Busulfan/Selected Azole Antifungals; Levoketoconazole Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Antifungal medicines or levoketoconazole may slow down how quickly your body processes busulfan.

What might happen:

The amount of busulfan in your blood may increase and cause more side effects than expected.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Be sure to keep all laboratory appointments. Let your doctor know if you develop any signs of an infection such as fever, chills, persistent sore throat; easy bruising or bleeding; unusual tiredness or fatigue; or abdominal pain.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Buggia I, Zecca M, Alessandrino EP, Locatelli F, Rosti G, Bosi A, Pession A, Rotoli B, Majolino I, Dallorso A, Regazzi MB. Itraconazole can increase systemic exposure to busulfan in patients given bone marrow transplantation. GITMO (Gruppo Italiano Trapianto di Midollo Osseo). Anticancer Res 1996 Jul-Aug;16(4A):2083-8.
  • 2.Nizoral (ketoconazole oral) US prescribing information. Janssen Pharmaceuticals February, 2014.
  • 3.Busulfex (busulfan) US prescribing information. Otsuka America Pharmaceutical, Inc. November, 2022.
  • 4.Myleran (busulfan) US prescribing information. GlaxoSmithKline February, 2005.
  • 5.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and- drug-interactions-table-substrates-inhibitors-and-inducers. Updated 11/14/2017.
  • 6.Palmer J, McCune JS, Perales MA, Marks D, Bubalo J, Mohty M, Wingard JR, Paci A, Hassan M, Bredeson C, Pidala J, Shah N, Shaughnessy P, Majhail N, Schriber J, Savani BN, Carpenter PA. Personalizing busulfan-based conditioning: considerations from the American Society for Blood and Marrow Transplantation Practice Guidelines Committee. Biol Blood Marrow Transplant 2016;1915-1925.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.