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 of Pegaspargase
There are a number of things you can do to manage the side effects of pegaspargase. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:
Allergic Reaction
In some cases, patients can have an allergic reaction to this medication. Signs of a reaction can include: shortness of breath or difficulty breathing, chest pain, rash, flushing, itching, swelling at the injection site, or a decrease in blood pressure. If you notice any changes in how you feel during the infusion, let your nurse know immediately.
High Blood Sugar
This medication can cause elevated blood sugar levels in patients with and without diabetes. Your oncology care team will monitor your blood sugar. If you develop increased thirst, urination or hunger, blurry vision, headaches, or your breath smells like fruit, notify your healthcare team. Diabetics should monitor their blood sugar closely and report elevations to the healthcare team.
Pancreatitis
This medication can cause an inflammation of the pancreas, called pancreatitis. Your care provider may order blood tests to check how your pancreas is functioning. Notify your healthcare team if you experience abdominal pain, nausea or vomiting.
Liver Toxicity
This medication can cause liver toxicity, which your oncology care team may monitor for using blood tests called liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, if you have rapid weight gain, if your urine appears dark or brown, or if you have swelling or pain in your abdomen (belly), as these can be signs of liver toxicity.
Blood Clots
Pegaspargase can increase the risk of blood clots. These clots can occur anywhere in the body. Symptoms of blood clots can include severe headache, swelling in the arm or leg, chest pain or shortness of breath, among others. If you experience any unusual symptoms, you should contact your healthcare provider immediately or go to an emergency room.
Bleeding
This medication can impact the ability for your blood to clot normally. This can cause excessive bleeding. Your healthcare team will monitor your blood clotting ability during and after treatment. Notify your healthcare team or go to the emergency room immediately if you experience uncontrolled bleeding; including blood in the urine, black or bloody stool, nosebleeds, or other bleeding.
Reproductive Concerns
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective non-hormonal birth control is necessary during treatment and for 3 months after the last dose. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should not breastfeed during treatment and for 1 month after the last dose.