WARNING

Myleran is a brand name for the drug busulfan, which is used to treat certain types of cancer, particularly chronic myeloid leukemia (CML) and as part of conditioning regimens for bone marrow transplantation. While Myleran can be effective in treating these conditions, it also comes with certain risks and potential side effects that should be carefully considered:

• Bone Marrow Suppression: Myleran can cause bone marrow suppression, leading to a decrease in the production of blood cells (red blood cells, white blood cells, and platelets). This can result in anemia, increased susceptibility to infections, and a higher risk of bleeding.
• Increased Risk of Infections: Due to bone marrow suppression, the body’s ability to fight infections is compromised. Patients taking Myleran may be more susceptible to infections, and these infections can be severe.
• Gastrointestinal Issues: Myleran can cause nausea, vomiting, and diarrhea, which can be bothersome and lead to dehydration and electrolyte imbalances.
• Pulmonary Toxicity: There have been reports of lung problems associated with Myleran treatment, including interstitial pulmonary fibrosis, which is a potentially serious condition affecting the lungs.
• Secondary Cancers: Long-term use of Myleran has been linked to an increased risk of developing secondary cancers, such as acute leukemia.
• Infertility and Birth Defects: Myleran can affect fertility in both men and women. It is essential for patients to discuss family planning options before starting treatment. The drug may also cause birth defects if used during pregnancy.
• Liver Toxicity: Myleran can cause liver problems, including liver function abnormalities, so regular monitoring of liver function is necessary during treatment.
• Skin Reactions: Some patients may experience skin reactions, such as rash or hyperpigmentation.
• Hematologic Malignancies: In rare cases, Myleran itself has been associated with the development of secondary hematologic malignancies.
• Drug Interactions: Myleran may interact with other medications, potentially affecting their efficacy or causing adverse effects.

It’s crucial for patients considering or currently taking Myleran to have a thorough discussion with their oncologist or healthcare provider about the potential risks, benefits, and appropriate monitoring during treatment. This allows for informed decision-making and personalized care to optimize treatment outcomes.

Why is this medication prescribed?

Myleran, also known by its generic name busulfan, is prescribed for specific medical conditions, primarily to treat chronic myeloid leukemia (CML) and as part of conditioning regimens for bone marrow transplantation. Let’s delve into each indication:

• Chronic Myeloid Leukemia (CML): Myleran is used in the treatment of CML, a type of cancer that affects the bone marrow and blood. It is classified as a “chemotherapeutic” agent, which means it works by slowing or stopping the growth of cancer cells. Myleran is typically used when other treatments, such as targeted therapies or tyrosine kinase inhibitors, have not been effective or are not suitable for the patient.
• Bone Marrow Transplantation: Myleran is used as part of a conditioning regimen before a bone marrow or stem cell transplantation. This is done to suppress the recipient’s immune system and prepare the body to accept the donor’s healthy stem cells or bone marrow. The transplantation is often performed in patients with certain types of leukemia, lymphoma, or other disorders that affect the bone marrow.

How should this medicine be used?

Myleran is usually administered orally in the form of tablets. The dosing and treatment schedule may vary depending on the specific medical condition being treated and individual patient factors. It’s essential to follow the instructions provided by the prescribing doctor or healthcare team. Here are some general guidelines:

• Dosage: The dosage of Myleran is determined based on the patient’s body weight, overall health, and the specific indication for treatment. The dose may be adjusted over time to achieve the best therapeutic effect while minimizing side effects.
• Timing: Myleran is typically taken once daily, either in a single dose or divided into multiple doses throughout the day. Again, the exact schedule will be determined by the healthcare provider.
• Duration: The duration of Myleran treatment will depend on the patient’s response to the medication and the overall treatment plan. It may be used for a specific period as part of a conditioning regimen for transplantation, or it may be used long-term for CML treatment.
• Monitoring: Regular medical check-ups and blood tests are essential during Myleran treatment to monitor its effectiveness and assess for any potential side effects or complications.
• Compliance: It is crucial to take Myleran exactly as prescribed, at the same time each day, and not to miss any doses. Compliance with the prescribed regimen can significantly impact treatment outcomes.

As with any medication, patients should inform their healthcare provider about any other medications, supplements, or medical conditions they have, as these factors can influence the safety and efficacy of Myleran treatment. Additionally, patients should report any concerning side effects or symptoms experienced during treatment promptly, to ensure appropriate management and adjustments to the treatment plan if necessary.

Other uses for this medicine

• Myleran’s primary use is in the treatment of chronic myeloid leukemia (CML) and as part of conditioning regimens before bone marrow transplantation.
• It is essential to note that Myleran is not a medication that should be used without a doctor’s prescription. The use of Myleran for conditions other than those approved by healthcare professionals is not recommended and could be dangerous.

What special precautions should I follow?

Special Precautions for Myleran:

When taking Myleran, certain precautions should be observed to ensure safe and effective use of the medication. Here are some important considerations:

• Medical History: Before starting Myleran, inform your healthcare provider of any pre-existing medical conditions, especially liver or kidney problems, lung disorders, previous cancer treatments, or a history of blood disorders.
• Pregnancy and Breastfeeding: Myleran should not be used during pregnancy, as it can cause harm to the developing fetus. It is also not recommended for breastfeeding mothers due to the potential risk to the nursing infant.
• Fertility: Myleran can affect fertility in both men and women. Patients should discuss family planning options with their healthcare provider before starting treatment.
• Infections: Myleran can weaken the immune system, making the body more susceptible to infections. Avoid close contact with people who have contagious illnesses, and inform your doctor promptly if you develop any signs of infection.
• Blood Tests: Regular blood tests are necessary to monitor blood cell counts and assess for bone marrow suppression and other potential side effects.
• Drug Interactions: Inform your healthcare provider about all medications, supplements, and herbal products you are taking to avoid potential interactions with Myleran.
• Sun Exposure: Myleran may increase sensitivity to sunlight. Limit sun exposure and use appropriate sun protection while on the medication.
• Liver Function: Myleran can affect liver function. Regular monitoring of liver enzymes is necessary during treatment.
• Lung Function: Myleran can cause lung problems in some individuals. If you experience new or worsening respiratory symptoms, notify your healthcare provider immediately.
• Proper Disposal: Take appropriate precautions for the proper disposal of Myleran tablets, following the guidelines provided by your healthcare provider or pharmacist.

Always follow your doctor’s instructions carefully and promptly report any concerning side effects or symptoms while taking Myleran. Adherence to these precautions can help ensure the safe and effective use of the medication.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Myleran use. However, it’s always a good idea to maintain a balanced and nutritious diet to support your overall health and well-being during cancer treatment.

What should I do if I forget a dose?

If you miss a dose of Myleran, it’s essential to take the missed dose as soon as you remember, unless it’s almost time for the next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for the missed one.

What side effects can this medication cause?

Myleran (busulfan) can cause several side effects, some of which can be common, while others are less frequent but more severe. It’s important to note that not all individuals will experience these side effects, and the severity and occurrence may vary from person to person. If you are prescribed Myleran, your healthcare provider will closely monitor you for any side effects and adjust the treatment as needed. Here are some of the possible side effects of Myleran:

Common Side Effects:

• Nausea and vomiting
• Diarrhea
• Mouth sores or ulcers
• Loss of appetite
• Fatigue or weakness
• Skin rash or itching
• Hair loss
• Abdominal pain
• Headache
• Fever or chills
• Muscle or joint pain

Less Common but More Serious Side Effects:

• Bone marrow suppression: Myleran can reduce the production of blood cells in the bone marrow, leading to anemia, increased risk of infections, and easy bleeding or bruising.
• Lung problems: Rarely, Myleran can cause lung issues, including interstitial pulmonary fibrosis, which can result in difficulty breathing and requires immediate medical attention.
• Liver toxicity: Myleran can affect liver function, leading to elevated liver enzymes or liver damage.
• Infertility: Myleran can cause temporary or permanent infertility in both men and women.
• Increased risk of secondary cancers: Long-term use of Myleran has been associated with an increased risk of developing secondary cancers, such as acute leukemia.
• Graft-versus-host disease (GVHD): In the context of bone marrow transplantation, Myleran is used as part of the conditioning regimen to suppress the recipient’s immune system. This can increase the risk of GVHD, a condition where the transplanted cells attack the recipient’s tissues.
• Teratogenic effects: Myleran can cause harm to a developing fetus, so it is essential to avoid pregnancy during treatment.

It’s important to report any new or worsening symptoms to your healthcare provider promptly, as they can indicate potential side effects or complications requiring medical attention. Your healthcare team will monitor you closely throughout the treatment to manage any side effects and adjust the dosage or treatment plan if necessary.

This list of side effects is not exhaustive, and other rare or unexpected reactions may occur. Always follow your healthcare provider’s advice and inform them of any pre-existing medical conditions or medications you are taking to ensure safe and appropriate use of Myleran.

What should I know about storage and disposal of this medication?

Storage and Disposal of Myleran:

• Storage: Store Myleran tablets at room temperature, away from direct sunlight, heat, and moisture. Follow the specific storage instructions provided by your pharmacist or on the medication packaging.
• Keep Out of Reach: Ensure that Myleran is kept out of reach of children and pets to prevent accidental ingestion.
• Original Packaging: Keep the tablets in their original packaging or a properly labeled container to avoid confusion with other medications.
• Do Not Use Expired Medication: Do not use Myleran if it has expired. Properly dispose of expired or unused medication according to local regulations.
• Special Handling: Some medications require special handling or disposal instructions. Check with your pharmacist or healthcare provider to see if any special precautions apply to Myleran.

In case of emergency/overdose

If you suspect an overdose of Myleran or experience severe reactions, seek immediate medical attention or contact your local poison control center. Overdosing on Myleran can lead to serious health complications, and prompt medical intervention is essential.

What other information should I know

• Compliance: Take Myleran exactly as prescribed by your healthcare provider. Do not adjust the dosage or stop taking the medication without consulting your doctor.
• Medical Check-ups: Regular medical check-ups and blood tests are crucial during Myleran treatment to monitor your response to the medication and detect any potential side effects.
• Avoid Pregnancy: Myleran can cause harm to a developing fetus, so it’s essential to avoid pregnancy during treatment. Use reliable contraception as recommended by your healthcare provider.
• Inform Healthcare Providers: Inform all healthcare providers, including dentists and specialists, that you are taking Myleran, as it may interact with other medications or treatments.
• Sun Exposure: Myleran can increase sensitivity to sunlight. Protect your skin from excessive sun exposure and use sunscreen.
• Supportive Care: Your healthcare provider may recommend additional medications or supportive care measures to manage side effects and improve your comfort during treatment.
• Travel: If you plan to travel, make sure you have an adequate supply of Myleran and any other necessary medications.
• Patient Assistance Programs: If the cost of Myleran is a concern, inquire about patient assistance programs that may help with medication expenses.
• Follow-up: Attend all scheduled follow-up appointments to assess your progress and discuss any concerns with your healthcare provider.

Always communicate openly with your healthcare team about any questions or issues you may have during Myleran treatment. Adhering to your treatment plan and keeping your medical team informed will optimize the effectiveness and safety of your therapy.