Parenteral Manual

Pegaspargase

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): 
Oncaspar
Classification: 
Antineoplastic
Original Date: 
August 2005
Revised Date: 
June 2023
Indications: 

A component of a multi-agent chemotherapeutic regimen for the first line treatment of acute lymphoblastic leukemia/lymphoma  

Reconstitution and Stability: 
  • Available as a 750 units/mL solution for injection 
  • Store unopened vials in the fridge in the original carton to protect from light. 
  • Dilute in 100 mL of 0.9% NaCl or D5W.  Diluted solution should be stored refrigerated (2 - 8 degrees celcius) for up to 48 hours 
Compatibility: 
  • No stability information available
  • Do not mix with other drugs
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 In 100mL 0.9%NaCl or D5W over 1 -2 hours
IV Continuous Infusion NO

 

Dosage: 

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

  • 2500 units/m2 as part of a combination chemotherapy regimen; do not administer more frequently than every 14 days 
Potential hazards of parenteral administration: 

Immediate (within a few minutes to hours) 

  • Anaphylaxis, other allergic reactions (6-43%) - urticaria, pruritus, respiratory distress, hypotension, chills, fever) 
  • Delayed (within a few days to weeks) 
  • Hemorrhagic and thrombotic cardiovascular events - decreased fibrinogen, clotting factors, antithrombin 
  • Hepatotoxicity - hypoalbuminemia, increased transaminases 
  • Hyperglycemia - monitor urine/blood glucose; hypoglycemia possible 
  • Pancreatitis - elevated serum amylase, assess for abdominal tenderness 
  • Myelosuppression 
Notes: 
  • Have anaphylaxis kit at bedside. Out-patients should remain in the clinic for at least one hour following injection. NOTE: anaphylaxis may be delayed following IM injection. 
  • Insulin may be required for severe hyperglycemia
  • Give asparaginase AFTER methotrexate, cytarabine and vincristine NOT BEFORE 
References: 
  • Oncaspar Product Monograph 

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