Pegaspargase (Oncaspar)
Pronounce: peg-as-para-gaze
Classification: Enzyme, antineoplastic agent
About Pegaspargase (Oncaspar)
All cells in the body need the amino acid asparagine to survive. Normal white blood cells can make their own asparagine, but cancerous white blood cells cannot. Pegaspargase is an enzyme that speeds up the breakdown of asparagine in the blood into aspartic acid and ammonia. This reduces the level of asparagine in the body. Without asparagine available in the body, the cancer cells die.
How to take Pegaspargase
Pegaspargase is given by intravenous (into a vein) infusion or as an injection given into a big muscle (called intramuscular or IM). It can be given alone, or in combination with other medications. The dose you receive depends on the regimen your oncology team is using. This medication can cause an allergic reaction so you may be given medications to prevent a reaction 30-60 minutes before your dose is given.
Possible Side Effects
These are some of the most common or most serious side effects of this medication. Talk with your provider about the side effects you are having and how they can be managed.
Allergic Reactions
Some people may have an allergic reaction to this medication. Signs of an allergic reaction are:
- Shortness of breath or trouble breathing.
- Chest pain.
- Rash.
- Itching.
- Flushing (reddening of the skin, often on the face, neck, or chest).
- A drop in blood pressure (you may feel lightheaded, dizzy, or weak).
If you have any of these signs while you are getting an infusion, tell your provider right away. The infusion will be slowed down or stopped. Depending on your reaction, you may still be able to get the medication if you are given medicine to prevent a reaction or if the medication is given at a slower rate.
High Blood Sugar
This medication can cause high blood sugar in patients with and without diabetes. Symptoms can be:
- Feeling more thirsty.
- More frequent urination.
- Feeling hungrier.
- Blurry vision.
- Headaches.
- Breath smelling like fruit.
All patients will have their blood sugar checked with blood tests. If you have diabetes and your blood sugars are higher than normal, talk to your provider. Tell your provider if you have any of these symptoms.
Pancreas Problems
This medication can affect your pancreas. Call your provider if you have any symptoms of pancreatitis (inflammation of the pancreas), such as:
- Bloating,
- Indigestion.
- Nausea and/or vomiting.
- Fatty stools (that are bulky, pale, oily, and sometimes float).
- Not feeling hungry (loss of appetite).
- Sweating.
- Abdominal (belly) pain or swelling.
- Weight loss.
Your provider may monitor certain blood levels with labs during and after treatment.
Liver Toxicity
This medication can cause liver toxicity, or liver problems, which your provider may monitor for with blood tests called liver function tests. Symptoms may be:
- Yellowing of your skin or eyes.
- Dark or brown urine.
- Pain in your abdomen (belly).
This medication, and when used in combination with other medications, may also potentially cause a serious side effect called veno-occlusive disease, also known as hepatic sinusoidal obstruction syndrome. This is caused by blockage of the blood flow through the small veins of the liver. Symptoms that should immediately be reported to your care team include yellowing of the skin or eyes, an enlarged liver which can lead to discomfort in the upper abdomen, weight gain, and fluid accumulation in the belly. The chance of having this side effect is higher if you are planning to receive a stem cell transplant after receiving this medication.
Tell your provider if you have any of these symptoms.
Blood Clots
This medication can put you at a higher risk for blood clots like deep vein thrombosis (DVT) or pulmonary embolism (PE). Symptoms may be:
- Swelling, redness, or pain in an arm or leg.
- Sudden shortness of breath.
If you have any of these symptoms, call 911.
Bleeding
If you notice you are bleeding more easily or for no reason, especially new bleeding from your gums or nose, call your provider right away. You may also bruise more easily.
If you have bright red or dark, tarry stool, blood in your vomit, vomit that looks like coffee grounds, or have any signs of stroke (severe headache, trouble talking, weakness on one side, confusion), call 911 right away.
Reproductive Concerns
There is a higher risk of health problems for your baby if you are pregnant, become pregnant, or get someone pregnant while on this medication. To lower the risk of birth defects, you should use birth control (contraception) to avoid pregnancy.
Talk with your provider about what kind of birth control is safest for you and your partner.
If you can become pregnant, you will need to use effective birth control for 3 months after the last dose of this medication, even if your menstrual cycle has stopped or changed.
If you can get someone pregnant, you will need to use effective birth control for 3 months after the last dose of this medication, even if you believe you are not producing sperm.
You should not breastfeed during treatment and for 1 month after the last dose of this medication.