Elspar Side Effects
Generic name: asparaginase escherichia coli
Medically reviewed by Drugs.com. Last updated on Jul 19, 2023.
Note: This document contains side effect information about asparaginase escherichia coli. Some dosage forms listed on this page may not apply to the brand name Elspar.
Applies to asparaginase escherichia coli: injection powder for solution.
Serious side effects of Elspar
Along with its needed effects, asparaginase escherichia coli (the active ingredient contained in Elspar) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking asparaginase escherichia coli:
- Abdominal or stomach pain
- blurred vision
- darkened urine
- difficulty with swallowing
- dry mouth
- fast heartbeat
- flushed, dry skin
- fruit-like breath odor
- increased hunger
- increased thirst
- increased urination
- joint pain
- loss of appetite
- pains in the chest, groin, or legs, especially calves of the legs
- pains in the stomach, side, or abdomen, possibly radiating to the back
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- shortness of breath
- skin rash
- stomach pain (severe) with nausea and vomiting
- sudden loss of coordination
- sudden onset of severe headaches
- sudden onset of slurred speech
- sudden vision changes
- tightness in the chest
- troubled breathing
- unexplained weight loss
- unusual bleeding or bruising
- unusual tiredness or weakness
- yellow eyes or skin
- convulsions (seizures)
- frequent urination
- loss of bladder control
- lower back or side pain
- muscle spasm or jerking of all extremities
- numbness or tingling in the hands, arms, or legs
- seeing, hearing, or feeling things that are not there
- severe weakness
- sores in the mouth or on the lips
- sudden loss of consciousness
- swelling of the feet or lower legs
- unusual thirst
- Inability to move the arms or legs
Incidence not known
- Abdominal or stomach tenderness
- bloody or cloudy urine
- change in consciousness
- clay-colored stools
- continuous nausea or vomiting
- loss of consciousness
- pounding in the ears
- slow heartbeat
Other side effects of Elspar
Some side effects of asparaginase escherichia coli may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Stomach cramps
- weight loss
For Healthcare Professionals
Applies to asparaginase escherichia coli: injectable powder for injection.
Hematologic side effects have included a marked decrease in circulating lymphoblasts, with normal or below normal leukocyte counts, within the first days after initiating therapy. This is sometimes accompanied by a marked rise in serum uric acid. Pre-renal azotemia has also been reported.
Hypofibrinogenemia has been reported. Depression of other clotting factors including factors V and VIII (marked decreases) and factors VII and IX (variable decreases) have also been reported. A low incidence of decrease in circulating platelets has been reported. Bleeding has been reported in a minority of patients with a demonstrable coagulopathy. Intracranial hemorrhage and fatal bleeding associated with low fibrinogen levels have been reported. Compensatory increased fibrinolytic activity has also been reported.
Transient bone marrow depression has rarely been observed as evidenced by a delay in return of hemoglobin or hematocrit levels to normal in patients undergoing hematologic remission of leukemia. Marked leukopenia has also been reported.
Hypertriglyceridemia has been reported.[Ref]
Most hepatic abnormalities are usually reversible upon discontinuation of therapy and some reversal has been reported during the course of therapy.[Ref]
Hepatic side effects have included elevations of SGOT, SGPT, alkaline phosphatase, bilirubin, and depression of serum albumin, cholesterol, and plasma fibrinogen. Both increases and decreases in total blood lipids have been reported. Marked hypoalbuminemia associated with peripheral edema has been reported. Fatty changes in the liver have been documented by biopsy. Malabsorption syndrome has also been reported.[Ref]
Nervous system side effects have included somnolence, fatigue, seizures, coma, and confusion. A Parkinson-like syndrome with tremor and a progressive increase in muscle tone has been reported rarely.[Ref]
Nervous system side effects have usually reversed spontaneously upon discontinuation of asparaginase.[Ref]
Cardiovascular side effects have included one reported case of acute myocardial infarction.[Ref]
Musculoskeletal side effects have included arthralgia.[Ref]
Respiratory side effects have included respiratory distress.[Ref]
The syndrome resembles hyperosmolar nonketonic hyperglycemia. While the syndrome usually responds to discontinuation of asparaginase, judicious use of IV fluid, and insulin, it has occasionally been fatal.[Ref]
Psychiatric side effects have included depression, agitation, confusion, paranoia, and hallucinations.[Ref]
Renal side effects include acute renal shut down and fatal renal insufficiency. Proteinuria has been reported infrequently.[Ref]
Serum concentrations of thyroxine-binding globulin have been reported to return to pretreatment values within four weeks of the last dose.[Ref]
Other side effects have included interference with the interpretation of thyroid function tests by production of a rapid and marked reduction in serum concentrations of thyroxine-binding globulin within days after the first dose.[Ref]
Oncologic side effects have included reports of small increases in pulmonary adenomas in animal studies..[Ref]
Immunosuppressive activity has been reported in animal experiments.[Ref]
More about Elspar (asparaginase escherichia coli)
- Check interactions
- Compare alternatives
- Dosage information
- During pregnancy
- Drug class: miscellaneous antineoplastics
Related treatment guides
1. Fragasso G, Pastore MR, Vicari A, Chierchia SL, Pozza G. Myocardial infarction in a patient with acute lymphoblastic leukemia during L-asparaginase therapy. Am J Hematol. 1995;48:136-7.
2. Product Information. Elspar (asparaginase). Merck & Co., Inc. 2001.
3. Parsons SK, Skapek SX, Neufeld EJ, Kuhlman C, Young ML, Donnelly M, Brunzell JD, Otvos JD, Sallan SE, Rifai N. Asparaginase-associated lipid abnormalities in children with acute lymphoblastic leukemia. Blood. 1997;89:1886-95.
4. Keung YK, Rizk R, Wu XY, Cobos E. Drug-induced hypertriglyceridemia with and without pancreatitis. South Med J. 1999;92:912-4.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.