Drug General Information (ID: DDIIP62XB3)
Drug Name			Metronidazole		Drug Info		Busulfan		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiinfective Agents				Antineoplastics
Structure

Mechanism of Metronidazole-Busulfan Interaction (Severity Level: Major)
Decreased metabolism (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Metronidazole				Busulfan
Mechanism		Increase the plasma concentrations of busulfan				Busulfan
Key Mechanism Factor 1
		Factor Name		Pharmacokinetics
		Factor Description		Alters the metabolism of the drug, leading to changes in the plasma concentration of the drug and affecting the pharmacological effects.
Mechanism Description		Decreased metabolism of Busulfan caused by Metronidazole

Recommended Action
Management		Due to the potential for severe toxicity and mortality associated with elevated busulfan plasma levels, concomitant use with metronidazole should be avoided. However, if concomitant therapy is necessary, close monitoring for signs of busulfan toxicity is recommended.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	Product Information. Busulfex (busulfan). ESP Pharma Inc, Edison, NJ.
3	Gulbis AM, Culotta KS, Jones RB, Andersson BS "Busulfan and metronidazole: an often forgotten but significant drug interaction." Ann Pharmacother 45 (2011): e39.[PMID: 21730282]