Asparaginase

Indications
 Parenteral
Induction of remissions in acute lymphoblastic leukaemia
Adult: 1000 units/kg/day via IV inj for 10 days after treatment with vincristine and prednisone or prednisolone. Alternatively, 6000 units/m2 via IM inj, given every 3rd day for 9 doses during treatment with vincristine and prednisone or prednisolone. As monotherapy: 200 units/kg/day via IV inj for 28 days. IV inj to be given over at least 30 min in a running infusion of normal saline or glucose 5%. For IM admin, no more than 2 ml of a solution in normal saline should be injected at a single site.
Child: As monotherapy: 200 units/kg/day via IV inj for 28 days, to be given over at least 30 min in a running infusion of normal saline or glucose 5%.

Special Populations: NOTE: When administered IV, drug should be given over 30 min along with NS or 5% dextrose.

Incompatibility: Incompatible with rubber and should not be mixed with other drugs.
Contraindications
 Pancreatitis, hypersensitivity. Pregnancy.
Warnings / Precautions
 Should be used after skin testing, in hospital setting. Liver disease, frequently blood count monitoring. Lactation.
Adverse Reactions
 Chills, pyrexia, liver disorders. Hyperammonaemia, decrease of fibrinogen and clotting factors, alteration in blood lipids and cholesterol, hypoalbuminaemia, uraemia, renal failure (occasional). Hyperglycaemia. Nausea, vomiting, anorexia, weight loss. CNS disturbances including depression, coma, hallucinations, Parkinson-like syndrome. Marked leucopenia, transient bone-marrow depression.
Potentially Fatal: Acute anaphylaxis; fatal hyperthermia; pancreatitis; ketoacidosis.
Drug Interactions
 Activity of methotrexate may be reduced if L-asparaginase is given before hand.
Potentially Fatal: IV admin of asparaginase may increase vincristine neurotoxicity.
See Below for More asparaginase Drug Interactions
Lab Interactions
 Interferes with thyroid function tests.
Mechanism of Actions
 Asparaginase interferes with malignant cell growth by breaking down asparagine to aspartic acid and ammonia as leukemic cells are unable to synthesise asparagine and depends on exogenous source of asparagine for survival. It acts on the G1 phase of the cell cycle.
Distribution: Distributed at lymph; does not penetrate the CSF.
Excretion: Urine (small amounts). Elimination half-life: 8-30 hr (IV); 49 hr (IM).
Storage Conditions
 Parenteral: Refrigerate at 2-8°C.
ATC Classification
 L01XX02 - asparaginase ; Belongs to the class of other antineoplastic agents. Used in the treatment of cancer.
Storage
 Parenteral: Refrigerate at 2-8°C.
Available As
  • Asparaginase 10000 iu
  • Asparaginase 250 mg
  • Asparaginase 5000 iu

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