Drug Action
Asparaginase is an enzyme which acts by breaking down L-asparagine to aspartic acid and ammonia, this disrupts protein synthesis of tumour cells.
PDF page 1005
Loading InternPractice…
Drug reference
Asparaginase is an enzyme which acts by breaking down L-asparagine to aspartic acid and ammonia, this disrupts protein synthesis of tumour cells.
PDF page 1005
Acute lymphoblastic leukaemia (in combination with other antineoplastic drugs) (specialist use only) ▶BY INTRAVENOUS INFUSION ▶Adult: 5000 units/m2 every 3 days
PDF page 1005
History of pancreatitis related to asparaginase therapy. history of serious haemorrhage related to asparaginase therapy. history of serious thrombosis related to asparaginase therapy. pancreatitis. pre-existing known coagulopathy
PDF page 1005
Diabetes (may raise blood glucose). hypersensitivity reactions. hypertriglyceridaemia (severe)—increased risk of acute pancreatitis CAUTIONS, FURTHER INFORMATION ▶Hypersensitivity reactions Serious hypersensitivity reactions, including life-threatening anaphylaxis, can occur— asparaginase should only be administered when appropriately trained staff and resuscitation facilities are immediately available; in the event of a hypersensitivity reaction, treatment should be stopped immediately and appropriate management initiated. Manufacturer advises an intracutaneous or small intravenous test dose can be used but is of limited value for predicting which patients will experience an allergic reaction.
PDF page 1005
Scottish Medicines Consortium (SMC) decisions SMC No. 1319/18 The Scottish Medicines Consortium has advised (April 2018) that asparaginase (Spectrila ®) is accepted for use within NHS Scotland when used as a component of antineoplastic combination therapy for the treatment of acute lymphoblastic leukaemia in paediatric patients from birth to 18 years and adults.
PDF page 1006
→Appendix 1: asparaginase
PDF page 1005
▶Common or very common Abdominal pain. agitation. anaemia. angioedema. appetite decreased. arthralgia. back pain. bronchospasm. confusion. depression. diarrhoea. disseminated intravascular coagulation. dizziness. drowsiness. dyspnoea. embolism and thrombosis. fatigue. flushing. haemorrhage. hallucination. hyperglycaemia. hypersensitivity. hypoalbuminaemia. hypoglycaemia. hypotension. increased risk of infection. leucopenia. nausea. neurological effects. oedema. pancreatitis. skin reactions . thrombocytopenia. vomiting. weight decreased ▶Uncommon Headache. hyperammonaemia. Immune system and malignant disease hyperuricaemia ▶Rare or very rare Coma. consciousness impaired. diabetic ketoacidosis. hepatic disorders. hyperparathyroidism. hypoparathyroidism. ischaemic stroke. necrotising pancreatitis. pancreatic pseudocyst. posterior reversible encephalopathy syndrome (PRES). seizure. tremor SIDE-EFFECTS, FURTHER INFORMATION There have been rare reports of cholestasis, icterus, hepatic cell necrosis and hepatic failure with fatal outcome; manufacturer advises interrupt treatment if these symptoms develop.
PDF page 1006
Manufacturer advises effective contraception in men and women of child- bearing potential during treatment and for at least 3 months after last dose; asparaginase may reduce effectiveness of oral contraceptives—additional precautions (e.g. barrier method) are required, see also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
PDF page 1006
Manufacturer advises avoid unless essential—toxicity in animal studies. See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
PDF page 1006
Manufacturer advises avoid—no information available.
PDF page 1006
Manufacturer advises avoid in severe impairment—no information available.
PDF page 1006
▶Manufacturer advises monitor trough serum asparaginase levels 3 days after administration; consider switching to a different asparaginase preparation if target levels not reached—seek expert advice. ▶Manufacturer advises monitor bilirubin, hepatic transaminases, and coagulation parameters before and during treatment; in addition, monitor plasma and urinary glucose, amylase, lipase, triglycerides, cholesterol and serum protein levels during treatment. l HANDLING AND STORAGE Manufacturer advises store in a refrigerator (2–8°C)—consult product literature for storage conditions after reconstitution and dilution.
PDF page 1006
There can be variation in the licensing of different medicines containing the same drug. Powder for solution for infusion ▶Spectrila (medac UK) A Asparaginase 10000 unit Spectrila 10,000unit powder for concentrate for solution for infusion vials | 1 vial P £450.00 (Hospital only)
PDF page 1006
Driving and skilled tasks Manufacturer advises asparaginase has moderate influence on driving and performance of skilled tasks—increased risk of dizziness and somnolence.
PDF page 1006
5000 units/m2 every 3 days
First-line fragment. Read the complete Indications and Dose section above.
PDF page 1005