Advanced Breast Cancer: Learn about treatment options.

asparaginase

Generic Name: asparaginase (as PAR a jin ase)
Brand Name: Elspar

What is asparaginase?

Asparaginase is a cancer medication that interferes with the growth of cancer cells and slows their growth and spread in the body.

Asparaginase is used to treat acute lymphocytic lymphoma.

Asparaginase may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about asparaginase?

Do not receive this medication if you are allergic to asparaginase or pegaspargase (Oncaspar), or if you have a history of liver disease or pancreas problems. Tell your doctor about all other cancer medications you are receiving.

Get emergency medical help if you think you have received too much of this medicine, or if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Even if you have received asparaginase without reaction in the past, you may have an allergic reaction to the medication when you receive it again.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Call your doctor at once if you have any of the following side effects during your treatment with asparaginase:

  • severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;

  • easy bruising or bleeding, unusual weakness;

  • fever, chills, body aches, flu symptoms;

  • sudden headache, confusion, problems with vision, speech, or balance;

  • agitation, hallucinations, seizure (convulsions); or

  • urinating less than usual or not at all.

Asparaginase is highly toxic and both the powder and solution must be handled with care. Avoid inhaling vapors from the medicine, or allowing the medicine to come into contact with your skin, eyes, nose, or mouth. If the medicine gets on your skin, wash the area right away with soap and water. If the medicine gets into your eyes, rinse them for at least 15 minutes with water, saline, or other irrigating solution and seek emergency medical attention.

Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.

What should I discuss with my health care provider before receiving asparaginase?

Do not receive this medication if you are allergic to asparaginase or pegaspargase (Oncaspar), or if you have a history of pancreas problems.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:

  • liver disease;

  • gout;

  • diabetes (asparaginase can raise blood sugar); or

  • if you are being treated with other cancer medications.

FDA pregnancy category C. It is not known whether asparaginase is harmful to an unborn baby. Before using this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether asparaginase passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How is asparaginase given?

Asparaginase is given as an injection through an IV needle placed into a vein, or as a shot into a muscle. You will receive this injection in a clinic or hospital setting. The IV medicine must be given slowly, and it can take up to 30 minutes to complete.

Before you receive your first treatment with this medication, you may need a skin test to make sure you are not allergic to asparaginase.

Asparaginase can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

This medication can cause you to have unusual results with certain thyroid tests. Tell any doctor who treats you that you are receiving asparaginase.

What happens if I miss a dose?

Contact your doctor if you miss an appointment for your asparaginase injection.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine. Overdose symptoms may include easy bruising or bleeding, unusual weakness, fever, chills, flu symptoms, confusion, agitation, hallucinations, urinating less than usual or not at all, and seizure (convulsions).

What should I avoid while receiving asparaginase?

Asparaginase is highly toxic and both the powder and solution must be handled with care. Avoid inhaling vapors from the medicine, or allowing the medicine to come into contact with your skin, eyes, nose, or mouth. If the medicine gets on your skin, wash the area right away with soap and water. If the medicine gets into your eyes, rinse them for at least 15 minutes with water, saline, or other irrigating solution and seek emergency medical attention.

Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.

Asparaginase side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Even if you have received asparaginase without reaction in the past, you may have an allergic reaction to the medication when you receive it again.

Call your doctor at once if you have any of these serious side effects:

  • severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;

  • easy bruising or bleeding, unusual weakness;

  • fever, chills, body aches, flu symptoms;

  • sudden headache, confusion, problems with vision, speech, or balance;

  • increased thirst or urination;

  • agitation, hallucinations, seizure (convulsions);

  • tremors, muscle stiffness; or

  • urinating more or less than usual, or not at all.

Less serious side effects may include:

  • mild skin rash or itching;

  • depression, drowsiness;

  • swelling in your hands, ankles, or feet;

  • nausea, vomiting, loss of appetite, weight loss;

  • stomach cramps; or

  • headache, feeling tired or irritable.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Asparaginase Dosing Information

Usual Adult Dose for Acute Lymphocytic Leukemia:

Intradermal Skin Test:

Because of the occurrence of allergic reactions, an intradermal skin test should be performed prior to the initial administration of asparaginase and when asparaginase is given after an interval of a week or more has elapsed between doses.

Use approximately two international units for the intradermal skin test. The skin test site should be observed for at least one hour for the appearance of a wheal or erythema either of which indicates a positive reaction. An allergic reaction even to the skin test dose in certain sensitized individuals may rarely occur. A negative skin test reaction does not preclude the possibility of the development of an allergic reaction.

Clinical data are insufficient for a recommendation concerning the use of combination regimens in adults. However, the use of asparaginase as the sole induction agent should be undertaken only in an unusual situation when a combined regimen is inappropriate because of toxicity or other specific patient-related factors, or in cases refractory to other therapy.

As a sole induction agent: 200 international units/kg/day intravenously for 28 days.

(When complete remissions were obtained with this regimen, they were of short duration, 1 to 3 months.)

Usual Pediatric Dose for Acute Lymphocytic Leukemia:

Intradermal Skin Test:

Because of the occurrence of allergic reactions, an intradermal skin test should be performed prior to the initial administration of asparaginase and when asparaginase is given after an interval of a week or more has elapsed between doses.

Use approximately two international units for the intradermal skin test. The skin test site should be observed for at least one hour for the appearance of a wheal or erythema either of which indicates a positive reaction. An allergic reaction even to the skin test dose in certain sensitized individuals may rarely occur. A negative skin test reaction does not preclude the possibility of the development of an allergic reaction.

Recommended Induction Regimens:

Combination regimens recommended for acute lymphocytic leukemia:

Regimen I

Prednisone 40 mg/m2 per day orally in three divided doses for 15 days, followed by tapering of the dosage as follows: 20 mg/square meter for 2 days, 10 mg/square meter for 2 days, 5 mg/square meter for 2 days, 2.5 mg/square meter for 2 days and then discontinue.

Vincristine sulfate 2 mg/m2 intravenously once weekly on days 1, 8, and 15 of the treatment period. The maximum single dose should not exceed 2 mg.

Asparaginase 1,000 international units/kg/day intravenously for ten successive days beginning on day 22 of the treatment period.

Regimen II

Prednisone 40 mg/m2 per day orally in three divided doses for 28 days (the total daily dose should be to the nearest 2.5 mg), following which the dosage of prednisone should be discontinued gradually over a 14 day period.

Vincristine sulfate 1.5 mg/m2 intravenously weekly for four doses, on days 1, 8, 15, and 22 of the treatment period. The maximum single dose should not exceed 2 mg.

Asparaginase 6,000 international units/m2 intramuscularly on days 4, 7, 10, 13, 16, 19, 22, 25, and 28 of the treatment period. When a remission is obtained with either of the above regimens, appropriate maintenance therapy must be instituted. asparaginase should not be used as part of a maintenance regimen. The above regimens do not preclude a need for special therapy directed toward the prevention of central nervous system leukemia.

Use of asparaginase as the sole induction agent should be undertaken only in an unusual situation when a combined regimen is inappropriate because of toxicity or other specific patient-related factors, or in cases refractory to other therapy.

As a sole induction agent: 200 international units/kg/day intravenously for 28 days.

(When complete remissions were obtained with this regimen, they were of short duration, 1 to 3 months.)

What other drugs will affect asparaginase?

Before receiving asparaginase, tell your doctor if you are using any of the following drugs:

  • vincristine (Oncovin, Vincasar);

  • prednisone (Deltasone, Meticorten, Orasone, and others); or

  • methotrexate (Folex, Rheumatrex, Trexall).

This list is not complete and there may be other drugs that can interact with asparaginase. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about asparaginase.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.03. Revision Date: 2010-12-15, 5:01:39 PM.

Hide
(web2)