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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. |
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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.
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Contraindications
Hypersensitivity. G6PD deficiency, and other cellular metabolic disorders causing haemolytic anaemia.
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Special Precautions
Patients with history of atopic allergies. Children. Pregnancy and lactation.
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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). |
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IV/Parenteral: C
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Monitoring Parameters
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.
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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.
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Action
Description:
Mechanism of Action: 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. |
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Storage
Stored between 2-8°C. Do not freeze. Protect from light.
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MIMS Class
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ATC Classification
V03AF07 - rasburicase ; Belongs to the class of detoxifying agents used in antineoplastic treatment.
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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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