Busulfan and Cyclophosphamide interaction
Busulfan and Cyclophosphamide: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Busulfan (MYLERAN) label · effective 2025-01-08
Hepatic veno-occlusive disease, which may be life threatening, has been reported in patients receiving busulfan, usually in combination with cyclophosphamide or other chemotherapeutic agents prior to bone marrow transplantation.
A reduced incidence of hepatic veno-occlusive disease and other regimen-related toxicities have been observed in patients treated with high-dose MYLERAN and cyclophosphamide when the first dose of cyclophosphamide has been delayed for >24 hours after the last dose of busulfan (see CLINICAL PHARMACOLOGY and Drug Interactions).
Cardiac tamponade has been reported in a small number of patients with thalassemia (2% in one series) who received busulfan and cyclophosphamide as the preparatory regimen for bone marrow transplantation.
From the Cyclophosphamide (Frindovyx) label · effective 2026-08-26
A cytoreductive regimen in preparation for bone marrow transplantation that consists of cyclophosphamide in combination with whole-body irradiation, busulfan, or other agents has been identified as a major risk factor.
…Indomethacin: Acute water intoxication has been reported with concomitant use of indomethacin Increase in other toxicities: ● Azathioprine: Increased risk of hepatotoxicity (liver necrosis) ● Busulfan: Increased incidence of hepatic veno-occlusive disease and mucositis has been reported. ● Protease inhibitors: Increased incidence of mucositis Increased risk of hemorrhagic…
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.