Rasburicase

What is Rasburicase

Rasburicase catalyzes the enzymatic oxidation of uric acid to the inactive and more soluble metabolite, allantoin.

It is a recombinant form of urate oxidase produced by cloning the gene for Aspergillus flavus urate oxidase for expression in Saccharomyces cerevisiae.

Rasburicase is indicated for the initial management of plasma uric acid levels in pediatric and adult patients with leukemia, lymphoma, and solid tumor malignancies who are receiving anticancer therapy expected to result in tumor lysis and subsequent elevation of plasma uric acid.

Brand Name

Elitek

Indications & Dosage

  • hyperuricemia

For the initial management of plasma uric acid levels in adult and pediatric patients with leukemia, lymphoma, and solid tumor malignancies who are receiving anti-cancer therapy expected to result in tumor lysis and elevation of plasma uric acid

NOTE: The FDA has designated rasburicase as an orphan drug for the treatment of malignancy-associated or chemotherapy-induced hyperuricemia.

Side Effects

  1. abdominal pain
  2. abdominal pain
  3. anaphylactic shock
  4. antibody formation
  5. anxiety
  6. anxiety
  7. arthralgia
  8. bleeding
  9. bronchospasm
  10. chest pain (unspecified)
  11. constipation
  12. diarrhea
  13. dyspnea
  14. edema
  15. edema
  16. elevated hepatic enzymes
  17. elevated hepatic enzymes
  18. fever
  19. headache
  20. hemolysis
  21. hyperbilirubinemia
  22. hyperbilirubinemia
  23. hyperphosphatemia
  24. hypophosphatemia
  25. hypophosphatemia
  26. hypotension
  27. hypoxia
  28. infection
  29. infection
  30. injection site reaction
  31. involuntary movements
  32. methemoglobinemia
  33. nausea
  34. nausea
  35. oral ulceration
  36. peripheral edema
  37. peripheral edema
  38. rash
  39. seizures
  40. serious hypersensitivity reactions or anaphylaxis
  41. supraventricular tachycardia (SVT)
  42. urticaria
  43. vomiting
  44. vomiting

Monitoring Parameters

  • arterial blood gases (ABGs)
  • CBC with differential
  • LDH
  • serum bilirubin
  • serum creatinine
  • serum electrolytes
  • serum uric acid

Contraindications

  • acute bronchospasm
  • breast-feeding
  • G6PD deficiency
  • hemolytic anemia
  • hypotension
  • interference with uric acid measurements
  • mannitol hypersensitivity
  • methemoglobin reductase deficiency
  • methemoglobinemia
  • pregnancy
  • serious hypersensitivity reactions or anaphylaxis
  • shock
  • urticaria
  • yeast hypersensitivity

Interactions

  • Articaine; Epinephrine
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Chloroprocaine
  • Lidocaine
  • Mepivacaine
  • Mepivacaine; Levonordefrin
  • Penicillin G Benzathine; Penicillin G Procaine
  • Penicillin G Procaine
  • Prilocaine
  • Prilocaine; Epinephrine
  • Ropivacaine
  • Tetracaine
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