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asparaginase

Other Name(s):
Appearance: Clear solution for injection

Medication Information Sheet
asparaginase (ah-SPARE-ah-gin-aze)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Kidrolase®, Erwinase®

Appearance:
Clear solution

for injection

What is this medication for?
  • Used in combination with other cancer drugs for treating blood cancer (Acute Lymphoblastic Leukemia).
What should I do before I have this medication?
  • Tell  your doctor if you have/had significant medical condition(s), especially if you have / had chicken pox (or have recently been exposed to someone else with this infection), shingles, diabetes, gout, or kidney stones. Also tell your doctor if you have had medical problems with your kidney, liver or pancreas, any allergies, or if you cannot tolerate asparaginase.
  • People with cancer have a higher risk of getting other cancers or developing blood clots. Some cancer medications may increase these risks, especially if used for a long period of time. Discuss any concerns about this medication with your health care team.
How will this medication affect sex, pregnancy and breastfeeding?
  • The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding
  • If there is ANY chance that you or your partner may become pregnant, you and your partner together must:►Use 2 effective forms of birth control at the same time while taking this drug: Keep using birth control until 6 months after the last dose (general recommendation). Discuss with your healthcare team.
  • Tell your doctor right away if you or your partner becomes pregnant.
  • Do not breastfeed while taking this drug.
  • Effects on Fertility: Probable
  • Effects on Fertility: Probable
How is this medication given?
  • This drug is given by injection into a vein, in the muscle or under the skin.

     

     

What else do I need to know while on this medication?
  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • For mild aches and pain:

    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
    • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding.
    • Talk to your health care team before you start or stop these medications.
    • If you feel unwell, take your temperature before taking any of these medications. They may hide a fever. 
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
  • Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.

What are the side effects of this medication?

The following side effects have been seen in people using asparaginase with other chemotherapy drugs, so some of these effects may also be related to chemotherapy.

Common side effects usually occur in more than 1 out of every 10 patients. Other side effects are less common, but may be severe. You may not have all of the side effects below. You may have side effects that are not listed.

 

 

Side effects and what to do When to contact doctor?
Less Common Side Effects, but may be Severe

Liver problems (yellow skin or eyes, dark urine)

Low proteins in blood (you may experience muscle weakness, fatigue or cramps, poor appetite, general body swelling)

Get emergency medical help right away

Allergic reaction
(fever, severe rash, itchiness, swollen face, lip or tongue, chest or throat tightness)

  • May occur during or shortly after the drug is given.
Get emergency medical help right away

Effects on the brain
(confusion, drowsiness, hallucinations, depression, nervousness)

Contact your health care team as soon as possible (office hours)

Bleeding/clotting disorder
(may include bleeding from more than one site, bruising, signs of blood clots, kidney/liver/lung problems, fever, confusion)

Get emergency medical help right away

Rupture in stomach or intestine wall
(Sudden, severe pain in belly or stomach area)

Get emergency medical help right away

High blood sugar

  • Check your own blood sugar if you are diabetic
  • Significant rise in blood sugar levels (Increased thirst and urinates frequently); Get emergency medical help if this occurs
Contact your health care team if no improvement or if severe

Sudden increase in body temperature
(usually with other symptoms such as rapid breathing, rapid heart-beat, muscle stiffness; muscle aches and brownish urine may occur)

Get emergency medical help right away

Rapid killing of cancer cells when you start treatment may lead to build up of cell waste products

  • If mild, this may cause gout, with joint pains, but if severe, may cause fevers, kidney failure, confusion and be life-threatening.
  • You MUST take the preventive medicines given by your doctor AND
  • Drink plenty of fluids (6-8 glasses per day) and void (urinate) frequently.
Get emergency medical help right away

Unusual bleeding or bruising

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting chemotherapy treatments:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often.
  • Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. See our Neutropenia (Low white blood cell count) pamphlet for more information.

Get emergency medical help right away

Proteins in Urine; Kidney problems
(lower back pain, body swelling)

  • Also look for passing little or no urine, darkening or blood in urine, or recent unusual weight gain
  • Your doctor may monitor for proteins in the urine regularly.
Get emergency medical help right away

Pancreas problems
(increased pain in centre of belly and may extend to back, appetite or weight loss)

Get emergency medical help right away

Blood clot
(limb pain or swelling, hardened vein in limb)

Get emergency medical help right away

Other less common side effects have been reported:

  • Fall in cholesterol levels
  • Diarrhea
  • Nausea and vomiting


For more links on how to manage your symptoms go to www.cancercare.on.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.