Reported Reactions

Drugs › Alkylating drug

Generic name

Busulfan: adverse event reports filed with FDA

11,825 reports list it as a suspect or interacting product, 2004–2026. Class: Alkylating drug. Also reported as Busulfan Injection.

11,825
reports as suspect product
0.1% of all reports · about 526 a year
1,095
reports, 12 months to June 2026
1,045 in the 12 months before
94.9%
marked serious by the reporter
93.5% across the class
28.9%
record death among outcomes, as reported
3,412 reports · not verified by FDA

Between January 2004 and June 2026, 11,825 adverse event reports received by FDA list busulfan, a generic name as a suspect or interacting product. Reports that mention it only as a concomitant medication (3,866) are left out of every figure here.

In the 12 months to June 2026, 1,095 reports listed it, close to the 1,045 of the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Over its reporting history that is about 526 reports a year and 0.1% of the 20,646,523 reports in the database, and 4.7% of the reports for the alkylating drug class. How many people take it is not in the data, so a count is not a rate of occurrence.

The reactions recorded most often are product use in unapproved indication (12.1%), off label use (11.7%) and mucosal inflammation (8%). A report can list several reactions, so shares add to more than 100%; 1,407 different terms appear across these reports. Product use in unapproved indication is recorded in 12.1% of these reports, a larger share than in the median alkylating drug drug (3.3%).

94.9% of the reports are marked serious by the reporter (93.5% across the class); 28.9% record death among the outcomes and 20.3% record hospitalisation, as reported. 60.1% of the reports came from other health professionals, and the largest patient age group is 45 to 64 (17.6%). FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event."

Reports by month, five years

0116231Jul 2021: 70Aug 2021: 88Sep 2021: 95Oct 2021: 118Nov 2021: 140Dec 2021: 662022Jan 2022: 40Feb 2022: 133Mar 2022: 61Apr 2022: 116May 2022: 37Jun 2022: 76Jul 2022: 73Aug 2022: 103Sep 2022: 72Oct 2022: 76Nov 2022: 64Dec 2022: 1312023Jan 2023: 63Feb 2023: 208Mar 2023: 27Apr 2023: 43May 2023: 53Jun 2023: 65Jul 2023: 71Aug 2023: 74Sep 2023: 48Oct 2023: 43Nov 2023: 68Dec 2023: 772024Jan 2024: 61Feb 2024: 119Mar 2024: 169Apr 2024: 129May 2024: 82Jun 2024: 75Jul 2024: 64Aug 2024: 60Sep 2024: 62Oct 2024: 79Nov 2024: 91Dec 2024: 1322025Jan 2025: 72Feb 2025: 136Mar 2025: 73Apr 2025: 92May 2025: 46Jun 2025: 138Jul 2025: 195Aug 2025: 57Sep 2025: 153Oct 2025: 57Nov 2025: 80Dec 2025: 432026Jan 2026: 36Feb 2026: 231Mar 2026: 39Apr 2026: 64May 2026: 69Jun 2026: 71

Reports by the month FDA received them. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases.

By year received

05951,1892004: 6420042005: 712006: 632007: 15020072008: 2032009: 1002010: 9220102011: 4092012: 2492013: 18020132014: 3822015: 2572016: 32820162017: 4282018: 8522019: 1,06020192020: 1,1892021: 1,1502022: 98220222023: 8402024: 1,1232025: 1,14220252026: 510

2026 covers reports received through June 2026 only.

Reactions recorded in the reports

share of Busulfan reports recording the termmedian drug in alkylating drug

  1. Product use in unapproved indicationused for a purpose not on the label12.1%1,428
  2. Off label useused for a purpose or in a way not on the label11.7%1,386
  3. Venoocclusive liver disease6.8%804
  4. Febrile neutropeniafever with low white blood cells5.6%663
  5. Drug ineffectivethe medicine did not work as expected5.2%610
  6. Pyrexiafever4.9%577
  7. Cytomegalovirus infection reactivation4.4%524
  8. Acute graft versus host disease3.9%463
  9. Infectionan infection, type not specified3.6%429
  10. Thrombocytopenialow platelets3.6%428
  11. Sepsisa severe body-wide response to infection3.6%421
  12. Chronic graft versus host disease3.4%400
  13. Respiratory failurethe lungs could not supply enough oxygen3.2%384
  14. Diarrhoealoose or frequent stools3.2%379
  15. Pneumonialung infection3.2%376
  16. Acute graft versus host disease in skin3.2%374
  17. Venoocclusive disease3.1%366
  18. Cystitis haemorrhagic3.1%362
  19. Pancytopenialow counts of all blood cells3%351
  20. Neutropenialow neutrophils, a type of white blood cell2.8%335
  21. BK virus infection2.6%313
  22. Multiple organ dysfunction syndromeseveral organs failing2.3%275
  23. Acute kidney injurysudden loss of kidney function2%240
  24. Septic shockshock arising from infection2%238

Top 30 of 1,407 MedDRA preferred terms recorded across these reports, with a plain-language gloss where one is available. One report can record several terms. The hollow bar is the median share across the 23 drugs in the alkylating drug class; it describes the reports, not the patients. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Outcomes recorded

Death28.9%3,412
Life-threatening8.1%958
Hospitalisation (initial or prolonged)20.3%2,399
Disability0.8%94
Congenital anomaly0.2%25
Other serious73.7%8,719
Not serious5.1%605

Outcome flags as the reporter set them; a report can carry several, and "other serious" is FDA's own category for serious reports outside the named outcomes. Grey bar: all 253,205 reports in the class. FDA has not verified any outcome and states that the reports "cannot be used to estimate the incidence of these events."

Patients and reporters

Patient age

Under 26.6%784
2 to 1116.1%1,908
12 to 177.3%864
18 to 4415.9%1,880
45 to 6417.6%2,082
65 to 743.5%419
75 and over0.3%33
Age not given32.6%3,855

Patient sex

Female30.1%3,556
Male41%4,854
Not given28.9%3,415

Who reported

Physician31.2%3,693
Pharmacist1.3%153
Other health professional60.1%7,106
Lawyer0%1
Consumer or non-health professional4%476
Not given3.3%396

Age and sex as stated in the report; the reporter's qualification is the primary source recorded by FDA. 24.9% of reports give the United States as the country of the event or reporter.

Reason for use recorded

Indication as recorded (MedDRA)ReportsShare
Bone marrow conditioning regimen3,51929.8%
Stem cell transplant1,1729.9%
Allogenic stem cell transplantation1,0038.5%
Acute myeloid leukaemia8116.9%
Prophylaxis against transplant rejection3733.2%
Chemotherapy1981.7%

The indication field is filled in by the reporter and is often blank; shares are of all 11,825 reports.

Drugs most often listed in the same reports

Drug (any role in the report)ReportsShare of Busulfan reports
Cyclophosphamide5,86049.6%
Fludarabine5,06942.9%
Mycophenolate mofetil3,23927.4%
Cyclosporine3,20027.1%
Methotrexate2,94624.9%
Thiotepa2,36420%
Tacrolimus1,97316.7%
Cytarabine1,62713.8%
Melphalan1,57413.3%
Fludarabine phosphate1,37711.6%

Other products listed in reports where Busulfan is a suspect product, whatever their own role. Co-listing means the two were recorded together; it says nothing about either product's part in the event. Only the 2,500 most-reported names are counted here.

In context

MeasureBusulfanAlkylating drugAll reports
Reports as suspect product11,825253,20520,646,523
Share of that pool—4.7%0.1%
Reports, latest 12 months1,095—1,332,454
Marked serious94.9%93.5%57.4%
Death recorded among outcomes, per 1,000 reports28920891
Hospitalisation recorded, per 1,000 reports203333213
Consumer-filed share4%6.3%45.8%
Top term, share of reportsProduct use in unapproved indication 12.1%median 3.3%1.2%

Shares are of reports, not of patients treated. The number of people taking a product is not in the data, so none of these figures is a rate, and differences between columns reflect who takes a product, who reports and how long it has been sold. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Other drugs in the alkylating drug class

DrugName typeReportsLatest 12 monthsMarked serious
Cyclophosphamidegeneric141,09912,36097.8%
Ifosfamidegeneric18,6581,32598.2%
Melphalangeneric17,19095698.5%
Temozolomidegeneric15,3241,05582.3%
Thiotepageneric7,8531,03598.8%
Bendamustine hydrochloridegeneric6,94125396%
Dacarbazinegeneric6,43151196.3%
Temodarbrand4,6522456.1%
Matulanebrand3,84528415.9%
Carmustinegeneric3,37818099%
Treandabrand3,330366.5%
Chlorambucilgeneric2,4867598.5%
Valchlorbrand2,1141628.4%
Mitomycingeneric2,04111792.4%
Lomustinegeneric1,1009294.8%

Ordered by report count for navigation only. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic." A brand and its generic are separate rows because reporters name them separately.

Questions about Busulfan reports

How many adverse event reports has FDA received for Busulfan?

11,825 reports list Busulfan as a suspect or interacting product in the openFDA FAERS release of 28 Sep 2026, covering reports received through June 2026. 1,095 of them arrived in the latest 12 months. Another 3,866 list it only as a concomitant medication.

What reactions are recorded in Busulfan reports?

product use in unapproved indication (12.1%), off label use (11.7%), mucosal inflammation (8%), venoocclusive liver disease (6.8%) and cytomegalovirus infection (5.7%). These are MedDRA preferred terms coded from what the reporter described; a report can list several, and a term's presence is not a finding that Busulfan was responsible.

How serious are the reports?

94.9% are marked serious by the reporter. Among the outcomes recorded, 28.9% of reports include death and 20.3% include hospitalisation. FDA has not verified these outcomes and states that the reports "cannot be used to estimate the incidence" of the events.

Who files these reports?

other health professional (60.1%), physician (31.2%) and consumer or non-health professional (4%). Most reports reach FDA through the manufacturer, which must forward reports it receives.

Are reports for Busulfan rising?

1,095 reports in the 12 months to June 2026, close to the 1,045 of the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Counts also move with how many people take a product, its time on the market and publicity.

Do these reports show that Busulfan was responsible for these reactions?

No. FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event." The reaction may relate to the condition being treated, to other medicines, or to something else.

Is this a list of the side effects of Busulfan?

No. It is a count of what was reported to FDA. The adverse reactions observed in clinical studies are printed on the FDA-approved label, which a pharmacist or clinician can go through with you.

How do I report an adverse event?

Consumers and health professionals can report to FDA through MedWatch (Form FDA 3500 online, or 1-800-FDA-1088), or to the manufacturer, which must pass reports on. See the guide on how to report.

Where this comes from. Counts are built from the openFDA Drug Adverse Event (FAERS) bulk export released 28 Sep 2026, which holds reports FDA received through 30 Jun 2026. Drug names are as reported, resolved to the brand or generic name on the FDA label where openFDA's harmonisation matched them; classes are the pharmacologic class (EPC) from the label and the National Drug Code Directory of 17 Sep 2026. A report counts here when it lists Busulfan as a suspect or interacting product; reports listing it only as a concomitant medication (3,866) are excluded. No report narrative, lot number, patient detail or reporter identity is published. See the methodology and sources; FDA's record is authoritative, and corrections are handled within five working days.

Drug data (FAERS) through 30 Jun 2026; device data (MAUDE) through 31 Aug 2026. Not medical advice.