Myleran2mg
Type:Tablet
Generic Name:Busulphan
Manufacturer:
Price:৳10.30
Indication
Chronic myeloid leukaemia, Bone marrow transplantation, Polycythemia vera, Essential thrombocythemia,
Administration
May be taken with or without food. Take w/ chilled liqd, ensure adequate fluid intake.
Adult Dose
Oral Palliative treatment of chronic myeloid leukemia Adult: 60 mcg/kg daily. Maintenance: 0.5-2 mg daily. Max: 4 mg daily. Polycythemia vera Adult: 4-6 mg daily continued for 4-6 wk with blood counts monitoring. Essential thrombocythemia Adult: 2-4 mg daily. Conditioning regimens for bone marrow transplantation Adult: 3.5-4 mg/kg daily in divided doses for 4 days up to a total dose of 14-16 mg/kg. Usually used with cyclophosphamide for ablation of recipient's bone marrow.
Contraindication
Pregnancy and lactation. Hypersensitivity.
Mode of Action
Busulfan reacts with N-7 position of guanosine and interferes with DNA replication and RNA transcription by alkylating and cross-linking the DNA strands.
Precaution
Prior treatment with other myelosuppressive drugs, patients predisposed to seizures. May cause secondary malignancies (tumors, acute leukaemias, ovarian failure). Previous irradiation/therapy. Monitor blood counts carefully during therapy. Discontinue if lung toxicity develops.
Side Effect
GI symptoms, anorexia, wt loss, weakness, hyperpigmentation, amenorrhoea, cataracts, cough or hoarseness, impaired fertility and gonadal function, dry skin, liver damage, gynaecomastia. Potentially Fatal: Bone marrow depression manifesting as thrombocytopaenia, leucopaenia, anaemia. Interstitial pulmonary fibrosis (known as "busulfan lung" on prolonged treatment).
Interaction
Decreased clearance when used with cyclophosphamide and itraconazole. Increased clearance by phenytoin. May reduce response to vaccines, possibility of generalized infections with live vaccines. Combination with thioguanine results in oesophageal varices and abdominal liver function tests. Potentially Fatal: Cytotoxic agents may increase risk of pulmonary toxicity.