Pegaspargase

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Pegaspargase Brand Name– Oncaspar

What is Pegaspargase

Pegaspargase is an asparagine specific enzyme that is indicated for the first-line treatment of acute lymphoblastic leukemia (ALL) in adults and pediatric patients and ALL in adults and pediatric patients who experienced hypersensitivity to native forms of L-asparaginase.

It is used in combination with multi-agent chemotherapy.

Use of pegaspargase is contraindicated in patients with severe hepatic impairment, a history of pancreatitis, or who have had a serious thrombosis or hemorrhagic event related to prior L-asparaginase therapy.

Indications

  • acute lymphocytic leukemia (ALL)

For the treatment of acute lymphocytic leukemia (ALL)

NOTE: The FDA has designated pegaspargase as an orphan drug for the treatment of ALL.

for the treatment of newly diagnosed ALL, in combination with multi-agent chemotherapy

Side Effects

  1. anaphylactic shock
  2. anaphylactoid reactions
  3. antibody formation
  4. bleeding
  5. bronchospasm
  6. coagulopathy
  7. elevated hepatic enzymes
  8. encephalopathy
  9. erythema
  10. hyperammonemia
  11. hyperamylasemia
  12. hyperbilirubinemia
  13. hypercholesterolemia
  14. hyperglycemia
  15. hypertriglyceridemia
  16. hypoalbuminemia
  17. hypotension
  18. infusion-related reactions
  19. intracranial bleeding
  20. laryngeal edema
  21. neutropenia
  22. pancreatitis
  23. prolonged bleeding time
  24. rash
  25. thromboembolism
  26. thrombosis
  27. urticaria

Monitoring Parameters

  • blood glucose
  • LFTs
  • pregnancy testing

Contraindications

  • bleeding
  • breast-feeding
  • contraception requirements
  • hepatic disease
  • hyperglycemia
  • infusion-related reactions
  • pancreatitis
  • pregnancy
  • pregnancy testing
  • reproductive risk
  • thromboembolism
  • thrombosis

Interactions

  • Abciximab
  • Alpha interferons
  • Alteplase
  • Amlodipine; Celecoxib
  • Anagrelide
  • Anticoagulants
  • Antithrombin III
  • Apixaban
  • Argatroban
  • Aspirin, ASA; Dipyridamole
  • Azelastine; Fluticasone
  • Beclomethasone
  • Betamethasone
  • Betrixaban
  • Bivalirudin
  • Budesonide
  • Budesonide; Formoterol
  • Carbamazepine
  • Celecoxib
  • Ciclesonide
  • Cilostazol
  • Clopidogrel
  • Clozapine
  • Corticosteroids
  • Cortisone
  • Cytarabine, ARA-C
  • Dabigatran
  • Dalteparin
  • Danaparoid
  • Deflazacort
  • Desirudin
  • Dexamethasone
  • Diclofenac
  • Diclofenac; Misoprostol
  • Dienogest; Estradiol valerate
  • Diflunisal
  • Digoxin
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Dipyridamole
  • Drospirenone
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Echinacea
  • Edoxaban
  • Elagolix; Estradiol; Norethindrone acetate
  • Enoxaparin
  • Eptifibatide
  • Esomeprazole; Naproxen
  • Estradiol; Levonorgestrel
  • Estradiol; Norethindrone
  • Estradiol; Norgestimate
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Etodolac
  • Etonogestrel
  • Famotidine; Ibuprofen
  • Febuxostat
  • Fenoprofen
  • Filgrastim, G-CSF
  • Fludrocortisone
  • Flunisolide
  • Flurbiprofen
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Fondaparinux
  • Formoterol; Mometasone
  • Heparin
  • Hydrocodone; Ibuprofen
  • Hydrocortisone
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Indomethacin
  • Interferon Alfa-2a
  • Interferon Alfa-2b
  • Interferon Alfa-2b; Ribavirin
  • Interferon Alfa-n3
  • Interferon Alfacon-1
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Lepirudin
  • Leuprolide; Norethindrone
  • Levonorgestrel
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Mestranol; Norethindrone
  • Methotrexate
  • Methylprednisolone
  • Mometasone
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Non-oral combination contraceptives
  • Nonsteroidal antiinflammatory drugs
  • Norethindrone
  • Norgestrel
  • Oral Contraceptives
  • Oxaprozin
  • Palifermin
  • Pegfilgrastim
  • Peginterferon Alfa-2a
  • Peginterferon Alfa-2b
  • Penicillamine
  • Pentosan
  • Piroxicam
  • Platelet Inhibitors
  • Prasugrel
  • Prednisolone
  • Prednisone
  • Reteplase, r-PA
  • Rivaroxaban
  • Rofecoxib
  • Segesterone Acetate; Ethinyl Estradiol
  • Streptokinase
  • Sulindac
  • Tbo-Filgrastim
  • Tenecteplase
  • Thrombolytic Agents
  • Ticagrelor
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Tolmetin
  • Triamcinolone
  • Tuberculin Purified Protein Derivative, PPD
  • Urokinase
  • Valdecoxib
  • Vincristine
  • Vincristine Liposomal
  • Vorapaxar
  • Warfarin
  • Zonisamide

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