Asparaginase (Generic Name)

Other Names: Erwinaze

About This Drug

Asparaginase is a drug used to treat cancer. It is given in the vein (IV) or as a shot in a muscle (IM).

Possible Side Effects (More Common) 

  • Nausea and throwing up (vomiting )
  • Feeling confused and/or having hallucinations (seeing, hearing, or feelings things that are not there)
  • Decreased appetite (decreased hunger)
  • Fever and chills
  • Soreness of the mouth and throat. You may have red areas, white patches, and/or sores that hurt.
  • Mood changes. You may experience changes in your moods, including depression. Mood changes are common in patients with cancer.
  • Irritation of your pancreas (pancreatitis). You may have severe stomach pains, nausea, and vomiting. Enzyme levels made by your pancreas may be high and will be checked as needed.
  • Increased blood sugar level. You may notice unusual thirst and frequent need to urinate.

Possible Side Effects (Less Common) 

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.
  • This drug may affect how your kidneys work. Your kidney function will be checked as needed
  • Blood clotting problems (rare). You may notice that you bruise more easily or have unusual bleeding. Your blood work will be checked as needed.
  • Blood clots: A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause trouble breathing, pain when breathing, and/or chest pain.

Allergic Reactions

Allergic reactions may happen in some patients while the drug is being given. A skin test is usually done before the first dose of the drug and if it is has been longer than a week between doses of the drug.

While you are getting this drug in your vein (IV), tell your nurse right away if you have any of these symptoms of an allergic reaction:

  • Trouble catching your breath
  • Feeling like your tongue or throat are swelling
  • Feeling your heart beat quickly  or in a not normal way (palpitations)
  • Feeling dizzy or lightheaded
  • Flushing, itching, rash, and/or hives

Treating Side Effects

  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements you should drink more fluids so that you do not become dehydrated (lack water in the body due to losing too much fluid).
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat.
  • Ask your doctor or nurse about medication to help stop or lessen nausea and vomiting.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • If you have numbness and tingling in your hands and feet, be careful when cooking, walking, and handling sharp objects and hot liquids.
  • Talk with your doctor or nurse if you feel you need help with your mood.

Food and Drug Interactions

There are no known interactions of asparaginase with food. This drug may interact with other medication. Tell your doctor and pharmacist about all the medication and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to Notify the Doctor

Notify your doctor or nurse right away if you have any of these symptoms:

  • Temperature of 100.5 F (38 C) or higher
  • Chills
  • Easy bleeding or bruising
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Wheezing or trouble breathing
  • Feeling dizzy or lightheaded
  • Hallucinations and sudden confusion
  • Seizures
  • Trouble being awakened
  • Headache that does not go away
  • Severe stomach pain with nausea and vomiting

Notify your doctor or nurse as soon as possible if you have any of these symptoms:

  • Extreme drowsiness that interferes with normal activities
  • Swelling of your feet or lower legs
  • Pain in your mouth or throat that makes it difficult to eat or drink
  • Nausea that is not relieved by prescribed medication
  • Frequent urination and unusual thirst
  • Tremors (twitches) in your arms or hands
  • Trouble walking or changes in the way you walk, feeling clumsy when buttoning clothes, opening jars, or other routine hand motions
  • Low back or side pain
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with normal activities
  • Rash and/or itching
  • Decreased urine

Sexual Problems and Reproduction Concerns

  • Pregnancy warning: It is not known if this drug may harm an unborn child.  For this reason, be sure to talk with your doctor if you are pregnant or planning to become pregnant while getting this drug.
  • Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can look at the possible risks of problems in the unborn baby due to this medication if an exposure happens during pregnancy.
  • Breast feeding warning: Women are advised not to breast feed during treatment because this drug could enter the breast milk and badly harm a breast feeding infant.

Revised September 2014

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