History of (with prior L-asparaginase treatment): pancreatitis; hemorrhagic events; serious thrombosis
No more than 2 mL should be administered at any one injection site
Anaphylaxis or serious allergic reactions may occur, monitor patient for 1 hr after administration; discontinue with serious allergic reactions
Glucose intolerance reported (irreversible in some cases); monitor serum glucose
Hepatotoxicity and abnormal liver function, including elevations of AST (SGOT), ALT (SGPT), alkaline phosphatase, bilirubin (direct and indirect), and depression of serum albumin, and plasma fibrinogen may occur; monitor
Discontinue if pancreatitis occurs; evaluate patients with abdominal pain for pancreatitis
Serious thrombotic events, including sagittal sinus thrombosis reported; discontinue if this occurs
Increased prothrombin time, increased PTT and hypofibrinogenemia may occur; monitor for coagulopathy
Pregnancy & Lactation
Pregnancy Category: C
Lactation: not known if excreted in breast milk
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
Mechanism of Action
Modified version of L-asparaginase depletes asparagine, the aminoacid required for protein synthesis, and in turn kills leukemic cells
Half-Life: 5-5.6 days
Onset: Asparagine depleted within 4 days (IM)
Duration: 21 days (IM); 2-4 weeks (IV in asparaginase naive adults)
Vd: 1.5 L/m² (IM in children); 2.4 L/m² (IV in adults)