Treosulfan

Generic name: treosulfan
Brand name: Grafapex
Dosage form: intravenous powder for injection (1 g; 5 g)
Drug class: Alkylating agents

Medically reviewed by Drugs.com on Mar 24, 2025. Written by Cerner Multum.

What is treosulfan?

Treosulfan is used in adults and children at least 1 year old with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) as preparation for a stem cell transplant.

Treosulfan is used in combination with other cancer treatments.

Treosulfan may also be used for purposes not listed in this medication guide.

Treosulfan side effects

Get emergency medical help if you have signs of an allergic reaction: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Treosulfan may cause serious side effects. Call your doctor at once if you have:

• swelling, pain, burning, irritation, or skin changes where the injection was given;

• severe itching, rash, or dryness of the skin;

• unusual bruising or bleeding, new signs of infection (fever, weakness, cough, diarrhea, burning when you urinate); or

• seizures.

Common side effects of treosulfan may include:

• infections, fever;

• mouth sores;

• muscle, bone, or joint pain;

• nausea or vomiting;

• swelling; or

• abnormal lab results.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Related/similar drugs

Warnings

You may get infections, even serious infections, or bleed more easily. Call your doctor if you have flu symptoms, fever, skin sores, cough, night sweats, neck stiffness, confusion, or vision problems.

Before taking this medicine

You should not be treated with treosulfan if you are allergic to it.

Tell your doctor if you have or have ever had:

• an active or recent infection;

• seizures;

• an organ transplant, or a stem cell transplant from a donor; or

• chemotherapy or radiation.

Using treosulfan may increase your risk of developing other cancers. Ask your doctor about this risk.

Treosulfan can harm an unborn baby if the mother or the father is receiving treosulfan.

• If you are a woman, you may need a pregnancy test to make sure you are not pregnant. Use birth control while using this medicine and for at least 6 months after your last dose.

• If you are a man, use birth control if your sex partner is able to get pregnant. Keep using birth control for at least 3 months after your last dose.

• Tell your doctor right away if a pregnancy occurs.

Do not breastfeed while using this medicine, and for at least 1 week after your last dose.

Treosulfan may affect fertility in men or women. Pregnancy could be harder to achieve while either parent is using this medicine.

How is treosulfan given?

Treosulfan is given as an infusion into a vein. A healthcare provider will give you this injection.

Tell your medical caregivers if you feel any burning or pain when treosulfan is injected.

You may be given other medications to help prevent serious side effects or allergic reaction. Keep taking these medicines for as long as your doctor has prescribed.

Doses are based on body surface area (height and weight). Your dose may change if you gain or lose weight or if you are still growing.

Clean "sweaty" skin areas (armpits, genital area) with a disposable washcloth and clear water. Keep skin clean and dry on days you receive the infusion. Change occlusive dressings and do not cover your skin with tight clothing after receiving the infusion. Change wet and soiled diapers as soon as possible during the 12 hours after each infusion.

You may need frequent medical tests after you stop using this medicine.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your treosulfan injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving treosulfan?

Treosulfan may cause skin reactions. Avoid applying creams or wearing tight clothing on days you receive treosulfan.

What other drugs will affect treosulfan?

Other drugs may affect treosulfan, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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