Asparaginase Erwinia Chrysanthemi Dosage

Medically reviewed by Drugs.com. Last updated on Dec 14, 2022.

Usual Adult Dose for Acute Lymphoblastic Leukemia

There are two recommended regimens that can be used to replace a long-acting asparaginase product dose:

When administered every 48 hours: 25 mg/m2 IM every 48 hours
Recommended duration:

• To replace one dose of Calaspargase Pegol product: 11 doses of this drug
• To replace one dose of Pegaspargase products: 7 doses of this drug

When administered on a Monday/Wednesday/Friday schedule: 25 mg/m2 IM on Monday and Wednesday mornings, and 50 mg/m2 IM on Friday afternoon (53 to 58 hours after Wednesday morning dose)
Recommended duration:

• To replace one dose of Calaspargase Pegol product: 9 doses of this drug
• To replace one dose of Pegaspargase products: 6 doses of this drug

Comments:

• Premedicate patients as recommended (see Administration advice)

Uses:

• Indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of patients with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) in adults who have developed hypersensitivity to E. coli-derived asparaginase.

Usual Adult Dose for Lymphoma

There are two recommended regimens that can be used to replace a long-acting asparaginase product dose:

When administered every 48 hours: 25 mg/m2 IM every 48 hours
Recommended duration:

• To replace one dose of Calaspargase Pegol product: 11 doses of this drug
• To replace one dose of Pegaspargase products: 7 doses of this drug

When administered on a Monday/Wednesday/Friday schedule: 25 mg/m2 IM on Monday and Wednesday mornings, and 50 mg/m2 IM on Friday afternoon (53 to 58 hours after Wednesday morning dose)
Recommended duration:

• To replace one dose of Calaspargase Pegol product: 9 doses of this drug
• To replace one dose of Pegaspargase products: 6 doses of this drug

Comments:

• Premedicate patients as recommended (see Administration advice)

Uses:

• Indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of patients with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) in adults who have developed hypersensitivity to E. coli-derived asparaginase.

Usual Pediatric Dose for Acute Lymphoblastic Leukemia

There are two recommended regimens that can be used to replace a long-acting asparaginase product dose:

When administered every 48 hours: 25 mg/m2 IM every 48 hours
Recommended duration:

• To replace one dose of Calaspargase Pegol product: 11 doses of this drug
• To replace one dose of Pegaspargase products: 7 doses of this drug

When administered on a Monday/Wednesday/Friday schedule: 25 mg/m2 IM on Monday and Wednesday mornings, and 50 mg/m2 IM on Friday afternoon (53 to 58 hours after Wednesday morning dose)
Recommended duration:

• To replace one dose of Calaspargase Pegol product: 9 doses of this drug
• To replace one dose of Pegaspargase products: 6 doses of this drug

Comments:

• Premedicate patients as recommended (see Administration advice)

Uses:

• Indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of pediatric patients one month old or older, with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) who have developed hypersensitivity to E. coli-derived asparaginase.

Usual Pediatric Dose for Lymphoma

There are two recommended regimens that can be used to replace a long-acting asparaginase product dose:

When administered every 48 hours: 25 mg/m2 IM every 48 hours
Recommended duration:

• To replace one dose of Calaspargase Pegol product: 11 doses of this drug
• To replace one dose of Pegaspargase products: 7 doses of this drug

When administered on a Monday/Wednesday/Friday schedule: 25 mg/m2 IM on Monday and Wednesday mornings, and 50 mg/m2 IM on Friday afternoon (53 to 58 hours after Wednesday morning dose)
Recommended duration:

• To replace one dose of Calaspargase Pegol product: 9 doses of this drug
• To replace one dose of Pegaspargase products: 6 doses of this drug

Comments:

• Premedicate patients as recommended (see Administration advice)

Uses:

• Indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of pediatric patients one month old or older, with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) who have developed hypersensitivity to E. coli-derived asparaginase.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Dose modifications for adverse reactions:

HYPERSENSITIVITY REACTIONS:

• Grade 2: Treat symptoms
• Grade 3 to 4: Discontinue permanently

PANCREATITIS:

• Grade 2 to 4:
• Withhold treatment for lipase or amylase elevations greater than 2 times the upper limit of normal (ULN), or for symptomatic pancreatitis.
• Resume treatment when lipase and amylase are less than 1.5 times the ULN, and symptoms resolve.
• Discontinue permanently if clinical necrotizing or hemorrhagic pancreatitis is confirmed.

THROMBOSIS:
Uncomplicated thrombosis:

• Withhold treatment, treat with appropriate antithrombotic therapy.
• Consider resuming treatment upon resolution of symptoms and continue antithrombotic therapy.

Severe or life-threatening thrombosis:

• Discontinue permanently and treat with appropriate antithrombotic therapy.

HEMORRHAGE:
Grade 3 to 4:

• Withhold treatment, evaluate coagulopathy, and consider clotting factor replacement as needed.
• Resume treatment with the next scheduled dose if the bleeding is controlled.

HEPATOTOXICITY:
Total bilirubin greater than 3 times to lower than 10 times ULN:

• Withhold treatment until total bilirubin levels decrease to 1.5 times the ULN or lower.

Total bilirubin greater than 10 times the ULN:

• Discontinue treatment (do not make up missed doses).

Precautions

US FDA requires a medication guide to assure safe use. For additional information: www.fda.gov/drugs/drug-safety-and-availability/medication-guides

CONTRAINDICATIONS:

• History of serious hypersensitivity to Erwinia asparaginase, including anaphylaxis
• Serious pancreatitis with previous L-asparaginase therapy
• Serious thrombosis with previous L-asparaginase therapy
• Serious hemorrhagic events with previous L-asparaginase therapy

Safety and efficacy have not been established in patients younger than 1 month old.
Safety and efficacy have not been established in patients 65 years or older.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Premedicate patients with acetaminophen, an H-1 receptor blocker, and an H-2 receptor blocker 30 to 60 minutes before administration to decrease the risk of hypersensitivity reactions.
• Ensure that medical support is available to appropriately manage anaphylactic reactions.
• Administer by intramuscular (IM) injection only.
• Do not inject in scar tissue or red, swollen areas.
• Rotate injection sites.

Storage requirements:

• Store unused or unopened vials and cartons at 2C to 8C (36F to 46F).
• Store in original carton to protect from light.
• Do not shake or freeze.
• If prepared dose is not used immediately, store the syringe at room temperature 15C to 25C (59F to 77F) for up to 8 hours or refrigerate at 2C to 8C (36F to 46F) for up to 24 hours. The syringe does not need to be protected from light during storage.

Preparation techniques: The manufacturer product information should be consulted.

Monitoring:

• Monitor bilirubin, transaminases, glucose levels at baseline and periodically every 2 to 3 weeks during treatment.

Patient advice:

• Read the Patient Information and Instructions for Use.

Further information

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

Medical Disclaimer