Adult Dosing
Acute lymphoblastic leukemia (ALL)
Note:
- For IM administration, limit the volume at a single injection site to 2 mL if a volume >2 mL two injection sites should be used
- Administered IV over a period of not less than thirty minutes through the side arm of an infusion of sodium chloride Injection or 5% Dextrose Injection
Pediatric Dosing
Acute lymphoblastic leukemia (ALL)
Note:
- For IM administration, limit the volume at a single injection site to 2 mL, if a volume >2 mL two injection sites should be used
- Administered IV over a period of not less than thirty minutes through the side arm of an infusion of sodium chloride Injection or 5% Dextrose Injection
[Outline]
See Supplemental Patient Information
- Asparaginase causes serious allergic reactions; patients with prior exposure to the drug or other Escherichia coli-derived are at higher risk.
- Monitor the patient for an hour after administration of drug with all the necessary resuscitation equipment and drugs to treat anaphylaxis
- May require premedication and desensitization with dexamethasone IV and pheniramine IV
- Discontinue the drug if serious thrombotic events, including sagittal sinus thrombosis occurs
- Asparaginase causes fulminant or fatal pancreatitis, evaluate the patients and discontinue the drug in patients with pancreatitis
- Monitor serum glucose, as irreversible glucose intolerance occurs in patients receiving asparaginase
- Increased prothrombin time, increased partial thromboplastin time, and hypofibrinogenemia occur with the therapy. Monitor coagulation parameters at baseline and periodically during and after treatment
- Observe for CNS hemorrhages
- Patients with severe or symptomatic coagulopathy should be treated with fresh-frozen plasma to replace coagulation factors
- Fulminant hepatic failure, hepatotoxicity and abnormal liver function occurs, monitor hepatic enzymes and bilirubin at baseline and periodically during treatment
Cautions: Use cautiously in
- Hepatic impairment
- Clotting abnormalities
- Prior asparaginase treatment
Supplemental Patient Information
- Immediately report to the healthcare professional if there is swelling of the face, arms or legs, with or without pain, acute difficulty in breathing/shortness of breath, severe headache, seizures, change in mental status, new onset chest pain, severe abdominal pain
- Inform if there is excessive thirst or an increase in the volume or frequency of urination
- Inform the clinician if pregnant
Pregnancy Category:C
Breastfeeding: Possibly unsafe. Because of the potential for serious adverse reactions in nursing infants a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
