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pegaspargase (Intramuscular route, Intravenous route)

peg-AS-par-jase

Commonly used brand name(s)

In the U.S.

  • Oncaspar

Available Dosage Forms:

  • Solution

Therapeutic Class: Antineoplastic Agent

Pharmacologic Class: Asparaginase (class)

Uses For pegaspargase

Pegaspargase belongs to the general group of medicines known as antineoplastics. It is used with other cancer medicines as a first-line treatment to a certain type of blood cancer called acute lymphoblastic leukemia (ALL). pegaspargase also treats ALL in patients who have had serious allergic reactions to L-asparaginase .

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Pegaspargase seems to interfere with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells also may be affected by pegaspargase, other effects also occur. Some of these effects may be serious and must be reported to your doctor.

Before you begin treatment with pegaspargase, you and your doctor should talk about the good pegaspargase will do as well as the risks of using it.

Pegaspargase is to be administered only by or under the immediate supervision of your doctor.

pegaspargase is available only with your doctor's prescription .

Before Using pegaspargase

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For pegaspargase, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to pegaspargase or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Infants up to 1 year of age—Safety and efficacy have not been established.

Children 1 year of age and older—pegaspargase has been studied in children 1 year of age and older and has not been shown to cause different side effects or problems than it does in adults. In fact, the side effects of pegaspargase seem to be less severe in children than in adults.

Geriatric

There is no specific information comparing the use of pegaspargase in the elderly with use in other age groups. Safety and efficacy of pegaspargase in the elderly have not been established.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving pegaspargase, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using pegaspargase with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Rotavirus Vaccine, Live

Using pegaspargase with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adenovirus Vaccine Type 4, Live
  • Adenovirus Vaccine Type 7, Live
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Influenza Virus Vaccine, Live
  • Measles Virus Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Rubella Virus Vaccine, Live
  • Smallpox Vaccine
  • Typhoid Vaccine
  • Varicella Virus Vaccine
  • Yellow Fever Vaccine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of pegaspargase. Make sure you tell your doctor if you have any other medical problems, especially:

  • Anticoagulant therapy (treatment with blood thinners) or
  • Bleeding problems—The chance of bleeding may be increased
  • Blood clots
  • Chickenpox (including recent exposure) or
  • Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body
  • Type 2 diabetes mellitus—The chance of side effects may be increased
  • Infection—Pegaspargase can decrease your body's ability to fight infection
  • Liver disease—Effects of pegaspargase may be increased because of slower removal of pegaspargase from the body
  • Pancreatitis—The chance of side effects may be increased

Proper Use of pegaspargase

Pegaspargase sometimes is given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your doctor to help you plan a way to take them at the right times .

While you are receiving pegaspargase, your doctor may want you to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well.

pegaspargase often causes nausea and vomiting. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects, especially if they are severe.

Dosing

The dose of pegaspargase will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of pegaspargase. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Precautions While Using pegaspargase

It is very important that your doctor check your progress at regular visits to make sure that pegaspargase is working properly and to check for unwanted effects.

While you are being treated with pegaspargase, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Pegaspargase may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral poliovirus vaccine, since there is a chance they could pass the poliovirus on to you. Also, avoid persons who have taken oral poliovirus vaccine. Do not get close to them, and do not stay in the same room with them for long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and the mouth.

Pegaspargase can temporarily lower the number of white blood cells in your blood, increasing the chance of getting infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infection. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or have painful or difficult urination.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising; black tarry stools; blood in urine or stools; or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury can occur.

If pegaspargase accidentally seeps out of the vein into which it is injected, it may damage some tissue and cause scarring. Tell the doctor or nurse right away if you notice redness, pain, or swelling at the place of injection.

pegaspargase may cause serious allergic reaction. Tell your doctor immediately if you start having trouble breathing, chest tightness, skin rash, or itching while you are receiving pegaspargase .

Some people who have received pegaspargase developed pancreatitis (inflammation of the pancreas). Check with your doctor if you experience sudden and severe stomach pain, nausea, vomiting, fever, or chills while on pegaspargase .

Check with your doctor immediately if you start having increased thirst or hunger, increased urination, pale skin, nausea, sweating, or faintness. This may be signs that you are having problems with the amount of blood sugar in your body .

pegaspargase may increase your risk of developing serious blood clots. Tell your doctor right away if you develop any sudden and severe headache, arm or leg swelling, shortness of breath, or chest pain .

pegaspargase Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

More common
  • Abdominal or stomach pain
  • blurry vision
  • constipation
  • dry mouth and skin
  • faintness
  • fatigue
  • fruit-like breath odor
  • increased hunger or thirst
  • increased need to urinate
  • nausea
  • skin paleness
  • skin rash
  • sweating
  • troubled breathing
  • unexplained weight loss
  • unusual bleeding or bruising
  • vomiting
Less common
  • Bloating
  • chest pain
  • confusion
  • cough
  • darkened urine
  • difficulty in breathing or swallowing
  • dizziness
  • fast heartbeat
  • fever or chills
  • headache
  • hives or itching
  • indigestion
  • itching, especially of hands and feet
  • loss of appetite
  • numbness, tingling, or swelling in arms or legs
  • pains in stomach, side, or abdomen, possibly radiating to the back
  • puffiness or swelling of the eyelids or around the eyes, face, lips or tongue
  • reddening of the skin, especially around ears
  • shortness of breath
  • swelling of eyes, face, or inside of nose
  • tightness in chest
  • unusual tiredness or weakness (sudden and severe)
  • wheezing
  • yellow eyes or skin
Rare
  • Black, tarry stools
  • blood in urine
  • hoarseness
  • lower back or side pain
  • painful or difficult urination
  • pinpoint red spots on skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • General feeling of discomfort or illness
Less common
  • Anxiety
  • behavior change similar to drunkenness
  • blurred vision
  • cold sweats
  • convulsions (seizures)
  • cool pale skin
  • difficulty in concentrating
  • drowsiness
  • lack of appetite
  • nervousness
  • nightmares
  • pain at place of injection
  • pain in joints or muscles
  • restless sleep
  • shakiness
  • slurred speech

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