Pegaspargase Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Acute Lymphoblastic Leukemia

2500 international units/m2 IV or IM no more frequently than every 14 days

Usual Pediatric Dose for Acute Lymphoblastic Leukemia

1 year or older: 2500 international units/m2 IV or IM no more frequently than every 14 days

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

Severe life-threatening reactions, including anaphylaxis, may occur during therapy. The risk of serious allergic reactions is higher in patients with known hypersensitivity to other forms of L-asparaginase. As a routine precaution, the manufacturer recommends to keep patients under observation for 1 hour with resuscitation equipment and other agents necessary to treat anaphylaxis available. Pegaspargase should be discontinued in patients with serious allergic reactions.

Serious thrombotic events, including sagittal sinus thrombosis have been reported in patients receiving pegaspargase. Pegaspargase should be discontinued in patients with serious thrombotic events.

Pancreatitis has been reported in patients receiving pegaspargase. Patients with abdominal pain should be evaluated for evidence of pancreatitis. Pegaspargase should be discontinued in patients with pancreatitis. Pegaspargase induced pancreatitis has been reported to occur within a median of 15 days from the start of therapy in children with acute lymphoblastic leukemia that received IM pegaspargase.

Glucose intolerance has been reported in patients receiving pegaspargase. In some instances, glucose intolerance is irreversible.

Increased prothrombin time, increased partial thromboplastin time, and hypofibrinogenemia have been reported in patients receiving pegaspargase. Coagulation parameters should be monitored at baseline and periodically during and after treatment. Therapy should be initiated with fresh-frozen plasma to replace coagulation factors in patients with severe or symptomatic coagulopathy.

Pegaspargase is only recommended for use under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents.

Dialysis

Data not available

Other Comments

Pegaspargase should be part of a multi-agent chemotherapeutic regimen.

Pegaspargase should not be used if there is any indication that the drug has been frozen. Although there may not be an apparent change in the appearance of the drug, pegaspargase activity is destroyed after freezing.

The preferred route of administration is intramuscular because of the decreased incidence of hepatotoxicity, coagulopathy, and gastrointestinal and renal disorders compared to the intravenous route.

IM administration: The volume at a single injection site should be limited to 2 mL. If the volume to be administered is greater than 2 mL, multiple injection sites should be used.

IV administration: The drug should be given over a period of 1 to 2 hours in 100 mL of sodium chloride or dextrose 5% through an infusion that is already running.

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