Rasburicase


Generic Medicine Info
Indications and Dosage
Intravenous
Cancer therapy-induced hyperuricaemia
Adult: 0.20 mg/kg once daily given via infusion over 30 minutes for 5-7 days, depending on uric acid levels and clinical assessment.
Child: Same as adult dose.
Reconstitution
Add 1 mL and 5 mL diluent to a vial labelled as containing 1.5 mg and 7.5 mg respectively to provide a solution containing 1.5 mg/mL. Gently swirl to mix. Do not shake. Further dilute with NaCl 0.9 % to a total volume of 50 mL.
Contraindications
Hypersensitivity. G6PD deficiency, and other cellular metabolic disorders causing haemolytic anaemia.
Special Precautions
Patients with history of atopic allergies. Children. Pregnancy and lactation.
Adverse Reactions
Significant: Severe haemolytic reactions, methaemoglobinaemia.
Gastrointestinal disorders: Diarrhoea, vomiting, nausea.
General disorders and admin site conditions: Fever.
Hepatobiliary disorders: Hyperbilirubinemia, increased serum ALT.
Infections and infestations: Sepsis.
Immune system disorders: IgG and IgE antibody development.
Nervous system disorders: Headache.
Metabolism and nutrition disorders: Peripheral oedema, hypophosphataemia, hypervolaemia.
Psychiatric disorders: Anxiety.
Respiratory, thoracic and mediastinal disorders: Pharyngolaryngeal pain.
Potentially Fatal: Serious hypersensitivity reactions (e.g. anaphylactic shock).
IV/Parenteral: C
MonitoringParameters
Perform G6PD deficiency screening prior to initiation of therapy. Monitor plasma uric acid levels 4 hours after administration then every 6-8 hours until tumour lysis syndrome resolution; CBC. Monitor for signs and symptoms of hypersensitivity reactions.
Lab Interference
May cause enzymatic degradation of uric acid in serum/blood/plasma samples when placed at room temperature resulting to low uric acid assay reading.
Action
Description: Rasburicase is a recombinant form of urate oxidase enzyme, which oxidises uric acid to allantoin (a water soluble and inactive metabolite) . It is used as prophylaxis and treatment of acute hyperuricaemia associated with chemotherapy.
Onset: Within 4 hours.
Pharmacokinetics:
Distribution: Volume of distribution: 76-138 mL/kg.
Excretion: Elimination half-life: Approx 16-23 hours.
Storage
Stored between 2-8°C. Do not freeze. Protect from light.
ATC Classification
V03AF07 - rasburicase ; Belongs to the class of detoxifying agents used in antineoplastic treatment.
References
Anon. Rasburicase. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 03/12/2018.

Anon. Rasburicase. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/12/2018.

Buckingham R (ed). Urate Oxidase. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/12/2018.

Elitek (Sanofi-aventis U.S. LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/12/2018.

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