Drug interactions between busulfan and Flagyl
| Results for the following 2 drugs: |
|---|
| busulfan |
| Flagyl (metronidazole) |
Interactions between your selected drugs
metronidazole ↔ busulfan
Applies to:Flagyl (metronidazole) and busulfan
GENERALLY AVOID: Coadministration with metronidazole may significantly increase the plasma concentrations of busulfan. The mechanism of interaction has not been described. In a group of patients receiving myeloablative therapy with busulfan (1 mg/kg orally for 4 days) prior to undergoing hematopoietic stem cell transplantation, five patients who were coadministered metronidazole (400 mg orally three times daily for 4 days) had an 87% increase in mean busulfan trough concentrations compared to ten patients who were administered busulfan alone. In nine patients who received metronidazole only for the last 2 days of busulfan administration, busulfan concentrations increased 79% compared to the first 2 days. In patients who received busulfan and metronidazole concomitantly for 4 days, all experienced elevated liver transaminases (AST, ALT) and bilirubin. Three patients also experienced veno-occlusive disease (one died with multi-organ failure), while one developed hemorrhagic cystitis. In the group who received metronidazole only on the last two days of busulfan therapy, six had elevated liver function tests, but no veno-occlusive disease was observed.
MANAGEMENT: Due to the potential for severe toxicity and mortality associated with elevated busulfan plasma levels, concomitant use with metronidazole should be avoided.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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