Erwinase

Generic name: asparaginase Erwinia chrysanthemi [ as-PAR-a-jin-ase-er-WIN-ee-a-kri-SAN-the-mee ]
Drug class: Miscellaneous antineoplastics

Medically reviewed by Philip Thornton, DipPharm. Last updated on Dec 14, 2022.

What is Erwinase?

Erwinase is an injectable medicine containing asparaginase Erwinia chrysanthemi. Asparaginase is a cancer medication that interferes with the growth and spread of cancer cells in the body.

Erwinase works by lowering the levels of asparagine in your body, a substance the cancer cells need to survive.

Erwinase is used to treat acute lymphoblastic acute lymphoblastic leukemia (ALL) in adults and children at least at least 4 months old.

Warnings

Some people develop a life-threatening allergic reaction to Erwinase. You will need to receive Erwinase in a hospital or clinic setting to quickly treat any serious side effects that occur.

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

Call your doctor at once if you have a serious side effect such as severe pain in your upper stomach, nausea and vomiting, easy bruising or bleeding, increased thirst of urination, sudden numbness or severe headache, warmth or swelling in your legs, or sudden problems with your vision, speech, or balance.

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

You should not use Erwinase if you have received any form of asparaginase in the past and it caused you to have:

a serious allergic reaction;
serious pancreas problems;
a life-threatening blood clot; or
serious bleeding problems.

To make sure Erwinase is safe for you, tell your doctor if you have:

problems with your liver or pancreas;
bleeding problems;
a blood clot; or
diabetes.

Erwinase may harm an unborn baby. You may need a pregnancy test to make sure you are not pregnant. Use birth control while using this medicine and for at least 3 months after your last dose. Tell your doctor if you become pregnant.

Erwinase can make hormonal birth control less effective, including birth control pills, injections, implants, skin patches, and vaginal rings. Use barrier birth control to prevent pregnancy: condom, diaphragm, cervical cap, or contraceptive sponge.

Do not breastfeed while using this medicine, and for at least 3 months after your last dose of Erwinase.

How should I use Erwinase?

Use Erwinase exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Erwinase is injected into a muscle or into a vein. Erwinase is usually given every 48 hours.

Read and follow all Instructions for Use. Ask your doctor or pharmacist if you need help.

Do not shake the medication bottle or you may ruin the medicine.

Prepare an injection only when you are ready to give it. Call your pharmacist if the medicine has changed colors or has particles in it.

Do not reuse a needle or syringe. Place them in a puncture-proof "sharps" container and dispose of it following state or local laws. Keep out of the reach of children and pets.

Your blood will need to be tested often and your dose or medication schedule may be changed based on the results.

Doses are based on body surface area (height and weight). Your dose may change if you gain or lose weight or if you are still growing.

You may be given other medications to help prevent serious side effects or allergic reaction. Keep taking these medicines for as long as your doctor has prescribed.

Throw away a vial (bottle) after one use, even if there is still medicine left inside.

Follow all storage instructions provided with Erwinase. Your pharmacist can provide more information about how to store this medicine.

Dosing information

Usual Adult Dose of Erwinase for Acute Lymphoblastic Leukemia:

To substitute for a dose of pegaspargase:
25,000 International Units/m2 intramuscularly three times a week (Monday/Wednesday/Friday) for six doses for each planned dose of pegaspargase.

To substitute for a dose of native E. coli asparaginase:
25,000 International Units/m2 administered intramuscularly for each scheduled dose of native E. coli asparaginase within a treatment regimen.

Comments:
-Limit the volume of reconstitution at a single injection site to 2 mL; if reconstituted dose to be administered is greater than 2 mL, use multiple injection sites.
-If a partial vial is used, do not save or reuse the unused drug for later administration. Discard unused portions.

Use:
-Indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of patients with acute lymphoblastic leukemia (ALL) who have developed hypersensitivity to E. coli-derived asparaginase.

Usual Pediatric Dose of Erwinase for Acute Lymphoblastic Leukemia:

To substitute for a dose of pegaspargase:
25,000 International Units/m2 intramuscularly three times a week (Monday/Wednesday/Friday) for six doses for each planned dose of pegaspargase.

To substitute for a dose of native E. coli asparaginase:
25,000 International Units/m2 administered intramuscularly for each scheduled dose of native E. coli asparaginase within a treatment.

Comments:
-Limit the volume of reconstitution at a single injection site to 2 mL; if reconstituted dose to be administered is greater than 2 mL, use multiple injection sites.
-If a partial vial is used, do not save or reuse the unused drug for later administration. Discard unused portions.

Uses:
-Indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of patients with acute lymphoblastic leukemia (ALL) who have developed hypersensitivity to E. coli-derived asparaginase.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Erwinase?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Erwinase side effects

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

Call your doctor at once if you have:

easy bruising or bleeding (nosebleeds, bleeding gums);
any bleeding that will not stop;
blisters or ulcers in your mouth, red or swollen gums, trouble swallowing;
signs of liver or pancreas problems - severe stomach pain (that may spread to your back), nausea or vomiting, jaundice (yellowing of the skin or eyes);
signs of a blood clot - sudden numbness or weakness (especially on one side of the body), severe headache, chest pain, feeling short of breath, pain or swelling in an arm or leg;
low white blood cell counts - fever, mouth sores, skin sores, sore throat, cough; or
high blood sugar - increased thirst, increased urination, dry mouth, fruity breath odor.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common Erwinase side effects may include:

liver or pancreas problems;
bleeding or blood clots;
high blood sugar;
stomach pain, loss of appetite, nausea, vomiting, diarrhea;
fever, headache, tiredness, mouth sores;
bone pain, muscle or joint pain;
allergic reaction, skin rash; or
abnormal liver function tests.

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.

What other drugs will affect Erwinase?

Other drugs may interact with asparaginase Erwinia chrysanthemi, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

More about Erwinaze (asparaginase erwinia chrysanthemi)

Patient resources

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Erwinase only for the indication prescribed.

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

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