conditions.

  • It is also used to prepare for stem cell transplantation.

  • Busulfan tablets should be swallowed whole with water, not crushed or chewed.

  • Do not stop taking busulfan without first speaking to your doctor.

  • Busulfan can increase your risk of infection, so avoid ill people and contact your doctor if you feel unwell.

  • You must use suitable contraception during treatment because busulfan can harm an unborn baby.

  • Always tell your doctor or pharmacist about other medicines or conditions before starting busulfan.

Continue reading below

About busulfan

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

Available as

Tablets

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.

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.

Continue reading below

  • 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.

  • 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.

Continue reading below

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.

  • 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.

Report side effects to a medicine or vaccine

If you experience side effects, you can report them online through the Yellow Card website.

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Unsure about mixing medicines?

Check for possible interactions between medicines, supplements and foods before taking them together.

Frequently asked questions

What is chronic myeloid leukaemia (CML) and how does busulfan help treat it?

Chronic myeloid leukaemia (CML) is a cancer of the blood-forming cells in the bone marrow. In CML, abnormal cells gradually fill the bone marrow and enter the bloodstream, leading to an increased number of white blood cells. Busulfan works by damaging the DNA in these cells, which stops them from multiplying and helps to control the increase in blood cell numbers.

Why is busulfan used before a stem cell transplant?

Busulfan is used to prepare for a stem cell transplant. This procedure involves transferring blood cells from a healthy donor's bone marrow to help the recipient produce healthy blood cells in their own bone marrow.

Are there any specific health conditions that would prevent me from taking busulfan?

Yes, your doctor or pharmacist needs to know about certain conditions before you start busulfan. These include if you're pregnant, breastfeeding, have recently had radiotherapy, or have problems with your liver or kidneys. Other important conditions to mention are breathing problems like asthma or COPD, an infection, epilepsy or a history of seizures, porphyria, or a history of gout. Also, inform them about all other medicines you are taking, including over-the-counter or herbal remedies, and any past allergic reactions to medicines.

What should I do if I accidentally miss a dose of busulfan or vomit after taking it?

If you are sick (vomiting) shortly after taking a dose, or if you forget a dose, you should contact your doctor or clinic for advice. They will tell you whether to take the dose again or wait until your next scheduled dose.

How long will I need to take busulfan tablets?

You may need to take busulfan for several weeks or even months. It's important not to stop taking the tablets without first speaking with your doctor.

What precautions should I take regarding contraception and family planning while on busulfan?

It's crucial that you do not get pregnant or father a child while taking busulfan. You should discuss suitable contraception methods with your doctor. If you plan to have children in the future, especially if you are male, discuss family planning with your doctor before starting busulfan, as there is a risk of reduced fertility after treatment.

Can I receive vaccinations while undergoing busulfan treatment?

While taking busulfan and for some time after treatment, you should not have any immunisations (vaccinations) without first talking to your doctor. This is because busulfan weakens your body's resistance, and some vaccines could lead to an infection.

How should I store busulfan and dispose of any unused tablets?

Keep busulfan tablets out of the reach and sight of children, and store them in a cool, dry place away from direct heat and light. Any unused or unwanted tablets should be returned to your pharmacy for proper disposal, as they require special handling.

Further reading and references

Continue reading below

About the authorView full bio

Author image

Michael Stewart, MRPharmS

Medicine Leaflet Review Manager – Contractor, Pharmacist

BPharm (Hons), MRPharmS

Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.

About the reviewer

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Sid Dajani

Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.

Article history

The information on this page is written and peer reviewed by qualified clinicians.

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