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Pegzilarginase-nbln injection may cause serious or life-threatening allergic reactions. These reactions may occur with the first few doses or at any time during your treatment. You will first receive your medication in a healthcare setting. Your doctor will watch you carefully during and after the injection. Your doctor may give you certain medications before you receive pegzilarginase-nbln injection to help to prevent a reaction. Tell your doctor if you experience difficulty swallowing or breathing, shortness of breath, wheezing, hoarseness, hives, rash, itching, redness of the skin, sudden redness of the face, neck or upper chest or swelling of the face, throat, tongue or lips.
WHY is this medicine prescribed?
Pegzilarginase-nbln is used to treat Arinase 1 Deficiency (ARG 1-D; an inherited condition with a partial or complete lack of the enzyme arginase in the body). Pegzilarginase-nbln is in a class of medications called enzymes. It works by reducing the amount of arginine in the body.
HOW should this medicine be used?
Pegzilarginase-nbln comes as a solution to be injected intravenously (into a vein) or subcutaneously (just under the skin) by a doctor or a nurse in a hospital or clinic. You will receive pegzilarginase-nbln intravenously once weekly over 30 minutes for 8 weeks. After that time you may receive it subcutaneously once weekly into your abdomen, thigh, or upper arms.
If you tolerate receiving the medication subcutaneously, your doctor may allow you or a caregiver to perform the injections at home. If you using pegzilarginase-nbln injection at home, your healthcare provider will show you or a caregiver how to prepare and inject a dose of the medication. Also read the manufacturer's information for the patient that comes with it. Be sure that you understand these directions. Ask your healthcare provider if you have any questions about how to prepare or inject the medication or how to dispose of used needles and syringes after you inject the medication.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.
Are there OTHER USES for this medication?
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What SPECIAL PRECAUTIONS should I follow?
Before recieving pegzilarginase-nbln,
What SPECIAL DIETARY instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do IF I FORGET to take a dose?
If you miss an appointment to receive a dose, contact your healthcare provider as soon as possible. If you are using pegzilarginase-nbln at home and miss a dose, contact your healthcare provider as you may need to receive the next doses in a healthcare setting.
What SIDE EFFECTS can this medicine cause?
Pegzilarginase-nbln may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
Some side effects can be serious. If you experience those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment.
Pegzilarginase-nbln may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
What should I do in case of OVERDOSE?
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at http://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
What should I know about STORAGE and DISPOSAL of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it in refrigerator and protect from light. Do not freeze or shake.
Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org
Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website http://goo.gl/c4Rm4p for more information.
What OTHER INFORMATION should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to pegzilarginase-nbln.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS® Patient Medication Information™ Copyright, 2026. The American Society of Health-System Pharmacists®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.
Selected Revisions: May 15, 2026.