L-Asparaginase

L-Asparaginase is used in the treatment of some kinds of cancer of white blood cells (leukemia). It may also be used to treat other types of cancer as determined by your doctor. It may be used on its own, or sometimes given together with certain other medicines as part of combination chemotherapy. L-Asparaginase is given as an injection by the doctor, but try to have it the same time each day to make sure it has the best effect. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to. The most common side effect of this medicine includes breathlessness, rash, vomiting, angioedema (swelling of deeper layers of skin), and nausea. It might cause increased blood sugar level, hence regular blood tests are required to monitor your blood sugar levels, response to the therapy and any side effects. It is advised that you drink extra fluids so that you pass more urine. This will help prevent bladder and kidney problems and keep your kidneys working well. This medicine may lower your body's resistance and increasing the susceptibility to infections. Infections can sometimes be life threatening. It is important to use effective contraception to avoid getting pregnant or fathering a child during treatment. Before taking this medicine, inform your doctor if you are pregnant, planning to become pregnant or breastfeeding. .

• Blood cancer (Acute lymphocytic leukemia)

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.

Adult Dose: 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. Child Dose: Parenteral Induction of remissions in acute lymphoblastic leukaemia 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%.

Your doctor or nurse will give you this medicine. Kindly do not self administer.

Common: • Breathlessness • Rash • Vomiting • Angioedema (swelling of deeper layers of skin) • Edema (swelling) • Nausea • Fatigue • Increased liver enzymes • Diarrhea • Decreased blood pressure • Flushing (sense of warmth in the face, ears, neck and trunk) • Low albumin level in blood • Increased glucose level in blood • Hives

[SAFE] L-Asparaginase does not usually affect your ability to drive.

Hypersensitivity. History of pancreatitis, thrombosis, or serious pancreatitis events with prior L-asparaginase treatment.

Activity of methotrexate may be reduced if L-asparaginase is given before hand. Potentially Fatal: IV admin of asparaginase may increase vincristine neurotoxicity.

[CONSULT YOUR DOCTOR] It is not known whether it is safe to consume alcohol with L-Asparaginase. Please consult your doctor.

[CONSULT YOUR DOCTOR] L-Asparaginase may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

[CONSULT YOUR DOCTOR] L-Asparaginase is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.

[SAFE IF PRESCRIBED] L-Asparaginase is probably safe to use in patients with kidney disease. Limited data available suggests that dose adjustment of L-Asparaginase may not be needed in these patients. Please consult your doctor. [CONSULT YOUR DOCTOR] There is limited information available on the use of L-Asparaginase in patients with liver disease. Please consult your doctor. However, regular monitoring of liver function tests is advised while you are taking this medicine.

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