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Conditioning Regimens

Lorazepam for seizure prophylaxis during high-dose busulfan administration

Abstract

Seizure is a recognized complication of high-dose busulfan (BU) therapy and phenytoin (DPH) is widely used as prophylaxis. A number of adverse effects have been associated with DPH and it may also interfere with BU metabolism. We used lorazepam (median dose 0.022 mg/kg) i.v. or p.o. before each dose and for 24 h after the last dose of BU as seizure prophylaxis to 29 children undergoing hematopoietic stem cell transplantation. The regimen was well tolerated and drowsiness was the only significant side-effect. Twelve patients were able to receive the entire prophylaxis by mouth. No seizure developed during and within 48 h of BU. Concomitant pharmacokinetic studies showed no alternation of the absorption and clearance of BU during lorazepam administration. Lorazepam can be used as an alternative for seizure prophylaxis during high-dose BU treatment.

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Chan, K., Mullen, C., Worth, L. et al. Lorazepam for seizure prophylaxis during high-dose busulfan administration. Bone Marrow Transplant 29, 963–965 (2002). https://doi.org/10.1038/sj.bmt.1703593

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