Take this medicine only as directed by your doctor. Do not take more or less of it, and do not take it more often than your doctor ordered. The exact amount of medicine you need has been carefully worked out. Taking too much may increase the chance of side effects, while taking too little may not improve your condition.

Take each dose at the same time each day to make sure it has the best effect.

While you are taking this medicine, your doctor may want you to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well.

This medicine sometimes causes nausea and vomiting. However, it is very important that you continue to use the medicine, even if you begin to feel ill. Do not stop taking this medicine without first checking with your doctor. Ask your health care professional for ways to lessen these effects.

If you vomit shortly after taking a dose of busulfan, check with your doctor. You will be told whether to take the dose again or to wait until the next scheduled dose.

Dosing

The dose of busulfan will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient's weight, and whether or not other medicines are also being taken. If you are taking busulfan at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of busulfan, ask your doctor.

Missed dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For busulfan, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to busulfan.

Pregnancy Although only one case has been reported, there is a chance that this medicine may cause birth defects if either the male or the female is taking it at the time of conception or if it is taken during pregnancy. In addition, many cancer medicines may cause sterility which could be permanent. Sterility may occur with busulfan and the possibility should be kept in mind.

Be sure that you have discussed this with your doctor before taking this medicine. It is best to use some kind of birth control while you are taking busulfan. Tell your doctor right away if you think you have become pregnant while taking busulfan.

Breast-feeding It is not known whether busulfan passes into breast milk. However, because this medicine may cause serious side effects, breast-feeding is generally not recommended while you are taking it.

Children Although there is no specific information comparing use of busulfan in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults.

Older adults Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of busulfan in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When taking busulfan it is especially important that your health care professional know if you are taking any of the following:

• Acetaminophen (e.g., Tylenol) or
• Acyclovir (e.g., Zovirax) or
• Amphotericin B by injection (e.g., Fungizone) or
• Anticonvulsants (seizure medicine) or
• Antidiabetics, oral (diabetes medicine you take by mouth) or
• Anti-infectives by mouth or by injection ( medicine for infection) or
• Antineoplastics (cancer medicine) or
• Antipsychotics (medicine for mental illness) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Captopril (e.g., Capoten) or
• Carbamazepine (e.g., Tegretol) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Cyclophosphamide (e.g., Cytoxan)
• Enalapril (e.g., Vasotec) or
• Flecainide (e.g., Tambocor) or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Gold salts (medicine for arthritis) or
• Imipenem and Cilastatin (e.g., Primaxin) or
• Inflammation or pain medicine, except narcotics or
• Interferon (e.g., Intron A, Roferon-A) or
• Itraconazole (e.g., Sporanox) or
• Lisinopril (e.g., Prinivil, Zestril) or
• Maprotiline (e.g., Ludiomil) or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Rheumatrex) or
• Penicillamine (e.g., Cuprimine) or
• Pimozide (e.g., Orap) or
• Plicamycin (e.g., Mithracin) or
• Procainamide (e.g., Pronestyl) or
• Promethazine (e.g., Phenergan) or
• Ramipril (e.g., Altace) or
• Sulfasalazine (e.g., Azulfidine) or
• Tocainide (e.g., Tonocard) or
• Tricyclic antidepressants (medicine for depression) or
• Trimeprazine (e.g., Temaril) or
• Zidovudine (e.g., AZT, Retrovir) or
• If you have ever been treated with radiation or cancer medicines Busulfan may increase the effects of these medicines or radiation therapy on the blood

• Probenecid (e.g., Benemid) or
• Sulfinpyrazone (e.g., Anturane) Busulfan may raise the amount of uric acid in the blood. Since these medicines are used to lower uric acid levels, they may not be as effective in patients taking busulfan

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles) Risk of severe disease affecting other parts of the body

• Gout (history of) or
• Kidney stones (or history of) Busulfan may increase levels of uric acid in the body, which can cause gout or kidney stones

• Head injury or
• Convulsions (seizures, history of) Busulfan injection and very high doses of oral busulfan can cause convulsions (seizures)

• Infection Busulfan may decrease your body's ability to fight infection
• Thalassemia Busulfan may cause increased pressure within the heart in children