• Part of combination chemotherapy in the treatment of ALL and lymphoblastic lymphoma in patients who developed hypersensitivity to E. coli-derived asparaginase.

Contraindicated in:

• Previous hypersensitivity
• History of pancreatitis with prior asparaginase therapy
• History of serious thrombosis or hemorrhagic events with prior asparaginase therapy
• OB: Pregnancy
• Lactation: Lactation.

Use Cautiously in:

• Rep: Women of reproductive potential.
• Pedi: Children <1 mo (safety and effectiveness not established).

CV: tachycardia.

Endo: hyperglycemia.

F and E: dehydration.

GI: ↓ appetite, ↑ liver enzymes, abdominal pain, constipation, diarrhea, hyperbilirubinemia, nausea, pancreatitis, stomatitis, vomiting.

Hemat: bleeding, thrombotic events.

MS: pain.

Neuro: headache, insomnia, peripheral neuropathy.

Resp: cough.

Misc: fatigue, fever, hypersensitivity reactions(including anaphylaxis and angioedema) , infection.

Drug-Drug:

• None reported.

• Solution for injection: 10 mg/0.5 mL;

• IM (Adults and Children ≥1 mo): Substitution for calaspargase pegol: 25 mg/m² every 48 hr for 11 doses substituted for each dose of calaspargase pegol or 25 mg/m² on Monday morning and Wednesday morning, then 50 mg/m² on Friday afternoon (administer 9 doses to substitute for each dose of calaspargase pegol. Substitution for pegaspargase: 25 mg/m² every 48 hr for 7 doses substituted for each dose of pegaspargaseor 25 mg/m² on Monday morning and Wednesday morning, then 50 mg/m² on Friday afternoon (administer 6 doses to substitute for each dose of pegaspargase.

Erwinaze, Rylaze

• Catalyst in the conversion of asparagine (an amino acid) to aspartic acid and ammonia.
• Depletes asparagine in leukemic cells.

• Death of leukemic and lymphoma cells.

Therapeutic Classification: antineoplastics

Pharmacologic Classification: enzymes

Absorption: 37% absorbed following IM administration unknown.

Distribution: Remains in the intravascular space. Poor penetration into the CSF.

Metabolism/Excretion: Slowly sequestered in the reticuloendothelial system.

Half-life: 15–18 hr.

• Explain purpose of medication to patient.
• Instruct patient to notify health care professional if signs and symptoms of hypersensitivity reaction, pancreatitis, thrombosis or hemorrhage (headache, arm or leg swelling, shortness of breath, chest pain) or hyperglycemia (excess thirst or increase in frequency or volume of urination), occur.
• Rep: May cause fetal harm. Advise females of reproductive potential to use effective nonhormonal contraception during and for 3 mos after last dose and to avoid breastfeeding during and for 1 wk after last dose. Advise female patients to notify health care professional promptly if pregnancy is planned or suspected, or if breast feeding.
• Emphasize need for periodic lab tests to monitor for side effects.

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