Pegaspargase, Injection peg-AS-par-jase

What are other names for this medicine?

Type of medicine: antineoplastic (anticancer)

Generic and brand names: pegaspargase, injection; Oncaspar

What is this medicine used for?

This medicine is given by injection (shots) to treat a blood disease called acute lymphocytic (lymphoblastic) leukemia (ALL). It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• bleeding problems
• blood clots
• diabetes
• liver disease
• pancreatitis (inflammation of the pancreas)

Tell your provider if you have any kind of infection or fever, especially chickenpox or herpes.

Females of childbearing age: Do not take this medicine if you are pregnant because it may harm the baby. Tell your healthcare provider if you are pregnant or if you plan to become pregnant while taking this medicine. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

These shots are given by your healthcare provider, usually every 14 days. The injections are given into a muscle or large vein. You may need other medicines at various times in addition to this one.

What should I watch out for?

You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may cause you to bleed more easily or to bleed longer. Avoid sports and activities that may cause injuries. Do not drink alcohol or take aspirin while receiving this medicine. It may increase the risk of bleeding. Report any unusual bleeding or bruising to your healthcare provider.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

You may get infections more easily when you are taking this medicine. Stay away from people with colds, flu, or other infections. Also, do not have any vaccines without getting your healthcare provider's approval first.

This medicine may make your mouth sore. Use a soft bristle brush or mouth swab to brush your teeth.

Diabetics: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing or sudden shortness of breath; tightness in your chest; swelling of your lips, tongue, and throat); chest pain.

Serious (report these to your healthcare provider right away): Unusual tiredness or weakness; black tarry stools; blood in urine; unusual bruising or bleeding; fever or chills; yellowing of the skin or eyes; seizures; severe confusion; severe headache; arm or leg swelling, or any unexplained swelling; severe stomach pain; severe nausea and vomiting; increased thirst; increased amount of urine or frequency of urinating.

Other: Pain at the spot where injections are given, diarrhea, abdominal pain, chills, loss of appetite, headache, night sweats, muscle or joint pain.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• aspirin or other salicylates
• medicine that reduces the chance of blood clots forming such as dabigatran (Pradaxa), dalteparin (Fragmin), dipyridamole (Aggrenox, Persantine), enoxaparin (Lovenox), heparin, and warfarin (Coumadin)
• nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• other medicines used to treat cancer such as methotrexate (Trexall) and vincristine
• prednisone
• vaccines

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.