Busulfan

Busulfan

Clinical data
Trade names	Myleran
AHFS/Drugs.com	Monograph
MedlinePlus	a682248
License data	US FDA: Busulfan
Pregnancy category	AU: D US: D (Evidence of risk)
Routes of administration	By mouth, intravenous
ATC code	L01AB01 (WHO)
Legal status
Legal status	AU: S4 (Prescription only) CA: ℞-only UK: POM (Prescription only) US: ℞-only
Pharmacokinetic data
Bioavailability	60–80% (oral)
Protein binding	32.4%
Metabolism	Liver
Biological half-life	2.5 hours
Excretion	Urine (25–60%)
Identifiers
IUPAC name Butane-1,4-diyl dimethanesulfonate
Synonyms	1,4-butanediol dimethanesulfonate
CAS Number	55-98-1 Y
PubChem CID	2478
IUPHAR/BPS	7136
DrugBank	DB01008 Y
ChemSpider	2384 Y
UNII	G1LN9045DK
KEGG	D00248 Y
ChEBI	CHEBI:28901 Y
ChEMBL	CHEMBL820 Y
ECHA InfoCard	100.000.228
Chemical and physical data
Formula	C6H14O6S2
Molar mass	246.304 g/mol
3D model (Jmol)	Interactive image
SMILES O=S(=O)(OCCCCOS(=O)(=O)C)C
InChI InChI=1S/C6H14O6S2/c1-13(7,8)11-5-3-4-6-12-14(2,9)10/h3-6H2,1-2H3 Y Key:COVZYZSDYWQREU-UHFFFAOYSA-N Y

Busulfan (Myleran, GlaxoSmithKline, Busulfex IV, Otsuka America Pharmaceutical, Inc.) is a cancer drug, in use since 1959.

Busulfan is a cell cycle non-specific alkylating antineoplastic agent, in the class of alkyl sulfonates. Its chemical designation is 1,4-butanediol dimethanesulfonate.

Busulfan was approved by the US Food and Drug Administration (FDA) for treatment of chronic myeloid leukemia (CML) in 1999. Busulfan was the mainstay of the chemotherapeutic treatment of chronic myeloid leukemia (CML) until it was displaced by the new gold standard, imatinib, though it is still in use to a degree as a result of the drug's relative low cost.

Busulfan is used in pediatrics and adults in combination with cyclophosphamide or fludarabine/clofarabine as a conditioning agent prior to bone marrow transplantation, especially in chronic myelogenous leukemia (CML) and other leukemias, lymphomas, and myeloproliferative disorders. Busulfan can control tumor burden but cannot prevent transformation or correct cytogenic abnormalities.

The drug was recently used in a study to examine the role of platelet-transported serotonin in liver regeneration.

Myleran is supplied in white film coated tablets with 2 mg of busulfan per tablet. After 2002, a great interest has appeared for intravenous presentations of busulfan. Busulfex is supplied as an intravenous solution with 6 mg/ml busulfan. Busulfex has proved equally effective as oral busulfan, with presumedly less toxic side effects. Pharmacokinetic and dynamic studies support this use, that has prompted its usage in transplantation regimes, particularly in frail patients. Fludarabine + busulfan is a typical example of this use.