Myleran (Busulfan)

Busulfan, the active ingredient in Myleran, is an alkylating agent presented as a tablet for oral use. It is employed in the treatment of chronic myelogenous leukemia and as part of conditioning regimens for hematopoietic stem cell transplantation. GNH USA supplies Myleran as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, transplant centres, oncology centres and pharmacies worldwide.

Busulfan is an alkylating antineoplastic agent used in specific hematologic malignancies and transplant preparation.

Chronic myelogenous leukemia: provides disease control and facilitates remission in adult patients. Conditioning regimen for hematopoietic stem cell transplantation: creates myeloablation to enable successful engraftment of donor cells.

Busulfan may cause a range of adverse reactions, from mild to severe.

Common Side Effects: - Nausea and vomiting - Mucositis or oral ulceration - Skin rash or hyperpigmentation - Transient fever or chills

Serious or Rare Side Effects: - Hepatic veno‑occlusive disease (VOD) - Pulmonary fibrosis or interstitial pneumonitis - Seizures, especially at high plasma concentrations - Severe bone‑marrow suppression leading to infection or bleeding

Careful monitoring and patient counseling are essential when using Busulfan. - Monitor blood counts: perform regular CBCs to detect myelosuppression. - Assess liver function: check hepatic enzymes before and during therapy. - Avoid use in pregnancy: Busulfan is contraindicated in pregnant women (Category D). - Adjust dose in hepatic impairment: reduce dosage or increase interval as clinically indicated. - Provide anticonvulsant prophylaxis when high plasma levels are anticipated. - Store at ambient temperature: keep tablets in the original container, protect from moisture and direct sunlight.

Busulfan can interact with several drug classes, requiring vigilance.

Major Interactions (Avoid): - Concomitant use with other alkylating agents (e.g., cyclophosphamide) increases toxicity. - Co‑administration with azathioprine may exacerbate bone‑marrow suppression. - High‑dose cyclophosphamide together with Busulfan raises risk of hepatic VOD.

Moderate Interactions (Monitor Closely): - CYP2B6 inducers such as rifampin can lower Busulfan plasma levels. - Anticonvulsants like phenytoin may increase Busulfan clearance. - NSAIDs may heighten gastrointestinal irritation and bleeding risk.