General Information of Drug (ID: DMXYJ9C)

Drug Name
Busulfan
Synonyms
Busulfano; Busulfanum; Busulfex; Busulphan; Busulphane; Butanedioldimethanesulfonate; Buzulfan; Citosulfan; Glyzophrol; Leucosulfan; Mablin; Methanesulfonic; Mielevcin; Mielosan; Mielucin; Milecitan; Mileran; Misulban; Mitosan; Mitostan; Myeleukon; Myeloleukon; Myelosan; Myelosanum; Mylecytan; Myleran; Mylerlan; Sulfabutin; Sulphabutin; Busulfan GlaxoSmithKline Brand; Busulfan Orphan Brand; Busulfan Wellcome; Busulfan Wellcome Brand; Glaxo Wellcome Brand of Busulfan; GlaxoSmithKline Brand of Busulfan; Myleran tablets; Orphan Brand of Busulfan; Tetramethylene bis[methanesulfonate]; Tetramethylene dimethane sulfonate; Tetramethylenester kyseliny methansulfonove; Tetramethylenester kyseliny methansulfonove[Czech]; Wellcome Brand of Busulfan; AN 33501; CB 2041; GT 2041; GT 41; X 149; Acid, tetramethylene ester; Alkylating agent: crosslinks guanine residues; Busulfan [INN:JAN]; Busulfano [INN-Spanish]; Busulfanum [INN-Latin]; MYLERAN (TN); Methanesulfonic acid, tetram ethylene ester; Methanesulfonic acid, tetramethylene ester; Myleran (TN); Sulfabutin (VAN); Tetramethylene bis(methanesulfonate); Tetramethylene {bis[methanesulfonate]}; Wellcome, Busulfan; C.B. 2041; G.T. 41; Myleran, Busulfex, Busulfan; Busulfan (JP15/USP/INN); Butane-1,4-diyl dimethanesulfonate; BUSULFAN (1,4-BUTANEDIOL, DIMETHANESULFONATE); N-Butane-1,3-di(methylsulfonate); 1,4-BUTANEDIOL DIMETHANESULFONATE; 1,4-Bis(methanesulfonoxy)butane; 1,4-Bis(methanesulfonyloxy)butane; 1,4-Bis[methanesulfonoxy]butane; 1,4-Butanedi yl dimethanesulfonate; 1,4-Butanediol dimethanesulphonate; 1,4-Butanediol dimethylsulfonate; 1,4-Butanediol, dimethanesulfonate; 1,4-Butanediol, dimethanesulphonate; 1,4-Butanediyl dimethanesulfonate; 1,4-Di(methylsulfonoxy)butane; 1,4-Dimesyloxybutane; 1,4-Dimethane sulfonyl oxybutane; 1,4-Dimethanesulfonoxybutane; 1,4-Dimethanesulfonoxylbutane; 1,4-Dimethanesulfonyloxybutane; 1,4-Dimethanesulphonyloxybutane; 1,4-Dimethylsulfonoxybutane; 1,4-Dimethylsulfonyloxybutane; 1,{4-Bis[methanesulfonoxy]butane}; 4-((Methylsulfonyl)oxy)butyl methanesulfonate; 4-methylsulfonyloxybutyl methanesulfonate
Indication
Disease Entry ICD 11 Status REF
Chronic myelogenous leukaemia 2A20.0 Approved [1]
Hematologic disease 3C0Z Approved [1]
Immunodeficiency 4A00-4A85 Approved [1]
Leukemia N.A. Approved [1]
Myeloproliferative syndrome 2A22 Approved [2]
Systemic lupus erythematosus 4A40.0 Approved [1]
Systemic sclerosis 4A42 Approved [1]
Neuroblastoma 2D11.2 Investigative [1]
Retinoblastoma 2D02.2 Investigative [1]
⏷ Show the Full List of Indication(s)
Therapeutic Class
Anticancer Agents
Drug Type
Small molecular drug
Structure
3D MOL 2D MOL
#Ro5 Violations (Lipinski): 0 Molecular Weight (mw) 246.3
Logarithm of the Partition Coefficient (xlogp) -0.5
Rotatable Bond Count (rotbonds) 7
Hydrogen Bond Donor Count (hbonddonor) 0
Hydrogen Bond Acceptor Count (hbondacc) 6
ADMET Property
BDDCS Class
Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 1: high solubility and high permeability [3]
Bioavailability
70% of drug becomes completely available to its intended biological destination(s) [4]
Clearance
The drug present in the plasma can be removed from the body at the rate of 2.4 mL/min/kg [5]
Elimination
1% of drug is excreted from urine in the unchanged form [3]
Half-life
The concentration or amount of drug in body reduced by one-half in 2.6 hours [5]
Metabolism
The drug is metabolized via the hepatic []
MRTD
The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 0.232 micromolar/kg/day [6]
Unbound Fraction
The unbound fraction of drug in plasma is 1% [5]
Vd
Fluid volume that would be required to contain the amount of drug present in the body at the same concentration as in the plasma 0.55 L/kg [5]
Water Solubility
The ability of drug to dissolve in water is measured as 0.1 mg/mL [3]
Chemical Identifiers
Formula
C6H14O6S2
IUPAC Name
4-methylsulfonyloxybutyl methanesulfonate
Canonical SMILES
CS(=O)(=O)OCCCCOS(=O)(=O)C
InChI
InChI=1S/C6H14O6S2/c1-13(7,8)11-5-3-4-6-12-14(2,9)10/h3-6H2,1-2H3
InChIKey
COVZYZSDYWQREU-UHFFFAOYSA-N
Cross-matching ID
PubChem CID
2478
ChEBI ID
CHEBI:28901
CAS Number
55-98-1
DrugBank ID
DB01008
TTD ID
D07SUG
INTEDE ID
DR0249
ACDINA ID
D00085
Combinatorial Drugs (CBD) Click to Jump to the Detailed CBD Information of This Drug
Repurposed Drugs (RPD) Click to Jump to the Detailed RPD Information of This Drug

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
Human Deoxyribonucleic acid (hDNA) TTUTN1I NOUNIPROTAC Modulator [7]

Drug-Metabolizing Enzyme (DME)
DME Name DME ID UniProt ID MOA REF
Cytochrome P450 3A4 (CYP3A4) DE4LYSA CP3A4_HUMAN Substrate [8]
Glutathione S-transferase alpha-1 (GSTA1) DE4ZHS1 GSTA1_HUMAN Substrate [9]
Glutathione S-transferase pi (GSTP1) DEK6079 GSTP1_HUMAN Substrate [10]
Glutathione S-transferase mu-1 (GSTM1) DEYZEJA GSTM1_HUMAN Substrate [10]
Microsomal glutathione S-transferase 2 (MGST2) DE31KMQ MGST2_HUMAN Substrate [11]
Glutathione S-transferase alpha-2 (GSTA2) DEH49YS GSTA2_HUMAN Substrate [12]

Drug Off-Target (DOT)
DOT Name DOT ID UniProt ID Interaction REF
Antithrombin-III (SERPINC1) OTDFATG0 ANT3_HUMAN Gene/Protein Processing [13]
Aryl hydrocarbon receptor (AHR) OTFE4EYE AHR_HUMAN Gene/Protein Processing [14]
Caspase-3 (CASP3) OTIJRBE7 CASP3_HUMAN Gene/Protein Processing [15]
Caspase-8 (CASP8) OTA8TVI8 CASP8_HUMAN Gene/Protein Processing [16]
Cellular tumor antigen p53 (TP53) OTIE1VH3 P53_HUMAN Gene/Protein Processing [14]
Cyclic AMP-dependent transcription factor ATF-4 (ATF4) OTRFV19J ATF4_HUMAN Gene/Protein Processing [14]
Cyclin-dependent kinase inhibitor 1 (CDKN1A) OTQWHCZE CDN1A_HUMAN Gene/Protein Processing [17]
Cytochrome P450 1A1 (CYP1A1) OTE4EFH8 CP1A1_HUMAN Gene/Protein Processing [18]
DNA repair nuclease/redox regulator APEX1 (APEX1) OT53OI14 APEX1_HUMAN Drug Response [19]
Glutathione S-transferase A1 (GSTA1) OTA7K5XA GSTA1_HUMAN Drug Response [20]
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Busulfan
DDI Drug Name DDI Drug ID Severity Mechanism Disease REF
Nilotinib DM7HXWT Moderate Decreased metabolism of Busulfan caused by Nilotinib mediated inhibition of CYP450 enzyme. Myeloproliferative neoplasm [2A20] [21]
Omacetaxine mepesuccinate DMPU2WX Moderate Additive myelosuppressive effects by the combination of Busulfan and Omacetaxine mepesuccinate. Myeloproliferative neoplasm [2A20] [22]
Coadministration of a Drug Treating the Disease Different from Busulfan (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Dronedarone DMA8FS5 Moderate Decreased metabolism of Busulfan caused by Dronedarone mediated inhibition of CYP450 enzyme. Angina pectoris [BA40] [23]
Roflumilast DMPGHY8 Moderate Additive immunosuppressive effects by the combination of Busulfan and Roflumilast. Asthma [CA23] [24]
Ofloxacin DM0VQN3 Minor Decreased absorption of Busulfan due to intestinal mucosa variation caused by Ofloxacin. Bacterial infection [1A00-1C4Z] [25]
Sparfloxacin DMB4HCT Minor Decreased absorption of Busulfan due to intestinal mucosa variation caused by Sparfloxacin. Bacterial infection [1A00-1C4Z] [25]
Gemifloxacin DMHT34O Minor Decreased absorption of Busulfan due to intestinal mucosa variation caused by Gemifloxacin. Bacterial infection [1A00-1C4Z] [25]
Norfloxacin DMIZ6W2 Minor Decreased absorption of Busulfan due to intestinal mucosa variation caused by Norfloxacin. Bacterial infection [1A00-1C4Z] [25]
ABT-492 DMJFD2I Minor Decreased absorption of Busulfan due to intestinal mucosa variation caused by ABT-492. Bacterial infection [1A00-1C4Z] [25]
Levofloxacin DMS60RB Minor Decreased absorption of Busulfan due to intestinal mucosa variation caused by Levofloxacin. Bacterial infection [1A00-1C4Z] [25]
Lapatinib DM3BH1Y Moderate Decreased metabolism of Busulfan caused by Lapatinib mediated inhibition of CYP450 enzyme. Breast cancer [2C60-2C6Y] [26]
Ivacaftor DMZC1HS Moderate Decreased metabolism of Busulfan caused by Ivacaftor mediated inhibition of CYP450 enzyme. Cystic fibrosis [CA25] [27]
Stiripentol DMMSDOY Moderate Decreased metabolism of Busulfan caused by Stiripentol mediated inhibition of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [28]
Rufinamide DMWE60C Moderate Increased metabolism of Busulfan caused by Rufinamide mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [24]
Miconazole DMPMYE8 Moderate Decreased metabolism of Busulfan caused by Miconazole mediated inhibition of CYP450 enzyme. Fungal infection [1F29-1F2F] [24]
Boceprevir DMBSHMF Moderate Decreased metabolism of Busulfan caused by Boceprevir mediated inhibition of CYP450 enzyme. Hepatitis virus infection [1E50-1E51] [29]
Telaprevir DMMRV29 Moderate Decreased metabolism of Busulfan caused by Telaprevir mediated inhibition of CYP450 enzyme. Hepatitis virus infection [1E50-1E51] [30]
Etravirine DMGV8QU Moderate Increased metabolism of Busulfan caused by Etravirine mediated induction of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [31]
Teriflunomide DMQ2FKJ Major Additive myelosuppressive effects by the combination of Busulfan and Teriflunomide. Hyper-lipoproteinaemia [5C80] [32]
Denosumab DMNI0KO Moderate Additive immunosuppressive effects by the combination of Busulfan and Denosumab. Low bone mass disorder [FB83] [33]
Brigatinib DM7W94S Moderate Increased metabolism of Busulfan caused by Brigatinib mediated induction of CYP450 enzyme. Lung cancer [2C25] [34]
Dabrafenib DMX6OE3 Moderate Increased metabolism of Busulfan caused by Dabrafenib mediated induction of CYP450 enzyme. Melanoma [2C30] [24]
Thalidomide DM70BU5 Major Additive thrombogenic effects by the combination of Busulfan and Thalidomide. Multiple myeloma [2A83] [35]
Tecfidera DM2OVDT Moderate Additive immunosuppressive effects by the combination of Busulfan and Tecfidera. Multiple sclerosis [8A40] [36]
Siponimod DM2R86O Major Additive immunosuppressive effects by the combination of Busulfan and Siponimod. Multiple sclerosis [8A40] [37]
Fingolimod DM5JVAN Major Additive immunosuppressive effects by the combination of Busulfan and Fingolimod. Multiple sclerosis [8A40] [38]
Ocrelizumab DMEZ2KH Moderate Additive immunosuppressive effects by the combination of Busulfan and Ocrelizumab. Multiple sclerosis [8A40] [39]
Ozanimod DMT6AM2 Major Additive immunosuppressive effects by the combination of Busulfan and Ozanimod. Multiple sclerosis [8A40] [24]
Temsirolimus DMS104F Moderate Increased plasma concentrations of Busulfan and Temsirolimus due to competitive inhibition of the same metabolic pathway. Renal cell carcinoma [2C90] [40]
Gatifloxacin DMSL679 Minor Decreased absorption of Busulfan due to intestinal mucosa variation caused by Gatifloxacin. Respiratory infection [CA07-CA4Z] [25]
Canakinumab DM8HLO5 Moderate Additive immunosuppressive effects by the combination of Busulfan and Canakinumab. Rheumatoid arthritis [FA20] [41]
Rilonacept DMGLUQS Moderate Additive immunosuppressive effects by the combination of Busulfan and Rilonacept. Rheumatoid arthritis [FA20] [41]
Golimumab DMHZV7X Major Additive immunosuppressive effects by the combination of Busulfan and Golimumab. Rheumatoid arthritis [FA20] [42]
Anthrax vaccine DM9GSWY Moderate Antagonize the effect of Busulfan when combined with Anthrax vaccine. Sepsis [1G40-1G41] [43]
Armodafinil DMGB035 Minor Increased metabolism of Busulfan caused by Armodafinil mediated induction of CYP450 enzyme. Solid tumour/cancer [2A00-2F9Z] [44]
Valganciclovir DMS2IUH Moderate Additive myelosuppressive effects by the combination of Busulfan and Valganciclovir. Virus infection [1A24-1D9Z] [37]
⏷ Show the Full List of 34 DDI Information of This Drug

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG
DIG Name DIG ID PubChem CID Functional Classification
Beta-D-lactose E00099 6134 Diluent; Dry powder inhaler carrier; Lyophilization aid
Magnesium stearate E00208 11177 lubricant
Titanium dioxide E00322 26042 Coating agent; Colorant; Opacifying agent
Triacetin E00080 5541 Humectant; Plasticizing agent; Solvent
Pharmaceutical Formulation
Formulation Name Drug Dosage Dosage Form Route
Busulfan 2 mg tablet 2 mg Oral Tablet Oral
Jump to Detail Pharmaceutical Formulation Page of This Drug

References

1 Busulfan FDA Label
2 URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 7136).
3 BDDCS applied to over 900 drugs
4 Critical Evaluation of Human Oral Bioavailability for Pharmaceutical Drugs by Using Various Cheminformatics Approaches
5 Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
6 Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
7 DNA intrastrand cross-link at the 5'-GA-3' sequence formed by busulfan and its role in the cytotoxic effect. Cancer Sci. 2004 May;95(5):454-8.
8 Update: clinically significant cytochrome P-450 drug interactions. Pharmacotherapy. 1998 Jan-Feb;18(1):84-112.
9 Glutathione S-transferase M1 polymorphism: a risk factor for hepatic venoocclusive disease in bone marrow transplantation. Blood. 2004 Sep 1;104(5):1574-7.
10 Busulfan conjugation by glutathione S-transferases alpha, mu, and pi. Drug Metab Dispos. 1996 Sep;24(9):1015-9.
11 Overexpression of glutathione-S-transferase, MGSTII, confers resistance to busulfan and melphalan. Cancer Invest. 2005;23(1):19-25.
12 Endothelial cells do not express GSTA1: potential relevance to busulfan-mediated endothelial damage during haematopoietic stem cell transplantation. Eur J Haematol. 2008 Apr;80(4):299-302.
13 Decreased incidence of hepatic veno-occlusive disease and fewer hemostatic derangements associated with intravenous busulfan vs oral busulfan in adults conditioned with busulfan + cyclophosphamide for allogeneic bone marrow transplantation. Ann Hematol. 2005 May;84(5):321-30. doi: 10.1007/s00277-004-0982-4. Epub 2004 Dec 4.
14 Direct transcriptomic comparison of xenobiotic metabolism and toxicity pathway induction of airway epithelium models at an air-liquid interface generated from induced pluripotent stem cells and primary bronchial epithelial cells. Cell Biol Toxicol. 2023 Feb;39(1):1-18. doi: 10.1007/s10565-022-09726-0. Epub 2022 May 31.
15 Reduced expression of Rho guanine nucleotide dissociation inhibitor-alpha modulates the cytotoxic effect of busulfan in HEK293 cells. Anticancer Drugs. 2007 Mar;18(3):333-40. doi: 10.1097/CAD.0b013e328011fd7f.
16 Altered gene expression in busulfan-resistant human myeloid leukemia. Leuk Res. 2008 Nov;32(11):1684-97. doi: 10.1016/j.leukres.2008.01.016. Epub 2008 Mar 12.
17 Busulfan selectively induces cellular senescence but not apoptosis in WI38 fibroblasts via a p53-independent but extracellular signal-regulated kinase-p38 mitogen-activated protein kinase-dependent mechanism. J Pharmacol Exp Ther. 2006 Nov;319(2):551-60. doi: 10.1124/jpet.106.107771. Epub 2006 Aug 1.
18 Association of CYP1A1 and CYP1B1 inhibition in in vitro assays with drug-induced liver injury. J Toxicol Sci. 2021;46(4):167-176. doi: 10.2131/jts.46.167.
19 Impairment of APE1 function enhances cellular sensitivity to clinically relevant alkylators and antimetabolites. Mol Cancer Res. 2009 Jun;7(6):897-906. doi: 10.1158/1541-7786.MCR-08-0519. Epub 2009 May 26.
20 Overexpression of glutathione S-transferase A1-1 in ECV 304 cells protects against busulfan mediated G2-arrest and induces tissue factor expression. Br J Pharmacol. 2002 Dec;137(7):1100-6. doi: 10.1038/sj.bjp.0704972.
21 Product Information. Tasigna (nilotinib). Novartis Pharmaceuticals, East Hanover, NJ.
22 Product Information. Synribo (omacetaxine). Teva Pharmaceuticals USA, North Wales, PA.
23 Product Information. Multaq (dronedarone). sanofi-aventis , Bridgewater, NJ.
24 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
25 Johnson EJ, MacGowan AP, Potter MN, et al "Reduced absorption of oral ciprofloxacin after chemotherapy for haematological malignancy." J Antimicrob Chemother 25 (1990): 837-42. [PMID: 2373666]
26 Product Information. Tykerb (lapatinib). Novartis Pharmaceuticals, East Hanover, NJ.
27 Product Information. Kalydeco (ivacaftor). Vertex Pharmaceuticals, Cambridge, MA.
28 EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports.".
29 Product Information. Victrelis (boceprevir). Schering-Plough Corporation, Kenilworth, NJ.
30 Product Information. Incivek (telaprevir). Vertex Pharmaceuticals, Cambridge, MA.
31 Product Information. Intelence (etravirine). Ortho Biotech Inc, Bridgewater, NJ.
32 Product Information. Arava (leflunomide). Hoechst Marion-Roussel Inc, Kansas City, MO.
33 Product Information. Prolia (denosumab). Amgen USA, Thousand Oaks, CA.
34 Product Information. Alunbrig (brigatinib). Ariad Pharmaceuticals Inc, Cambridge, MA.
35 Bennett CL, Nebeker JR, Samore MH, et al "The Research on Adverse Drug Events and Reports (RADAR) project." JAMA 293 (2005): 2131-40. [PMID: 15870417]
36 Product Information. Vumerity (diroximel fumarate). Alkermes, Inc, Cambridge, MA.
37 Cerner Multum, Inc. "Australian Product Information.".
38 Product Information. Gilenya (fingolimod). Novartis Pharmaceuticals, East Hanover, NJ.
39 Product Information. Ocrevus (ocrelizumab). Genentech, South San Francisco, CA.
40 Product Information. Prograf (tacrolimus). Fujisawa, Deerfield, IL.
41 Product Information. Arcalyst (rilonacept). Regeneron Pharmaceuticals Inc, Tarrytown, NY.
42 Product Information. Cimzia (certolizumab). UCB Pharma Inc, Smyrna, GA.
43 CDC. Centers for Disease Control and Prevention/ "Recommendations of the advisory committtee on immunization practices (ACIP): use of vaccines and immune globulins in persons with altered immunocompetence." MMWR Morb Mortal Wkly Rep 42(RR-04) (1993): 1-18. [PMID: 20300058]
44 Doherty MM, Charman WN "The mucosa of the small intestine: how clinically relevant as an organ of drug metabolism?" Clin Pharmacokinet 41 (2002): 235-53. [PMID: 11978143]