Parenteral Manual

Rasburicase

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
RECOMBINANT URATE OXIDASE, SR 29142, Fasturetec
Classification: 
Uricolytic agent
Original Date: 
August 2005
Revised Date: 
October 2018
Indications: 
  • Rapid treatment of acute hyperuricemia, especially in the event of impending or acute renal failure (tumor lysis syndrome)
Reconstitution and Stability: 
  • Available in vials containing 1.5 mg of rasburicase as a lyophilized powder
  • Reconstitute with 1 mL of supplied diluent (sterile water for injection with Poloxamer 188) for a final concentration of 1.5 mg/mL
  • Swirl gently to dissolve.  Do not vortex or shake vial.
  • Reconstituted solution may be diluted further with 0.9% NS to a total volume of 50 mL
  • Reconstituted or diluted solution stable 24 hours refrigerated
  • DO NOT FILTER
Compatibility: 

- Solutions Compatible: 0.9% NS

- No other compatibility information.  Run in dedicated line.  Flush well before and after with at least 15 mL of  0.9% NS

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct

NO

IV Intermittent Infusion

YES  Large Volume Pump ONLY
Infusion time: 30 minutes
Usual Dilution: add dose to 50 mL minibag of 0.9% NaCl

DO NOT FILTER

IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

  • 0.15  -  0.2 mg/kg/day for 1-7 days (usually no more than 3 days required)
  • Usual maximum dose: 6 mg/dose
Potential hazards of parenteral administration: 
  • Fever, headache, abdominal pain, nausea, vomiting, rash with or without erythema, dyspnea
  • Injection site pain or local reaction
  • Anaphylaxis, bronchospasm
Notes: 
  • Usually indicated for uric acid level greater than 400
  • Contraindicated in patients with G-6PD deficiency (risk of hemolysis)
  • Maintain anaphylaxis precautions and have medications available at the bedside
  • NB: All blood samples for uric acid assay must be immediately placed on ice (heparin/green top tube) and run immediately. Rasburicase's enzymatic activity continues to degrade uric acid levels in blood sample and will give a falsely low reading.  (May wish to pre-cool sample tubes.)

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