Drug Interaction between Metronidazole and Busulfan

Metronidazole (Flagyl) is a nitroimidazole used as an antibiotic and antiprotozoal medication.
Busulfan is a cell cycle non-specific alkylating antineoplastic agent used in the management of leukemias, lymphomas and other myeloproliferative disorders.

The concomitant use of both Metronidazole and Busulfan can lead to a major drug interaction. This is because Metronidazole (Flagyl) has been known to significantly increase the plasma concentrations of Busulfan. The mechanism of action is currently unclear, however, increase in plasma concentrations between 79% - 87% has been often reported.

This is considered a major drug interaction in which very close monitoring or an alternative is strongly advised.

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