• First-line treatment of acute lymphoblastic leukemia (ALL) (in combination with other chemotherapy agents).
• Treatment of ALL in patients who have had a previous hypersensitivity reaction to native l-asparaginase (in combination with other chemotherapy agents).

Contraindicated in:

• Hypersensitivity to pegaspargase
• History of serious thrombosis with previous l-asparaginase therapy
• History of pancreatitis, including pancreatitis association with previous l-asparaginase therapy
• History of serious hemorrhagic events to previous l-asparaginase therapy
• Severe hepatic impairment
• OB: Pregnancy (may cause fetal harm)
• Lactation: Lactation.

Use Cautiously in:

• History of previous hypersensitivity reaction to l-asparaginase (↑ risk of hypersensitivity reaction)
• Rep: Women of reproductive potential.

Endo: hypercholesterolemia, hyperglycemia, hypertriglyceridemia.

CV: peripheral edema.

GI: HEPATOTOXICITY, PANCREATITIS, abdominal pain, anorexia, diarrhea, nausea, vomiting.

Hemat: HEMORRHAGE, THROMBOSIS, neutropenia.

Local: injection site reactions.

MS: arthralgia, myalgia.

Neuro: paresthesia , SEIZURES, headache, malaise.

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA), chills, night sweats.

Drug-Drug:

• May alter response to anticoagulants or antiplatelet agents.

• Solution for injection: 750 units/mL;

• IM, IV (Adults >21 yr): 2500 units/m² no more frequently than every 14 days.
• IM, IV (Adults and Children 21 yr): 2000 units/m² no more frequently than every 14 days.

Oncaspar

• Consists of l-asparaginase bound to polyethylene glycol (PEG). This compound depletes asparagine, which leukemic cells cannot synthesize. Normal cells are able to produce their own asparagine and are less susceptible to the effects of asparaginase. Binding to PEG renders asparaginase less antigenic and therefore less likely to induce hypersensitivity reactions.

• Death of leukemic cells.

Therapeutic Classification: antineoplastics

Pharmacologic Classification: enzymes

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Metabolized by serum proteases and in the reticuloendothelial system.

Half-life: 5.7 days (less in patients with previous hypersensitivity to native l-asparaginase).

(hematologic effects)

• Inform patient of the possibility of hypersensitivity reactions, including anaphylaxis.
• Advise patient that concurrent use of other medications may increase the risk of bleeding and the toxicity of pegaspargase. Consult health care professional before taking any other medications, including OTC drugs.
• Instruct patient to notify health care professional if abdominal pain, severe nausea and vomiting, jaundice, fever, chills, sore throat, bleeding or bruising, excess thirst or urination, or mouth sores occur. Caution patient to avoid crowds and persons with known infections. Instruct patient to use soft toothbrush, electric razor, and to be especially careful to avoid falls. Patients should also be cautioned not to drink alcoholic beverages or take medications containing aspirin or NSAIDs because these may precipitate gastric bleeding.
• Instruct patient not to receive any vaccinations without advice of health care professional. Advise parents that this may alter child’s immunization schedule.
• Rep: Advise females of reproductive potential to use 2 methods of effective contraception, including a barrier method, and avoid breast feeding during therapy and for at least 3 mo after last dose. Pegaspargase may decrease effectiveness of oral contraceptives, oral contraceptives are not recommended.
• Emphasize the need for periodic lab tests to monitor for side effects.

peg-ass-PAR-jase

NDC Code^*

• 0944- Baxalta US Inc.
  • 0944-3810- ONCASPAR
    • 0944-3810-01- 1 VIAL, SINGLE-USE in 1 CARTON (0944-3810-01) > 5 mL in 1 VIAL, SINGLE-USE