Parenteral Manual

Calaspargase Pegol

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): 
Asparlas
Classification: 
Antineoplastic
Original Date: 
November 2024
Indications: 

  • A component of a multi-agent chemotherapeutic regimen for the treatment of acute lymphoblastic leukaemia (ALL)

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 may be stored at room temperature for up to 4 hours or refrigerated (2 - 8 degrees celcius) for up to 24 hours
  • Protect from light
  • Do not shake or freeze
Compatibility: 

No compatibility data

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 Push NO
IV Intermittent Infusion Yes - in 100mL 0.9%NS or D5W over 1-2 hours
IV Continuous Infusion NO

 

Dosage: 

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

  • 2500 units/m2/dose as part of a combination chemotherapy regimen; do not administer more frequently than every 21 days
    • Dose capping at 3,750 units/dose (1 vial) per institutional policy is permissible in cases of baseline obesity
Potential hazards of parenteral administration: 

Immediate (within a few minutes to hours):

  • Anaphylaxis, other allergic reactions (7-21%) (hives, flushed or pale skin, angioedema, erythema, decreased blood pressure, bronchospasm, dyspnea, pruritus and rash)

Delayed (within days to weeks):

  • Hemorrhagic and thrombotic cardiovascular events - decreased fibrinogen, clotting factors, antithrombin
  • Hepatotoxicity – hypoalbuminemia, increased transaminases (ALT/AST), hyperbilirubinemia
  • Hypokalemia, hyponatremia
  • Febrile neutropenia
  • Mucositis
  • Hyperglycemia, and hypoglycemia possible
  • Pancreatitis – persistent abdominal pain, elevated serum amylase and/or lipase
  • CNS toxicity (convulsion, confusion, or somnolence)
Notes: 
  • Have anaphylaxis kit at bedside. Outpatients should remain in the clinic for at least one hour following injection for observation.
  • Insulin may be required for severe hyperglycemia.
  • Give asparaginase AFTER methotrexate, cytarabine and vincristine NOT BEFORE
  • L-asparaginase levels may be considered as per protocol to monitor efficacy
References: 
  • Asparlas Product Monograph. Servier Canada Inc. March 2024

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