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Asparaginase information from DrugsUpdate  

See Available Brands of Asparaginase in India

P - Contraindicated in pregnancy
L - Contraindicated in lactation
LI - Lab*

Asparaginase (EC 3.5.1.1) is an enzyme that catalyzes the hydrolysis of asparagine to aspartic acid. It is marketed under the brand name Elspar, to treat acute lymphoblastic leukemia (ALL) and is also used in some mast cell tumor protocols. Unlike other chemotherapy agents, it can be given as an intramuscular, subcutaneous, or intravenous injection without fear of tissue irritation.

Pharmacodynamics

Information not available

Pharmacokinetics

Absorption
IM
T max is 14 to 24 h.
Distribution
Vd is approximately 70% to 80% of the estimated plasma volume.
Elimination
Trace amounts found in urine.
IV
T ½ is 8 to 30 h.
IM
T ½ is 39 to 49 h.

Asparaginase Indications / Asparaginase Uses

In induction of remissions in acute lymphoblastic leukaemia.

Asparaginase Adverse Reactions / Asparaginase Side Effects

Chills, pyrexia, liver disorders. Hyperammonaemia, decrease of fibrinogen and clotting factors, alteration in blood lipids and cholesterol, hypoalbuminaemia, uraemia, renal failure (occasional). Hyperglycaemia. Nausea, vomiting, anorexia, weight loss. CNS disturbances including depression, coma, hallucinations, Parkinson-like syndrome. Marked leucopenia, transient bone-marrow depression.
Potentially Fatal: Acute anaphylaxis; fatal hyperthermia; pancreatitis; ketoacidosis.

Precautions

Warnings
Anaphylaxis
Be prepared to treat anaphylaxis at each administration.
Intradermal skin test should be performed prior to initial administration of this drug and repeated when at least 1 wk separates doses.
Monitor
Leukocyte counts
Monitor leukocyte counts and serum uric acid. Take appropriate preventive measures. Monitor peripheral blood count and bone marrow frequently.
Serum amylase
Obtain frequent serum amylase to detect early evidence of pancreatitis. If pancreatitis occurs, discontinue therapy.

Special Precautions

Should be used after skin testing, in hospital setting. Liver disease, frequently blood count monitoring. Lactation.

Other Drug Interactions

Activity of methotrexate may be reduced if L-asparaginase is given before hand.
Potentially Fatal: IV admin of asparaginase may increase vincristine neurotoxicity.

Other Interactions

Information not available

Dosage

Parenteral
Induction of remissions in acute lymphoblastic leukaemia
Adult: 1000 units/kg/day via IV inj for 10 days after treatment with vincristine and prednisone or prednisolone. Alternatively, 6000 units/m2 via IM inj, given every 3rd day for 9 doses during treatment with vincristine and prednisone or prednisolone. As monotherapy: 200 units/kg/day via IV inj for 28 days. IV inj to be given over at least 30 min in a running infusion of normal saline or glucose 5%. For IM admin, no more than 2 ml of a solution in normal saline should be injected at a single site.
Child: As monotherapy: 200 units/kg/day via IV inj for 28 days, to be given over at least 30 min in a running infusion of normal saline or glucose 5%.
Incompatibility: Incompatible with rubber and should not be mixed with other drugs.

Food(before/after)

Information not available

List of Contraindications

Asparaginase and Pregnancy

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Asparaginase and Lactation

Discontinue breast-feeding or the drug

Asparaginase and Children

Toxicity is reported to be greater in adults than in children

Asparaginase and Geriatic

Information not available

Asparaginase and Other Contraindications

Pancreatitis, hypersensitivity. Pregnancy

Storage

Parenteral: Refrigerate at 2-8°C

Lab interference

Parenteral: Refrigerate at 2-8°C

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