Asparaginase Erwinia chrysanthemi (Erwinaze®)

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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

Allergic reactions, including anaphylaxis are rare but may happen in some patients. If this happens, do not take another dose of this drug. You should get urgent medical treatment. Signs of allergic reaction to this drug may be:

  • swelling of the face
  • feeling like your tongue or throat are swelling
  • trouble breathing
  • rash
  • itching
  • fever
  • chills
  • feeling dizzy
  • feeling that your heart is beating in a fast or not normal way.

Blood sugar levels may changes. If you have diabetes, changes may need to be made to your diabetes medication.

Nausea and throwing up (vomiting)

Inflammation of your pancreas

Stroke. If you have any of these symptoms for 2 minutes, call 911. Symptoms of a stroke such as:

  • sudden numbness or weakness of your face, arm, or leg, especially on one side of your body
  • sudden confusion
  • trouble speaking or understanding
  • sudden trouble seeing in one or both eyes
  • sudden trouble walking, feeling dizzy, loss of balance or coordination
  • or sudden bad headache with no known cause.

Abnormal bleeding – symptoms may be coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding.

Changes in your liver function.

Note: Each of the side effects above was reported in 1% or greater of patients treated with asparaginase. Not all possible side effects are included above.

Warnings and Precautions

High blood sugar with ketones, which can be serious. You could feel tired, have nausea and throwing up (vomiting), pass urine often, have increased thirst or hunger and have rapid and deep breathing.

Blood clots and events such as stroke and heart attack. 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.

Important Information

This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.

Treating Side Effects

If you’re diabetic, keep good control of your blood sugar level. Tell your nurse or your doctor if your glucose levels are higher or lower than normal.

Drink plenty of fluids (a minimum of eight glasses per day is recommended).

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 from losing too much fluid).

To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.

Food and Drug Interactions

There are no known interactions of asparaginase with food.

This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines 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 Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills • Blood in your urine, vomit (bright red or coffee-ground) and/or stools ( bright red, or black/tarry)
  • Coughing up blood
  • Wheezing and/or trouble breathing
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke. If you have any of these symptoms for 2 minutes, call 911. Symptoms include:
    • Sudden numbness or weakness of your face, arm, or leg, especially on one side of your body
    • Sudden confusion, trouble speaking or understanding
    • Sudden trouble seeing in one or both eyes
    • Sudden trouble walking, feeling dizzy, loss of balance or coordination
    • Sudden bad headache with no known cause.
  • Signs of possible liver problems:
    • Dark urine
    • Pale bowel movements
    • Bad stomach pain
    • Feeling very tired and weak
    • Unusual itching
    • Yellowing of the eyes or skin
  • Abnormal blood sugar
  • Unusual thirst, passing urine often, headache, sweating, shakiness, irritability
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Signs of allergic reaction:
    • Swelling of the face
    • Feeling like your tongue or throat are swelling
    • Trouble breathing
    • Rash
    • Itching
    • Fever
    • Chills
    • Feeling dizzy
    • Feeling that your heart is beating in a fast or not normal way
  • Your leg or arm is swollen, red, warm and/or painful
  • If you think you may be pregnant or have impregnated your partner

Reproduction Warnings

  • 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 receiving this drug. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children.

Revised September 2017