BUSULFAN

Decreased Bone Marrow Function:  This medication decreases bone marrow function, an effect that may lead to a low number of blood cells such as red cells, white cells, and platelets. This effect can cause anemia, decrease your body’s ability to fight an infection, or cause you to bruise or bleed more easily. Tell your doctor immediately if you develop any of the following symptoms: signs of an infection (such as fever, chills, persistent sore throat), easy bruising/bleeding, pale skin, unusual tiredness.

Darkening skin or dry mouth may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Many people using this medication develop serious side effects. However, your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk.

Tell your doctor right away if you have any serious side effects, including:

• signs of liver disease (such as persistent nausea/vomiting, severe stomach/abdominal pain, yellowing skin/eyes, dark urine)
• seizures
• unusual/extreme tiredness
• painful urination
• toe/joint pain
• fainting
• fast/pounding heartbeat
• cloudy/blurred vision

This medication may affect the ovaries, possibly reducing fertility and causing hormone changes (such as missed menstrual periods). Talk to your doctor for more details.

This medication can decrease sperm production and shrink the testicles, effects that may lower male fertility. Talk to your doctor for more details.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Precautions

• Allergy: Before taking busulfan, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
• Medical History: Before using this medication, tell your doctor or pharmacist if you had: blood/bone marrow disorders (such as bone marrow suppression, neutropenia, thrombocytopenia, anemia), brain disorders (such as seizures, head injury).
• Infections: Busulfan can make you more likely to get infections or may worsen any current infections. Therefore, wash your hands well to prevent the spread of infection. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu).
• Immunizations: Do not have immunizations/vaccinations without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).
• In female children, this medication may prevent puberty. This medication may make it harder for females to become pregnant or for males to father children. Discuss with your doctor for more details.

Pregnancy Risk: Busulfan is not recommended for use during pregnancy. It may harm an unborn baby.

Breastfeeding:  It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

Interactions

• Some products that may interact with this drug include: acetaminophen, itraconazole, metronidazole, thioguanine.
• Also report the use of drugs which might increase seizure risk when combined with busulfan including tramadol, phenothiazines (such as thioridazine), theophylline, or tricyclic antidepressants (such as amitriptyline), among others. Consult your doctor or pharmacist for details.

Overdose

If overdose is suspected, contact a poison control center or emergency room immediately.

Symptoms of overdose include: easy bruising/bleeding, pale skin, unusual tiredness.

Notes: Do not share this medication with others.

Laboratory and/or medical tests (such as complete blood count, hematocrit/hemoglobin, liver function) must be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Missed Dose: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage: Store at room temperature at 77 degrees F (25 degrees C) away from light and moisture. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.