Asparaginase escherichia coli Disease Interactions

Impaired synthesis of fibrinogen and decreased serum levels of clotting factors have been reported in patients in asparaginase therapy. Bleeding has been observed in patients with coagulation disorders. Patients should be instructed to immediately report any signs or symptoms suggesting bleeding such as petechiae, purpura, hematuria, or melena. Therapy with asparaginase should be administered cautiously to patients with coagulation disorders. The use of asparaginase is contraindicated in patients with serious bleeding or history of serious hemorrhagic events with prior to asparaginase therapy.

The use of asparaginase is contraindicated in patients with pancreatitis or a history of pancreatitis. Pegaspargase can cause decreased insulin synthesis or may cause inflammation and/or necrosis of cells of the pancreas. Fulminant and fatal pancreatitis has occurred. Clinical monitoring of pancreatic function, including serum amylase levels, is recommended.

Reversible liver abnormalities such as elevated liver transaminase and bilirubin levels and decreased albumin synthesis have been reported during asparaginase therapy. Fatty changes in the liver have been noted. Patients should be instructed to immediately report any sign or symptoms of hepatic dysfunction such as jaundice, dark urine, right upper quadrant pain, or anorexia. Therapy with asparaginase should be administered cautiously to patients with or predisposed to compromised hepatic function. Clinical monitoring of hepatic function is recommended.

Glucose intolerance has been reported in patients receiving asparaginase. In some cases glucose intolerance may be irreversible. Monitor glucose levels in patients at baseline and periodically during treatment. Administer insulin therapy as necessary in patients with hyperglycemia. Therapy with asparaginase should be administered cautiously in patients with diabetes mellitus.

Transient myelosuppression has been observed during asparaginase therapy, however its myelosuppressive effect has not been well characterized. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended. Therapy with asparaginase should be administered cautiously in patients with severe bone marrow suppression.

Reversible CNS symptoms, varying from mild to severe, such as depression, confusion, agitation, or hallucinations have been reported. Patients with existing or predisposition to psychoses or emotional disorders may be at increase risk for CNS symptoms associated with asparaginase therapy. Clinical monitoring of mental status is recommended.