IV Busulfex Dosage/Direction for Use

Initial Dosing Information: Administer Busulfan (IV Busulfex) in combination with cyclophosphamide as a conditioning regimen prior to bone marrow or peripheral blood progenitor cell replacement. For patients weighing more than 12 kg, the recommended doses are: Busulfan (IV Busulfex) 0.8 mg per kg (ideal body weight or actual body weight, whichever is lower) intravenously via a central venous catheter as a two-hour infusion every six hours for four consecutive days for a total of 16 doses (Days -7, 6, -5 and -4); Cyclophosphamide 60 mg per kg intravenously as a one-hour infusion on each of two days beginning no sooner than six hours following the 16th dose of Busulfan (IV Busulfex) (Days -3 and -2); Administer hematopoietic progenitor cells on Day 0.
Premedicate patients with anticonvulsants (e.g., benzodiazepines, phenytoin, valproic acid or levetiracetam) to prevent seizures reported with the use of high dose Busulfan (IV Busulfex). Administer anticonvulsants 12 hours prior to Busulfan (IV Busulfex) to 24 hours after the last dose of Busulfan (IV Busulfex) (see Seizures under Precautions).
Administer antiemetics prior to the first dose of Busulfan (IV Busulfex) and continue on a fixed schedule through Busulfan (IV Busulfex) administration.
Busulfan (IV Busulfex) clearance is best predicted when the Busulfan (IV Busulfex) dose is administered based on adjusted ideal body weight. Dosing Busulfan (IV Busulfex) based on actual body weight, ideal body weight or other factors can produce significant differences in Busulfan (IV Busulfex) clearance among lean, normal and obese patients.
Calculate ideal body weight (IBW) as follows (height in cm, and weight in kg):
Men: IBW (kg)=50+0.91x (height in cm -152); Women: IBW (kg)=45+0.91x (height in cm -152).
For obese or severely obese patients, base Busulfan (IV Busulfex) dosing on adjusted ideal body weight (AIBW): AIBW= IBW +0.25x (actual weight -IBW).