asparaginase erwinia chrysanthemi

High Alert

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

Contraind./Precautions ⬆ ⬇

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).

Adv. Reactions/Side Effects ⬆ ⬇

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

Interactions ⬆ ⬇

Drug-drug:

None reported.

Availability ⬆ ⬇

Solution for injection: 10 mg/0.5 mL

Route/Dosage ⬆ ⬇

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.

US Brand Names ⬆ ⬇

~~Erwinaze,~~ Rylaze

Action ⬆ ⬇

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

Therapeutic effects:

Death of leukemic and lymphoma cells.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: enzymes

Pharmacokinetics ⬆ ⬇

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.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
IM	unknown	unknown	unknown

Patient/Family Teaching ⬆ ⬇

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.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

82507- AGC Biologics A/S
- 82507-001-
  - 82507-001-01- 1000 mL in 1 BOTTLE (82507-001-01)

82507- AGC Biologics A/S
- 82507-001-
  - 82507-001-02- 5000 mL in 1 BOTTLE (82507-001-02)

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Indications ⬇