Pegaspargase Injection

What is this medication?

PEGASPARGASE (peg AS par jase) treats leukemia. It works by slowing down the growth of cancer cells.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Oncaspar

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

  • Bleeding disorders
  • Diabetes or conditions that affect blood sugar levels
  • History of blood clots
  • History of pancreatitis
  • Liver disease
  • An unusual or allergic reaction to pegaspargase, other medications, foods, dyes, or preservatives
  • Pregnant or trying to get pregnant
  • Breastfeeding

How should I use this medication?

This medication is injected into a vein or muscle. It is given by your care team in a hospital or clinic setting.

Talk to your care team about the use of this medication in children. While it may be prescribed for children as young as 1 month of age for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

Keep appointments for follow-up doses. It is important not to miss your dose. Call your care team if you are unable to keep an appointment.

What may interact with this medication?

  • Cytarabine
  • Dexamethasone
  • Estrogen and progestin hormones
  • Methotrexate
  • Vincristine

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Your condition will be monitored carefully while you are receiving this medication. You may need blood work while taking this medication.

This medication may increase blood sugar. The risk may be higher in patients who already have diabetes. Ask your care team what you can do to lower your risk of diabetes while taking this medication. Ask your care team if changes in diet or medications are needed if you have diabetes.

This medication can cause serious infusion reactions or allergic reactions. To reduce the risk, your care team may give you other medications to take before receiving this one. Be sure to follow the directions from your care team.

Talk to your care team if you may be pregnant. Serious birth defects can occur if you take this medication during pregnancy and for 3 months after the last dose. You will need a negative pregnancy test before starting this medication. Estrogen and progestin hormones may not work as well while you are taking this medication. Contraception is recommended while taking this medication and for 3 months after the last dose. Your care team can help you find the option that works for you.

Do not breastfeed while taking this medication and for 1 month after the last dose.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
  • Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
  • Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
  • High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
  • Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
  • Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
  • Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

  • Diarrhea
  • Pain, redness, or irritation at injection site

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

This medication is given in a hospital or clinic. It will not be stored at home.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

© 2024 Elsevier/Gold Standard (2023-05-11 00:00:00)


Additional Information From Chemocare.com About Pegaspargase

Self-Care Tips:

  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • For flu-like symptoms, keep warm with blankets and drink plenty of liquids.  There are medications that can help reduce the discomfort caused by chills.
  • You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
  • Wash your hands often.
  • To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
  • Use an electric razor and a soft toothbrush to minimize bleeding.
  • Avoid contact sports or activities that could cause injury.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals. 
  • Avoid driving and tasks that require being alert until your response to this drug is well understood.
  • Avoid sun exposure.  Wear SPF 15 (or higher) sunblock and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely.  You should discuss this with your doctor.
  • Get plenty of rest. 
  • Maintain good nutrition.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

How Pegaspargase Works:

All cells need a chemical called asparagine to stay alive. Normal cells can make this chemical for themselves, while cancer cells cannot.  The enzyme asparaginase breaks down asparagine in the body. Since the cancer cells cannot make more asparagine, they die.  Pegaspargase is a modified version of the enzyme asparaginase.

When pegaspargase breaks down asparagine it is broken down into 2 chemicals, aspartic acid and ammonia.  The neurologic side effects seen with asparaginase (such as, confusion, excessive sleepiness, agitation, disorientation, or coma) are related to increased levels of these chemicals circulating in the body.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org


When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)

The following symptoms require medical attention, but are not an emergency.  Contact your health care provider within 24 hours of noticing any of the following:

  • Nausea (interferes with ability to eat and unrelieved with prescribed medication)
  • Vomiting (vomiting more than 4-5 times in a 24 hour period)
  • Persistent upper abdominal pain or pain that worsens with eating
  • Abdominal swelling
  • Diarrhea (4-6 episodes in a 24-hour period)
  • Unusual bleeding or bruising
  • Swelling, redness and/or pain in one leg or arm and not the other. Extreme fatigue (unable to carry on self-care activities).
  • Yellowing of the skin or eyes
  • Unusual thirst, need to urinate frequently
  • Swelling of feet and ankles or sudden weight gain
  • Confusion, excessive sleepiness, hallucinations (seeing, hearing or feeling things that are not there), agitation, or disorientation (not able to recognize familiar surroundings).

Always inform your health care provider if you experience any unusual symptoms.


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