Asparaginase

Dosage Forms

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Powder for injection

10,000 IU

Uses

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Acute lymphoblastic anaemia

Dose and Duration

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Acute lymphoblastic anaemia

Can be given by IV, IM or SC injection For all patients the usual dose is 6,000 units/m2 body surface area (200 units/kg of body weight), three times a week for 3 weeks

Contraindications

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History of pancreatitis related to asparaginase therapy
Previous allergic reaction to L-asparaginase

Side Effects

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Hypersensitivity (rashes, urticaria, laryngeal oedema, bronchospasm, hypotension)
Anaphylaxis
Coagulation abnormalities (e.g. thromboses)
Bleeding disorders
Liver dysfunction, altered liver enzyme parameters
Pancreatic disorders
Lethargy, sleepiness, confusion, dizziness, neurotoxicity, convulsions, headache
Dyspnoea
Diarrhoea
Nausea and vomiting
Fever, chills, generalised body pain
Swelling of limbs
Injection site reactions (pain, swelling, redness)
Hyperglycaemia

Interactions

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Methotrexate (cancelled effect of methotrexate)
Prednisolone (decrease in fibrinogen and antithrombin III clotting factors. Increased risk of thromboses)
Vincristine (increased risk of anaphylaxis and toxicity)

Patient instructions

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Report immediately to health worker if you experience hypersensitivity or bleeding disorders

Pregnancy

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Do not use

Breastfeeding

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Do not use

Storage

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Store between 2‒8°C. Do not freeze.

⚠️ Caution

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Discontinue treatment immediately if hypersensitivity occurs
Facilities for management of anaphylaxis should be readily available
Monitor patient closely when used in combination with other hepatotoxic medicines
Monitor patient closely when used in combination with other medicines that cause bleeding disorders (warfarin, steroids, NSAIDS)
Monitor liver function tests during treatment
Anticancer medicines should only be handled by health workers trained and experienced in cytotoxic medicines