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Calaspargase Pegol Dosage

Medically reviewed by Drugs.com. Last updated on Nov 1, 2019.

Applies to the following strengths: 750 units/mL

Usual Adult Dose for Acute Lymphoblastic Leukemia

18 to 21 years:
2500 units/m2 IV over 60 minutes no more frequently than every 21 days

Use: This drug indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia in adults 18 to 21 years old

Usual Pediatric Dose for Acute Lymphoblastic Leukemia

1 month and older:
2500 units/m2 IV over 60 minutes no more frequently than every 21 days

Use: This drug indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia in pediatric patients age 1 month and older

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Severe hepatic impairment: Contraindicated

Dose Adjustments

DOSE MODIFICATIONS:
INFUSION REACTION/HYPERSENSITIVITY REACTION:
-Grade 1: Reduce infusion rate by 50%.
-Grade 2: Interrupt infusion; treat symptoms; when symptoms resolve, resume infusion at a 50% reduced rate.
-Grade 3 or 4: Permanently discontinue therapy.
HEMORRHAGE:
-Grade 3 or 4: Withhold therapy; evaluate for coagulopathy and consider clotting factor replacement as needed; resume therapy with the next scheduled dose if bleeding is controlled.
PANCREATITIS:
-Grade 3 or 4: Withhold therapy for elevations in lipase or amylase greater than 3 times the upper limit of normal (ULN) until enzyme levels stabilize or are declining. Discontinue therapy permanently if clinical pancreatitis is confirmed.
THROMBOEMBOLISM:
-Uncomplicated deep vein thrombosis: Withhold therapy; treat with antithrombotics; when symptoms resolve consider resuming therapy while continuing antithrombotics.
-Severe or life-threatening thrombosis: Discontinue therapy permanently. Treat with antithrombotics.
HEPATOTOXICITY:
-Total bilirubin more than 3 x ULN to no more than 10 x ULN: Withhold therapy until total bilirubin levels go down to 1.5 x ULN or less.
-Total bilirubin more than 10 x ULN: Permanently discontinue therapy and do not make up for missed doses.

Precautions

CONTRAINDICATIONS:
-Hypersensitivity (including anaphylaxis) to the active component or any of the ingredients
-History of serious thrombosis during previous L-asparaginase therapy
-History of serious pancreatitis during previous L-asparaginase therapy
-History of serious hemorrhagic events during previous L-asparaginase therapy
-Severe hepatic impairment

Safety and efficacy have not been established in patients younger than 1 month or older than 21 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Storage requirements:
-The diluted solution may be stored for up to 4 hours at room temperature (15C to 25C [59F to 77F]) or refrigerated at 2C to 8C (36F to 46F) for up to 24 hours.
-Protect from light.
-Do not freeze or shake.

Reconstitution/preparation techniques:
-This drug is a clear and colorless solution.
-Visually inspect for particulate matter, cloudiness, or discoloration and discard the vial if any of these are present.
-Do not administer if the vial has been shaken or vigorously agitated, frozen, or stored at room temperature for more than 48 hours.
-Dilute vial in 100 mL of 0.9% sodium chloride injection 5% dextrose injection using sterile/aseptic technique.
-Discard any unused portion left in a vial.
-After dilution, administer immediately into a running infusion of either 0.9% sodium chloride or 5% dextrose, respectively.
-Administer the dose over a period of 1 hour.
-Do not infuse other drugs through the same IV line.

IV compatibility:
-Compatible with 0.9% sodium chloride injection or 5% dextrose.

Monitoring:
-Monitor patients at least weekly, with bilirubin, transaminases, glucose, and clinical examinations until recovery from the cycle of therapy.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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