L-Asparaginase

Indications & Dose:

Acute lymphocytic leukaemia, hypoglycaemia due to hypersensitivity associated with pancreatic is let tumours (insulinomas). Malignant lymphoma,acute leukaemia.
DOSE
Adults

Acute lymphocytic leukemia: 200 IU/kg daily i/v for 28 days. Insuli-nomas: 20.000 IU given daily via hepatic artery for 7-10 days.

Paediatrics

Acute hymphocytic leukemia same as adult for i/ v.For i/m, 6000 iu/m body surface area.
Three times a week alone or in combination with vincristine and prednisone

Contraindications:

Chicken pox, herpes zooster. Anaphylactic reaction to L-asparaginae, history of pancreatitis or if pancreatitis is present

Side Effects:

Hypersensitivity reaction, fatal hyperthermia, depression of clotting factor, severe pancreatitis, hepatotoxicity. Nausea, vomiting, headache, fever, abdominal pain, hyperglycaemia leading to coma, hypersensitivity, renal damage, coagulation defects, thrombosis, CNS depression or hyperexcitability, acute haemorrhagic pancreatitis.

Cautions:

Diabetes mellitus, goitre, gout, hepatic function impairment, infection, previous exposure to cytotoxic drugs or radiation therapy.

Precautions:

Hypersensitivity.

Pregnancy: Use only if potential benefit justifies risk to the foetus.
Breast-feeding: Discontinue nursing or the drug.
Old age: Use with caution. 

Interaction:

Drugs

Vincristine and Prednisone: Associated with increased toxicity.
Methotrexate: Effect on malignant cells diminished or abolished as long as plasma asparginase levels are suppressed.
Cytarabine: Synergistic effect.

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: