Parenteral Manual

Crisantaspase

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): 
Rylaze®
Classification: 
Antineoplastic
Original Date: 
October 2023
Indications: 
  • A component of a multi-agent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia/lymphoma who have developed hypersensitivity to E.coli-derived asparaginase 
Reconstitution and Stability: 
  • Available as a 20 mg/mL solution for injection 
  • Store unopened vials in the fridge in the original carton to protect from light 
  • Stable in syringe for 4 hours at room temperature. The syringe does not need to be protected from light once prepared.  
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 Yes, inject into large muscle. Maximum 2 mL per site
IV Direct NO
IV Intermittent Infusion NO
IV Continuous Infusion NO

 

Dosage: 

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

  • Pediatric: 25 mg/m2 on Monday and Wednesday, 50mg/m2 on Friday for a total of 6 doses. 
Potential hazards of parenteral administration: 

Immediate (within a few minutes to hours):

  • Anaphylaxis, other allergic reactions  - urticaria, pruritus, respiratory distress, hypotension, chills, fever) 
  • Nausea and vomiting  
  • Pain/bruising at injection site - hold site at least 5 minutes after injection or until bleeding stops.  Apply ice if platelet counts low. 

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: 

Rylaze Product Monograph. Jazz Pharmaceuticals. September 2022

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.