Drug interactions
Busulfan + Cyclophosphamide
Severity: Major
Busulfan and Cyclophosphamide: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both agents are myelosuppressive alkylators, and together they markedly increase marrow toxicity. Busulfan given shortly before cyclophosphamide may also alter cyclophosphamide metabolism and increase hepatic toxicity such as veno-occlusive disease.
What this interaction means in plain words
Busulfan and Cyclophosphamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Busulfan belongs to Oncology; Cyclophosphamide belongs to Oncology.
Why it happens
Additive myelosuppression, with busulfan depleting glutathione and competing for hepatic metabolism of cyclophosphamide.
What to do
Use only in planned regimens with established sequencing and doses, and monitor blood counts and liver function closely. Allow an interval between busulfan and cyclophosphamide as specified in the protocol.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Cyclophosphamide
Other interactions of Busulfan
- Busulfan + Carboplatin Major
- Busulfan + Chlorambucil Major
- Busulfan + Fingolimod Major
- Busulfan + Hydroxyurea Major
- Busulfan + Ifosfamide Major
- Busulfan + Itraconazole Major
Frequently asked questions
Can I take Busulfan with Cyclophosphamide?
MediHelp rates the interaction as major. Busulfan and Cyclophosphamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both agents are myelosuppressive alkylators, and together they markedly increase marrow toxicity. Busulfan given shortly before cyclophosphamide may also alter cyclophosphamide metabolism and increase hepatic toxicity such as veno-occlusive disease.
How serious is the interaction between Busulfan and Cyclophosphamide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use only in planned regimens with established sequencing and doses, and monitor blood counts and liver function closely. Allow an interval between busulfan and cyclophosphamide as specified in the protocol.
What other medicines interact with Cyclophosphamide?
MediHelp also lists interactions of Cyclophosphamide with, for example, Adenovirus types 4 and 7 live, Belatacept, Bendamustine. The full list is on the Cyclophosphamide page.
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