Effectiveness of Tai Chi vs Cognitive Behavioural Therapy for Insomnia in Middle-Aged and Older Adults
November 27, 2025
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Brand Name :
Myleran
(United States) [Available] ,Busulfex
(United States) [Available]Synonyms :
Busulfan
Class :
Brand Name :
Myleran
(United States) [Available] ,Busulfex
(United States) [Available]Synonyms :
Busulfan
Class :
Adult dosingÂ
tabletÂ
2mgÂ
injectable solutionÂ
6mg/mLÂ
Chronic Myelogenous (Myeloid, Myelocytic, Granulocytic) LeukemiaÂ
Induction: 60 mcg/kg/day or 1.8 mg/m²; usually 4–8 mg orally once daily.Â
Maintenance: 1–4 mg daily or 2 mg weekly to keep WBC between 10,000–20,000/mmÂł.Â
Hold treatment if WBC drops to ~15,000/mmÂł.Â
Monitor monthly and restart induction when WBC rises to ~50,000/mmÂł.Â
IV Dosing (Transplant Conditioning):Â
Administer 0.8 mg/kg IV every 6 hours for 4 days (16 doses)Â
Until WBC reaches ~15,000/mmÂł or per protocolÂ
Safety and efficacy not establishedÂ
Refer adult dosingÂ
Interaction with busulfan can diminish the therapeutic effect of the vaccine. Live-attenuated Vaccines should be avoided for 3 months after ending immunosuppressive therapy.
Interaction with busulfan can diminish the therapeutic effect of the vaccine. Live-attenuated Vaccines should be avoided for 3 months after ending immunosuppressive therapy.
Interaction with busulfan can diminish the therapeutic effect of the vaccine. Live-attenuated Vaccines should be avoided for 3 months after ending immunosuppressive therapy.
May increase the immunosuppressive effect of tucatinib
May increase the immunosuppressive effect of tofacitinib
It may enhance the effect when combined with lonafarnib by affecting CYP3A4 metabolism
It may enhance the immunosuppressive effects when combined with idecabtagene vicleucel
may enhance the adverse effects of bone marrow suppression
may enhance the adverse effects of bone marrow suppression
may enhance the adverse effects of bone marrow suppression
Increased risk of myelosuppressive effects.
Increased risk of myelosuppressive effects.
Increased risk of myelosuppressive effects
Increased risk of myelosuppressive effects
Pharmacodynamic synergism may lead to toxicity of immunosuppressant and myelosupressant effects
increase the therapeutic effects of busulfan by inhibiting metabolism
increase the therapeutic effects of busulfan by inhibiting metabolism
increase the therapeutic effects of busulfan by inhibiting metabolism
may enhance the concentration of serum when combined with busulfan
When busulfan is used together with fluconazole, this leads to reduction in the busulfan metabolism
When busulfan is used together with capsaicin, this leads to enhanced risk or seriousness of methemoglobinemia
When busulfan is used together with andrographolide, this leads to enhanced risk or seriousness of bleeding
by pharmacodynamic antagonistic interaction, busulfan reduces the effectiveness of the influenza A (H5N1) vaccine
When busulfan is used together with oleandomycin, this leads to enhanced concentration serum of busulfan
When busulfan is used together with patupilone, this leads to enhanced concentration serum of busulfan
When busulfan is used together with ridaforolimus, this leads to enhanced concentration serum of busulfan
By synergism effects, the toxicity of the other drug increases.
when both drugs combine the risk of both drug increases the toxicity of other by synergism.
both drug toxicity increases by synergism action
 when thiotepa and busulfan combine, the toxicity of both drugs increases by synergism     
when both the drugs are combined, the risk or severity of adverse effects increases    
when both drugs are combined, the risk or severity of adverse effects increases  
it may enhance the serum concentration of busulfan
may increase the hepatotoxic effect of acetaminophen
decreases metabolism of busulfan and increases therapeutic effects
Inhibits the CYP3A4 metabolism of busulfan and increases the effect.
It may reduce the toxic effects of busulfan. (pharmacodynamic synergism)
It may reduce the toxic effects of busulfan. (pharmacodynamic synergism)
Busulfan undergoes hydrolysis to release methanesulfonate groups, forming carbonium ions. These reactive ions alkylate DNA, disrupting DNA replication and RNA transcription, ultimately impairing nucleic acid function and leading to cell death.Â
Primarily targets rapidly dividing hematopoietic cells, making it effective in treating chronic myeloid leukemia (CML) and as a conditioning agent for hematopoietic stem cell transplantation in hematologic malignancies.Â
1 % to 10 %
Frequent bone marrow suppression may require dose reduction or discontinuation; biopsy may be needed.Â
Stem cell transplant is crucial to prevent serious complications.Â
Ongoing monitoring is essential.Â
Should be used only under specialist oncology supervision.Â
ContraindicationsÂ
Known hypersensitivity or resistance to busulfanÂ
Patients without a confirmed diagnosis of chronic myeloid leukemia (CML)Â
CautionsÂ
Risk of bone marrow suppressionÂ
Seizures have been reported; start anticonvulsant prophylaxis before treatment and closely monitor patients with a history of seizures, head injury, or those on seizure-inducing medicationsÂ
Cardiac tamponade has been observed in children with thalassemia receiving busulfan plus cyclophosphamideÂ
Possible ovarian failureÂ
Risk of secondary cancersÂ
Antiemetics may be advised to reduce nausea and vomitingÂ
Category N: There is no data available for the drug under this category
PharmacologyÂ
Busulfan is an alkylating chemotherapeutic agent that interferes with cancer cell DNA by substituting alkyl groups for hydrogen atoms. This causes DNA cross-linking, which inhibits the transcription of DNA into RNA, leading to reduced protein synthesis and resulting in cytotoxic, mutagenic, and carcinogenic effects.Â
Specifically, busulfan undergoes hydrolysis of its two methanesulfonate groups, producing reactive carbonium ions. These ions form DNA intrastrand cross-links by binding to guanine bases, disrupting the DNA structure and function in cancer cells.Â
PharmacokineticsÂ
AbsorptionÂ
Oral absorption is variable and affected by factors like disease and age; IV formulation provides more consistent blood levels.Â
DistributionÂ
About 32% binds irreversibly to plasma proteins; crosses into cerebrospinal fluid, contributing to CNS effects.Â
MetabolismÂ
Mainly metabolized via glutathione conjugation and further liver oxidation.Â
Elimination/ExcretionÂ
Less than 2% is excreted unchanged in urine; metabolites include sulfolane and others. Clearance varies (~25%) and depends on infusion rate.Â
PharmacodynamicsÂ
Busulfan exerts its therapeutic effect by alkylating DNA, leading to the formation of DNA cross-links that inhibit DNA replication and RNA transcription. This disruption prevents cancer cells from synthesizing essential proteins, causing cell cycle arrest and ultimately cell death. Its cytotoxic activity primarily targets rapidly dividing hematopoietic cells, making it effective in treating certain leukemias and as a conditioning agent before stem cell transplantation. Additionally, busulfan’s interaction with cellular proteins and glutathione increases oxidative stress, further contributing to its anticancer effects.Â
IV administrationÂ
Dilute busulfan injection in normal saline (NS) or 5% dextrose (D5W) only; avoid other diluents. Use a dilution volume at least 10 times the concentrate to ensure a final concentration of ≥0.5 mg/mL. Administer as an intravenous infusion over 2 hours via a central venous catheter every 6 hours for 4 days (16 total doses). Do not give as a rapid IV push or bolus, and avoid simultaneous infusion of other drugs. Avoid using polycarbonate syringes for administration.Â
Generic Name: BusulfanÂ
Pronunciation: BYOO-sul-fanÂ
Busulfan is used for the treatment of chronic myelogenous leukemia as far. As the drug does not cure the disease but helps control the complications to improve the quality of life.
The medication is generally taken orally with or without meals once a day.
As the drug shows transdermal and intrapleural absorption, pregnant women must not inhale the dust of the tablets or take the medication.
The side effects may include skin darkening and dry mouth, which may also worsen.
Busulfan may also cause other types of cancer like acute leukemia.
To check on a missed dose, you must take the amount as soon as you remember and should not double the dose if the skipped dose is near the next dose.
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