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Pegaspargase Side Effects

In Summary

Commonly reported side effects of pegaspargase include: hypersensitivity reaction. Other side effects include: blood coagulation disorder. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to pegaspargase: solution

As well as its needed effects, pegaspargase may cause unwanted side effects that require medical attention.

Severity: Moderate

If any of the following side effects occur while taking pegaspargase, check with your doctor or nurse as soon as possible:

More common:
  • Abdominal or stomach pain
  • blurry vision
  • constipation
  • dry mouth and skin
  • faintness
  • fatigue
  • fruit-like breath odor
  • increased hunger or thirst
  • increased need to urinate
  • nausea
  • skin paleness
  • skin rash
  • sweating
  • troubled breathing
  • unexplained weight loss
  • unusual bleeding or bruising
  • vomiting
Less common:
  • Bloating
  • chest pain
  • confusion
  • cough
  • darkened urine
  • difficulty in breathing or swallowing
  • dizziness
  • fast heartbeat
  • fever or chills
  • headache
  • hives or itching
  • indigestion
  • itching, especially of hands and feet
  • loss of appetite
  • numbness, tingling, or swelling in arms or legs
  • pains in stomach, side, or abdomen, possibly radiating to the back
  • puffiness or swelling of the eyelids or around the eyes, face, lips or tongue
  • reddening of the skin, especially around ears
  • shortness of breath
  • swelling of eyes, face, or inside of nose
  • tightness in chest
  • unusual tiredness or weakness (sudden and severe)
  • wheezing
  • yellow eyes or skin
  • Black, tarry stools
  • blood in urine
  • hoarseness
  • lower back or side pain
  • painful or difficult urination
  • pinpoint red spots on skin

Minor Side Effects

Some pegaspargase side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:
  • General feeling of discomfort or illness
Less common:
  • Anxiety
  • behavior change similar to drunkenness
  • blurred vision
  • cold sweats
  • convulsions (seizures)
  • cool pale skin
  • difficulty in concentrating
  • drowsiness
  • lack of appetite
  • nervousness
  • nightmares
  • pain at place of injection
  • pain in joints or muscles
  • restless sleep
  • shakiness
  • slurred speech

For Healthcare Professionals

Applies to pegaspargase: injectable solution


The most commonly reported side effects were elevated transaminases and clinical allergic reactions to asparaginase (including bronchospasm, hypotension, laryngeal edema, local erythema or swelling, systemic rash, and urticaria).[Ref]


Very common (10% or more): Clinical allergic reactions to asparaginase, including bronchospasm, hypotension, laryngeal edema, local erythema or swelling, systemic rash, and urticaria (non-hypersensitive patients up to 10%; previously hypersensitive patients up to 32%)

Nervous system

Common (1% to 10%): Central nervous system thrombosis/hemorrhage


Common (1% to 10%): Thrombosis[Ref]


Common (1% to 10%): Pancreatitis[Ref]


Common (1% to 10%): Coagulopathy (prolonged prothrombin time or partial thromboplastin time; or hypofibrinogenemia)[Ref]


Very common (10% or more): Elevated transaminases (up to 11%)
Common (1% to 10%): Hyperbilirubinemia
Frequency not reported: Hepatotoxicity, abnormal liver function[Ref]


Common (1% to 10%): Hyperglycemia (requiring insulin therapy)
Frequency not reported: Glucose intolerance


1. "Product Information. Oncaspar (pegaspargase)." Rhone-Poulenc Rorer, Collegeville, PA.

It is possible that some side effects of pegaspargase may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

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