Busulfan

What is busulfan?

Busulfan (also called Myleran® or busulfex) is an anticancer drug. It is a small white 2-mg tablet or a liquid taken by mouth. It is also a clear liquid given by vein (IV).

Busulfan can pose a health hazard to caregivers. All caregivers should take safety precautions while giving this drug. For 48 hours after this drug is given, the patient’s body fluids can contain the drug. During that 48-hour period, caregivers should follow safety guidelines when handling the patient’s vomit, blood, urine, and bowel movements, including diapers. These guidelines include wearing gloves when cleaning up body fluids. For a complete list of safety precautions, see “Do you know… Protecting caregivers from drug hazards.”

Possible side effects of busulfan

Early

• Nausea and vomiting (especially with high doses)
• Dizziness, blurred vision, and seizures (with high doses — rare)

Later (more than a day after treatment starts)

• Mouth sores
• Low blood counts
• Lung damage
• Liver damage (reversible)
• Sterility

These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse.

In case of a severe side effect or reaction, call the doctor, nurse or pharmacist at 595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once the call is connected.

Special instructions for busulfan

• Call the doctor or nurse right away if you have shaking movements, loss of balance, tremors, or seizures.
• If you vomit within one (1) hour after taking busulfan, call your nurse or doctor. Do not repeat the dose before talking to your doctor or nurse.
• Your doctor may prescribe a medicine called phenytoin (Dilantin®) to prevent seizures.
• Your doctor may prescribe an anti-nausea medicine to decrease nausea and vomiting.
• While busulfan is given, you will have chest X-rays and breathing tests to check for lung damage and blood tests to check for liver damage.
• Store the busulfan tablets at room temperature in a dry place. Store the oral liquid in a refrigerator.

Safe handling of busulfan

All chemotherapy drugs taken by mouth can pose a health hazard to caregivers and patients. You should be careful when handling this medicine and try to keep the drug from touching the skin. Taking precautions will ensure that both the patient and the caregiver are protected as well as possible.

• Prepare a clean area where the drug can be handled safely (away from areas where food is prepared, out of the reach of children, and out from under any air vents or fans).
• We suggest you or the caregiver wear gloves while handling this medicine. Wash your hands right away if your skin comes in contact with the medicine.
• Carefully wash tablet cutters with warm soapy water after each use and allow to dry. Completely clean up any spills in the area where the medicine is prepared.
• For the liquid, St. Jude will provide enough oral syringes for each dose. Use each oral syringe only one (1) time and then discard it in the trash. Do not try to wash and reuse the syringes.