In the U.S.—

In Canada—

Another commonly used name is colaspase.

• Antineoplastic

Asparaginase ( a-SPARE-a-gi-nase) belongs to the group of medicines known as enzymes. It is used to treat some kinds of cancer of the blood. It may also be used to treat other kinds of cancer, as determined by your doctor.

All cells need a chemical called asparagine to stay alive. Normal cells can make this chemical for themselves, while cancer cells cannot. Asparaginase breaks down asparagine in the body. Since the cancer cells cannot make more asparagine, they die.

Before you begin treatment with asparaginase, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Asparaginase is to be administered only by or under the supervision of your doctor. It is available in the following dosage form:

Parenteral
• Injection (U.S. and Canada)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For asparaginase, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to asparaginase.

Pregnancy—Asparaginase has not been studied in pregnant women. However, studies in mice and rats have shown that asparaginase slows the weight gain of infants and may also increase the risk of birth defects or cause a decrease in successful pregnancies. In addition, asparaginase has caused birth defects in rabbits.

It is best to use some kind of birth control while you are receiving asparaginase. Tell your doctor right away if you think you have become pregnant while receiving asparaginase.

Breast-feeding—It is not known whether asparaginase passes into breast milk. However, because asparaginase may cause serious side effects, breast-feeding is generally not recommended while you are receiving it.

Children—This medicine has been tested in children and has not been shown to cause different side effects or problems than it does in adults. In fact, the side effects of this medicine seem to be less severe in children than in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of asparaginase in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving asparaginase it is especially important that your health care professional know if you are taking any of the following:

• Probenecid (e.g., Benemid) or
• Sulfinpyrazone (e.g., Anturane)—Asparaginase may raise the concentration of uric acid in the blood. Since these medicines are used to lower uric acid levels, they may not work as well in patients receiving asparaginase

• If you have ever been treated with radiation or cancer medicines—Asparaginase may increase the total effects of these medications and radiation therapy

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Diabetes mellitus (sugar diabetes)—Asparaginase may increase glucose (sugar) in the blood

• Gout or
• Kidney stones—Asparaginase may increase levels of uric acid in the body, which can cause gout or kidney stones

• Infection—Asparaginase can reduce your body's ability to fight infection

• Liver disease—Asparaginase may worsen the condition

• Pancreatitis (inflammation of the pancreas)—Asparaginase may cause pancreatitis

This medicine is usually given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to remember to take them at the right times.

While you are using this medicine, your doctor may want you to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well.

This medicine often causes nausea, vomiting, and loss of appetite. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. After several doses, your stomach upset should lessen. Ask your health care professional for ways to lessen these effects.

Dosing—

The dose of asparaginase will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient's weight, and whether or not other medicines are also being taken. If you are receiving asparaginase at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of asparaginase, ask your doctor.

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

While you are being treated with asparaginase, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Asparaginase may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Before you have any medical tests, tell the medical doctor in charge that you are receiving this medicine. The results of thyroid tests may be affected by this medicine.

Along with its needed effects, a medicine may cause some unwanted effects. Some side effects will have signs or symptoms that you can see or feel. Your doctor may watch for others by doing certain tests. Some of the unwanted effects that may be caused by asparaginase are listed below. Although not all of these effects may occur, if they do occur, they may need medical attention.

Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.

Check with your doctor or nurse immediately if any of the following side effects occur:

• More common
  • Joint pain;  puffy face;  skin rash or itching;  stomach pain (severe) with nausea and vomiting;  trouble in breathing 
  
  

• Less common
  • Frequent urination;  swelling of feet or lower legs;  unusual thirst 
  
  

• Rare
  • Fever or chills;  headache (severe);  inability to move arm or leg;  infection ;  pain in lower legs;  unusual bleeding or bruising 
  
  

Check with your health care professional as soon as possible if any of the following side effects occur:

• Less common
  • Confusion;  drowsiness;  hallucinations (seeing, hearing, or feeling things that are not there);  lower back or side pain;  mental depression;  nervousness;  sores in mouth or on lips;  unusual tiredness 
  
  

This medicine may also cause the following side effect that your doctor will watch for:

• More common
  • Bleeding problems;  liver problems 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• More common
  • Headache (mild);  loss of appetite;  nausea or vomiting;  stomach cramps;  weight loss 
  
  

After you stop receiving asparaginase, it may still produce some side effects that need attention. During this period of time, check with your doctor or nurse immediately if any of the following side effects occur:

• Headache (severe);  inability to move arm or leg;  stomach pain (severe) with nausea and vomiting 

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your health care professional.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, asparaginase is used in certain patients with the following condition:

• Cancer of the lymph system (certain types)

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for this use.