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Erwinaze

Generic Name: asparaginase Erwinia chrysanthemi (as PAR a jin ase er WIN ee a kri SAN the mee)
Brand Names: Erwinaze

Medically reviewed by Philip Thornton, DipPharm. Last updated on May 11, 2020.

What is Erwinaze?

Erwinaze 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.

Erwinaze is used to treat acute lymphoblastic acute lymphoblastic leukemia (ALL) .

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

Important Information

Some people develop a life-threatening allergic reaction to Erwinaze. You will need to receive Erwinaze 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 Erwinaze: 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 receive Erwinaze if you are allergic to asparaginase Erwinia chrysanthemi, or if you have received asparaginase (Elspar) in the past and it caused you to have:

  • serious pancreas problems;

  • a blood clot; or

  • serious bleeding problems.

To make sure Erwinaze is safe for you, tell your doctor if you have ever had:

  • diabetes;

  • a bleeding or blood clotting disorder such as hemophilia;

  • blood clots; or

  • pancreas problems.

You may need to have a negative pregnancy test before starting this treatment.

Asparaginase Erwinia chrysanthemi may harm an unborn baby. Use effective birth control to prevent pregnancy. Keep using birth control for at least 3 months after your last dose. Tell your doctor if you become pregnant.

Asparaginase Erwinia chrysanthemi can make birth control pills less effective. Ask your doctor about using a non-oral birth control to prevent pregnancy. This includes injections, implants, skin patches, vaginal rings, condom, diaphragm, cervical cap, or contraceptive sponge.

You should not breastfeed while using Erwinaze, and for at least 3 months after your last dose.

How should I use Erwinaze?

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

Erwinaze is injected into a muscle, or as an infusion into a vein. A healthcare provider may teach you how to properly use the medication by yourself.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don't understand all instructions.

Prepare an injection only when you are ready to give it. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.

Store unopened vials (bottles) of Erwinaze in the refrigerator. Protect from light.

Store mixed medicine at room temperature and use it within 4 hours. Do not refrigerate or freeze after mixing.

Erwinaze dosing information

Usual Adult Dose of Erwinaze 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 Erwinaze 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 Erwinaze?

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

Erwinaze side effects

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

Call your doctor at once if you have:

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

  • easy bruising, unusual bleeding, purple or red spots under your skin;

  • any bleeding that will not stop;

  • high blood sugar - increased thirst, increased urination, dry mouth, fruity breath odor; or

  • signs of a blood clot - sudden numbness or weakness (especially on one side of the body), slurred speech, balance problems, chest pain, sudden cough, rapid breathing, coughing up blood.

Common Erwinaze side effects include:

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 Erwinaze?

Other drugs may interact with asparaginase Erwinia chrysanthemi, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

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

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