Oncaspar (Pegaspargase): Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

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Overview: Oncaspar is used to treat certain people with acute lymphoblastic leukemia. It is given by a health care provider as an infusion into a vein or as an injection into a muscle. Common side effects include changes in certain lab tests, high blood sugar, high triglycerides, an inflamed pancreas, blood clots, and infection. Keep all appointments, including for blood tests, while you are using Oncaspar. Tell your health care provider right away or get emergency help if you have yellowing of your skin or eyes, severe stomach pain, unusual bleeding or bruising, a severe headache, arm or leg swelling, or chest pain. These could be signs of a serious side effect.

Uses

What is Oncaspar used for?

Oncaspar (pegaspargase) is commonly used to treat certain people with acute lymphoblastic leukemia (ALL), which is a type of blood cancer.

Oncaspar may also be used for other conditions as determined by your health care provider.

How does Oncaspar work (mechanism of action)?

Oncaspar is a form of an enzyme called L-asparaginase. This enzyme breaks down asparagine, which is an amino acid (a building block of protein). Some cancer cells need asparagine to grow and survive. By breaking down asparagine, Oncaspar is thought to lower asparagine levels and help kill certain cancer cells.

How is Oncaspar supplied (dosage forms)?

Oncaspar is available in an injectable form that is given by a health care provider.

How should I store Oncaspar?

Oncaspar is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of Oncaspar?

The most common side effects of Oncaspar are listed below. Tell your health care provider if you have any of these side effects that bother you.

Changes in certain liver tests, which could be a sign of liver damage (see below)
Fever with low levels of a type of white blood cell (febrile neutropenia)
High triglyceride levels
High blood sugar (see below)
Inflammation of the pancreas (see below)
Changes in blood clotting tests
Blood clots (see below)
Allergic reactions (see below)
Sepsis, which is a severe response to an infection
Infection

There may be other side effects of Oncaspar that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Oncaspar?

While less common, the most serious side effects of Oncaspar are described below, along with what to do if they happen.

Severe Allergic Reactions. Oncaspar may cause allergic reactions, which can be serious. Your health care provider will likely monitor you for about an hour after you receive Oncaspar because of this risk. Get help right away if you have any of the following symptoms of a serious allergic reaction.

Breathing problems or wheezing
Racing heart
Fever or general ill feeling
Swollen lymph nodes
Swelling of the face, lips, eyes, mouth, tongue, or throat
Trouble swallowing or throat tightness
Itching or skin rash
Bumps on the skin called hives, which can be red, pink, white, or brown depending on your skin tone
Nausea or vomiting
Dizziness, feeling lightheaded, or fainting
Stomach cramps
Joint pain

Blood Clots. Oncaspar may cause a blood clot in your arteries or veins and could cause a stroke, heart attack, or venous thromboembolism, including a blood clot in the lungs (pulmonary embolism) or deep vein thrombosis (DVT). Get emergency help if you have any of the following signs of a blood clot.

Chest pain or pressure
Fast or abnormal heartbeat
Trouble breathing or shortness of breath
Pain in your back, jaw, throat, or arm
Sweating, upset stomach, vomiting, or dizziness
Sudden weakness on one side of your body
Sudden and severe headache
Slurred speech or trouble understanding speech
Pain, swelling, or tenderness in your arm or leg
Vision loss
Bulging eyes
Double vision

Inflammation of the Pancreas (Pancreatitis). Oncaspar may cause inflammation of the pancreas, which is called pancreatitis. Call your health care provider right away if you have symptoms of pancreatitis, including vomiting or severe stomach pain, such as pain in the upper part of your belly that travels to your back.

High Blood Sugar. Oncaspar may increase your blood sugar levels (hyperglycemia). Talk to your health care provider about how to maintain healthy blood sugar levels. Keep all appointments with your health care provider for blood tests. Call your health care provider if you have the following symptoms of high blood sugar.

Thirsty more than usual
Peeing more than usual
Increase in hunger
Tiredness
Feeling sick to your stomach
Confusion
Your breath smelling fruity

Severe Bleeding. Oncaspar can increase your risk of severe bleeding that can lead to death. Some people with serious bleeding may need a blood transfusion or surgery. Call your health care provider right away if you have any unusual bleeding or bruising, or if you have any of the following signs of severe bleeding.

Pink, red, or brown urine (pee)
Vomit with blood that looks like coffee grounds
Red or black stools (looks like tar)
Coughing up blood or blood clots

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using Oncaspar. Oncaspar may also increase the risk of blocked blood vessels in the liver, which can be life-threatening. Keep all appointments for blood tests while using Oncaspar. Call your health care provider right away if you have any of the following symptoms of liver damage.

Nausea or vomiting
Feeling full or having stomach or belly pain or tenderness
Fever
Weakness or unusual tiredness
Itching
Loss of appetite
Light-colored poop
Dark-colored urine (pee)
Your skin or the whites of your eyes turning yellowish (also called jaundice)
Fast weight gain
Fluid retention or a buildup of fluid in in the belly (ascites)

Warnings & Precautions

Who should not use Oncaspar?

Allergies to Ingredients. People who are allergic to any of the following should not use Oncaspar.

Oncaspar
Pegaspargase
Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Oncaspar.

Prior Problems With L-Asparaginase. Oncaspar should not be used if you have used a medicine called L-asparaginase (also called asparaginase) in the past and had a serious blood clot, bleeding, or an inflamed pancreas (pancreatitis). Oncaspar is a form of L-asparaginase. Tell your health care provider if you have had any problems with L-asparaginase in the past.

Liver Problems. Oncaspar should not be used if your liver is not working as well as it should be. If there is a concern about the health of your liver, your health care provider may do tests to see if it is working well enough to take this medicine.

What should I know about Oncaspar before using it?

Oncaspar is usually given as an infusion into a vein (intravenously, or IV) or as an injection into a muscle (intramuscularly, or IM) by a health care provider in a hospital or clinic.

Your health care provider may give you medicines to help reduce the risk of certain side effects from Oncaspar. Take these medicines exactly as your health care provider recommends.

Keep all appointments, including for blood tests, with your health care provider. This will help them know if it is safe for you to keep using this medicine.

What should I tell my health care provider before using Oncaspar?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Oncaspar is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

Diabetes or high blood sugar
Liver problems
Pancreas problems
Problems with bleeding or blood clots

Other Medicines and Supplements. Oncaspar may interact with other medicines and supplements. Before using Oncaspar, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Oncaspar may cause harm to a fetus. Your health care provider may do a test to make sure you are not pregnant before starting Oncaspar. If you can get pregnant, you should use effective nonhormonal birth control while using Oncaspar and for at least three months after your last dose. Tell your health care provider right away if you are pregnant, think you might be pregnant, or plan to become pregnant.

Breastfeeding. Do not breastfeed while using Oncaspar and for one month after your last dose. It is not known if Oncaspar passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

How can I get more information about Oncaspar?

For more information about Oncaspar, you can visit the drugmaker’s website at www.oncaspar.com or call them at 800-807-6124.

Interactions

Does Oncaspar interact with foods or drinks?

There are no known interactions between Oncaspar and foods or drinks.

It is unknown if drinking alcohol will affect Oncaspar, but heavy drinking can slow your immune response and make it harder for your body to fight cancer.

Does Oncaspar interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Oncaspar.

Dexamethasone, which is a corticosteroid medicine for certain inflammatory conditions
A birth control pill, patch, vaginal ring, implant, injection, or intrauterine device (IUD) that contains hormones

This may not be a complete list of medicines that can interact with Oncaspar. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker