Busulfan Side Effects

Medically reviewed by Drugs.com. Last updated on Dec 3, 2024.

Applies to busulfan: intravenous solution.

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep you or your sexual partner from getting pregnant during or after treatment. If you think you have become pregnant while using this medicine, tell your doctor right away.

Busulfan can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

This medicine may cause hepatic veno-occlusive disease (HVOD). This usually occurs if you receive too much busulfan, or receive this medicine before radiation treatment, or have a prior progenitor cell transplant. Call your doctor right away if you have a bloated abdomen or stomach, upper right abdominal or stomach pain, weight gain, or yellow eyes or skin.

While you are being treated with busulfan, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Busulfan may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Before you have any medical tests, tell the medical doctor in charge that you are using this medicine. The results of some body tissue studies may be affected by this medicine.

Talk with your doctor before using this medicine if you plan to have children. Some men who use this medicine have become infertile (unable to have children).

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects of busulfan

Along with its needed effects, busulfan may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking busulfan:

Other side effects of busulfan

Some side effects of busulfan may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to busulfan: intravenous solution, oral tablet.

Hematologic adverse events

• Very common (10% or more): Prolonged myelosuppression (i.e., severe granulocytopenia, leukopenia, thrombocytopenia, anemia, or any combination thereof) (100%)
• Rare (less than 0.1%): Aplastic anemia
• Frequency not reported: Prolonged prothrombin time
• Postmarketing reports: Febrile neutropenia^[Ref]

Respiratory

• Very common (10% or more): Rhinitis (44%), lung disorder (34%), cough (28%), epistaxis (25%), dyspnea (25%)
• Rare (less than 0.1%): Bronchopulmonary dysplasia
• Frequency not reported: Pneumonia, hyperventilation, alveolar hemorrhage, pharyngitis, hiccup, asthma, atelectasis, pleural effusion, hypoxia, hemoptysis, sinusitis, interstitial fibrosis^[Ref]

Cardiovascular

• Very common (10% or more): Tachycardia (44%), hypertension (36%), chest pain (26%), vasodilation (25%)
• Common (1% to 10%): Cardiac tamponade in patients with thalassemia (at high doses)
• Frequency not reported: Arrhythmia, atrial fibrillation, ventricular extrasystoles, third degree heart block, thrombosis (all episodes were associated with the central venous catheter), hypotension, flushing and hot flashes, cardiomegaly, ECG abnormality, left-sided heart failure, pericardial effusion, cardiac tamponade
• Postmarketing reports: Thrombotic microangiopathy (TMA)^[Ref]

Ocular

• Rare (less than 0.1%): Lens disorder and cataract (which may be bilateral), corneal thinning (reported after bone marrow transplantation preceded by high-dose therapy)^[Ref]

Dermatologic

• Very common (10% or more): Rash (57%), pruritus (28%)
• Common (1% to 10%): Alopecia^[Ref]

Metabolic

• Very common (10% or more): Hypomagnesemia (77%), hyperglycemia (66%), hypokalemia (64%), hypocalcemia (49%), hyperbilirubinemia (49%), edema (36%), serum glutamic pyruvic transaminase (SGPT) elevation (31%), creatinine increased (21%)
• Frequency not reported: Hypervolemia, hypophosphatemia, hyponatremia^[Ref]

Hepatic

• Very common (10% or more): SGPT Elevation
• Common (1% to 10%): Hepatic veno-occlusive disease (HVOD)
• Rare (less than 0.1%): Jaundice, abnormal hepatic function, biliary fibrosis
• Frequency not reported: Alkaline phosphatase increase, jaundice, hepatomegaly^[Ref]

Nervous system

• Very common (10% or more): Headache (69%), asthenia (51%), dizziness (30%)
• Common (1% to 10%): Seizures
• Very rare (less than 0.01%): Myasthenia gravis
• Frequency not reported: Cerebral hemorrhage, coma, delirium, agitation, encephalopathy, confusion, hallucinations, lethargy, somnolence^[Ref]

Oncologic

• Common (1% to 10%): Neoplasms benign, malignant, and unspecified (including cysts and polyps)
• Postmarketing reports: Tumor lysis syndrome, cellular dysplasia^[Ref]

Genitourinary

• Very rare (less than 0.01%): Gynecomastia
• Frequency not reported: Dysuria, oliguria, hematuria, hemorrhagic cystitis^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (98%), stomatitis (mucositis) (97%), vomiting (95%), anorexia (85%), diarrhea (84%), abdominal pain (72%), dyspepsia (44%), dry mouth (26%), rectal disorder (25%), abdominal enlargement (23%)
• Frequency not reported: Esophagitis, ileus, hematemesis, pancreatitis, rectal discomfort
• Postmarketing reports: Tooth hypoplasia^[Ref]

Musculoskeletal

• Very common (10% or more): Chills (46%), back pain (23%)
• Frequency not reported: Myalgia, arthralgia^[Ref]

Immunologic

• Frequency not reported: Graft-versus-host disease
• Postmarketing reports: Severe bacterial, viral (e.g., cytomegalovirus viremia), fungal infections, sepsis^[Ref]

Hypersensitivity

• Very common (10% or more): Allergic reaction (26%)^[Ref]

Local

• Very common (10% or more): Injection site inflammation (25%)
• Frequency not reported: Injection site pain^[Ref]

Renal

• Frequency not reported: Blood urea nitrogen (BUN) increased^[Ref]

See also:

Further information

Busulfan side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

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