Asparaginase (L-Asparaginase, Erwinia L-asparaginase, Elspar®, Kidrolase®, Erwinaze)
Last Modified: July 23, 2015
Classification: Enzyme, Antineoplastic agent
Asparaginase is an enzyme (a protein that makes chemical reactions go faster) that speeds up the reaction that turns asparagine into aspartic acid and ammonia. Cancerous white blood cells depend on asparagine to survive, so if all of it is used up through the catalyzed reaction, the cancerous cells die. Normal white blood cells can produce their own asparagine, and are therefore less affected by the drug.
There are several forms of asparaginase, made from different bacteria and your care team will determine which type is best for you.
How to Take Asparaginase
Asparaginase is given by intravenous (into a vein) infusion over 30 minutes or as an injection given into a big muscle (called intramuscular or IM). It can be given alone or in combination with other drugs. Asparaginase can be given in various dosing schedules, depending on the regimen and the type of asparaginase being used.
Possible Side Effects
There are a number of things you can do to manage the side effects of asparaginase. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:
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. You will be monitored for an hour after the infusion or injection.
Asparaginase 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.
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.
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. Call your healthcare team if you experience abdominal pain, nausea or vomiting.
This medication can cause changes to your blood sugar levels. Your healthcare team will periodically monitor your blood glucose level while you are receiving asparaginase. Notify your healthcare team if you experience frequent urination or feel thirsty all the time, as these can be signs of elevated blood sugar.
This medication can cause liver toxicity. Your healthcare provider will monitor your liver function with blood tests. If these tests become abnormal, your healthcare provider may need to lower the medication dose or stop the medication. Notify your healthcare provider if you notice yellowing of the skin or eyes (jaundice), your urine appears dark or tea-colored, or you develop pain in the abdomen, as these can be signs of liver toxicity.
Asparaginase can cause neurotoxicity, which can include extreme drowsiness, confusion, personality changes and hallucinations. If you develop any unusual symptoms, go to the emergency room right away.
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 birth control is necessary during and after treatment. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should consult with your healthcare team before breastfeeding while receiving this medication.