Generic Name: Rasburicase Brand Name(s): Generics only. No brands available.

Uses

What is Rasburicase used for?

Rasburicase is used to prevent high blood levels of uric acid from occurring in children with cancer (e.g., leukemia, lymphoma, solid malignant tumors) who are about to receive cancer chemotherapy treatment. When chemotherapy is given, cancer cells are destroyed, releasing large amounts of uric acid into the bloodstream. This medication allows uric acid to more easily be removed from the body by the kidneys.

How should I take Rasburicase?

This medication is given by injection into a vein, usually over 30 minutes, or as directed by your doctor. Rasburicase is given once a day for 5 days. Timing of cancer chemotherapy and rasburicase doses is important. Chemotherapy is usually started 4 to 24 hours after the first dose of rasburicase.

Fluids are also given into the vein with this medication to help decrease your uric acid levels.

How do I store Rasburicase?

The lyophilized drug product and the diluent for reconstitution should be stored at 2°C to 8°C (36°F to 46°F); do not freeze. Protect from light. Reconstituted solution and solution diluted for infusion may be stored for up to 24 hours at 2°C to 8°C (36°F to 46°F). Discard unused product.

If you need to store rasburicase at home, talk with your doctor, nurse, or pharmacist about how to store it.

There may be different brands of Rasburicase that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Rasburicase down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Rasburicase?

Before using this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain metabolic conditions (e.g., G6PD deficiency), previous red blood cell damage (e.g., hemolysis, methemoglobinemia) with this medication, kidney disease, dehydration.

Caution is advised when using this drug in children less than 2 years old because they may be more sensitive to the side effects of the drug.

This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.

It is not known whether this drug passes into breast milk. Breast-feeding is not recommended while using this drug.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Rasburicase during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Rasburicase. Rasburicase is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Rasburicase?

Vomiting, nausea, headache, stomach pain, constipation, diarrhea, mouth sores/ulcers or rash may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: persistent sore throat, fever, chills.

Get medical help right away if you have any very serious side effects, including: weakness, yellowing eyes and skin, dark urine, blue or gray skin color.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Rasburicase?

A product that may interact with this drug is: allopurinol.

This medication can interfere with the uric acid in the blood sample tubes when the tubes remain at room temperature, therefore leading to falsely low uric acid results. Laboratory personnel must follow special procedures to process the blood sample.

Rasburicase may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Rasburicase?

Rasburicase may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Rasburicase?

Rasburicase may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Rasburicase.

What is the dose of Rasburicase for an adult?

Usual Adult Dose for Hyperuricemia Secondary to Chemotherapy

0.2 mg/kg as a 30-minute IV infusion once a day for up to 5 days

Comments:

-Use beyond 5 days or administration of more than 1 course of therapy is not recommended

-The exact duration should be based upon adequate monitoring of uric acid levels in plasma and clinical judgement.

-This drug is only approved for a single course of treatment.

Use: For the initial management of plasma uric acid levels in patients with leukemia, lymphoma, and solid tumor malignancies who are receiving chemotherapy expected to result in tumor lysis and subsequent elevation of plasma uric acid.

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

No adjustment recommended

Dose Adjustments

For any patient who develops a severe hypersensitivity reaction, hemolysis, or methemoglobinemia: This drug should be immediately and permanently discontinued.

Other Comments

Administration advice:

-Administer by IV infusion; do not give by IV bolus injection.

-Infuse over 30 minutes through a separate line or flush line with at least 15 mL of normal saline prior to and after administration.

-Do not use filters during infusion.

Storage requirements:

-Prior to reconstitution, store lyophilized product and diluent at 2C to 8C (36F to 46F); protect from light; do not freeze.

-Use immediately; reconstituted or diluted solution may be stored at 2C to 8C for up to 24 hours after reconstitution if needed.

Reconstitution/preparation techniques:

-Must be reconstituted with the diluent provided.

-Reconstitute 1.5 mg vial with 1 mL of diluent; reconstitute 7.5 mg vial with 5 mL of diluent.

-Mix by swirling; do not shake or vortex; only clear, colorless solutions should be used; discard if particulate matter is visible or product is discolored.

-Inject calculated dose into an infusion bag containing the appropriate amount of 0.9% NS to achieve a final total volume of 50 mL.

-Do not use filters during reconstitution or infusion.

IV compatibility:

-Use separate line or flush line with at least 15 mL of normal saline prior to and after administration.

-Do not dilute in glucose solution as there is a potential for incompatibility.

General:

-Administration of this drug should be under the supervision of a physician trained in chemotherapy of hematological malignancies.

-Safety and efficacy have only been established for a single course of treatment.

Monitoring:

-Monitor uric acid levels; it is important to ensure proper handling of blood samples as this drug will enzymatically degrade uric acid in blood samples left at room temperature resulting in inaccurate uric acid measurements.

Patient advice:

-Patients should be informed of the risk of serious hypersensitivity reactions and should be instructed to immediately notify their healthcare professional if they experience an allergic reaction, bronchospasm, chest pain or tightness, dyspnea, hypoxia, hypotension, or urticaria.

What is the dose of Rasburicase for a child?

Usual Pediatric Dose for Hyperuricemia Secondary to Chemotherapy

0.2 mg/kg as a 30-minute IV infusion once a day for up to 5 days

Comments:

-Use beyond 5 days or administration of more than 1 course of therapy is not recommended.

-The exact duration should be based upon adequate monitoring of uric acid levels in plasma and clinical judgement.

-This drug is only approved for a single course of treatment.

Use: For the initial management of plasma uric acid levels in patients with leukemia, lymphoma, and solid tumor malignancies who are receiving chemotherapy expected to result in tumor lysis and subsequent elevation of plasma uric acid

How is Rasburicase available?

Rasburicase is available in the following dosage forms and strengths:

  • Intravenous powder for injection.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Rasburicase, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: April 21, 2018 | Last Modified: April 21, 2018

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