Why is this medication prescribed?

Erwinaze is prescribed for patients who have acute lymphoblastic leukemia (ALL), a type of blood cancer. Specifically, it is used in patients who have developed an allergy or intolerance to another medication called pegaspargase, which is also used in the treatment of ALL.

Erwinaze contains the enzyme asparaginase, which works by breaking down the amino acid asparagine in the blood. ALL cells need asparagine to grow and survive, but they cannot make it themselves. Instead, they rely on the body’s circulating asparagine. By breaking down asparagine, Erwinaze deprives the cancer cells of this essential nutrient, effectively inhibiting their growth and causing them to die.

How should this medicine be used?

Erwinaze is typically administered by a healthcare professional, either as an injection into a muscle (intramuscular injection) or as an infusion into a vein (intravenous infusion). The dosage and frequency of Erwinaze administration depend on various factors such as the patient’s age, weight, overall health, and response to treatment. It’s crucial to follow the specific instructions provided by the healthcare provider regarding the dosage and schedule of Erwinaze administration.

Patients receiving Erwinaze treatment may require close monitoring by healthcare professionals to assess their response to the medication and to manage any potential side effects or adverse reactions. Common side effects of Erwinaze may include allergic reactions, liver problems, blood clotting issues, pancreatitis, and changes in blood sugar levels, among others.

It’s essential for patients to communicate openly with their healthcare team about any concerns or side effects they may experience during Erwinaze treatment.

Other uses for this medicine

Erwinaze (asparaginase Erwinia chrysanthemi) is primarily used in the treatment of acute lymphoblastic leukemia (ALL) in patients who have developed hypersensitivity to E. coli-derived asparaginase. However, there may be some off-label or investigational uses for Erwinaze in other conditions. These uses would be determined by healthcare professionals based on individual patient circumstances and the available evidence.

What special precautions should I follow?

Special precautions should be followed when using Erwinaze:

• Allergy/Hypersensitivity: Patients should be monitored closely for signs of allergic reactions during and after administration of Erwinaze. These reactions can include rash, itching, difficulty breathing, swelling of the face, lips, or tongue, or severe dizziness. If any allergic reaction occurs, treatment should be discontinued immediately, and appropriate medical intervention should be initiated.
• Pancreatitis: Erwinaze may cause pancreatitis, which is inflammation of the pancreas. Patients should be monitored for signs and symptoms of pancreatitis, such as severe abdominal pain, nausea, vomiting, and fever. If pancreatitis is suspected, treatment with Erwinaze should be discontinued, and appropriate medical management should be initiated.
• Liver Function: Erwinaze may cause liver toxicity, including elevations in liver enzymes and bilirubin. Liver function tests should be monitored regularly during treatment with Erwinaze. If significant liver toxicity occurs, treatment may need to be interrupted or discontinued, and appropriate medical management should be initiated.
• Blood Clotting: Erwinaze may affect blood clotting function, leading to an increased risk of bleeding or thrombosis (blood clot formation). Patients should be monitored for signs and symptoms of bleeding or blood clots, such as easy bruising, nosebleeds, prolonged bleeding from cuts, chest pain, shortness of breath, or swelling in the legs. If any signs of blood clotting abnormalities occur, appropriate medical intervention should be initiated.
• Blood Glucose Levels: Erwinaze may affect blood glucose levels, leading to hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar). Blood glucose levels should be monitored regularly during treatment with Erwinaze, especially in patients with diabetes or a history of glucose intolerance. If significant changes in blood glucose levels occur, appropriate medical management should be initiated.
• Pregnancy and Breastfeeding: The safety of Erwinaze in pregnant or breastfeeding women has not been established. Women who are pregnant or breastfeeding should discuss the potential risks and benefits of Erwinaze treatment with their healthcare provider.
• Other Medications: Patients should inform their healthcare provider about all medications, supplements, or herbal products they are taking, as some medications may interact with Erwinaze and affect its effectiveness or increase the risk of side effects.

It’s crucial for patients to follow their healthcare provider’s instructions carefully and to report any side effects or concerns promptly during treatment with Erwinaze.

What special dietary instructions should I follow?

Regarding special dietary instructions for Erwinaze, there are no specific dietary restrictions associated with its use. However, it’s essential to maintain a balanced and nutritious diet to support overall health and well-being during cancer treatment. Your healthcare provider or a registered dietitian can provide personalized dietary guidance based on your individual needs and preferences.

What should I do if I forget a dose?

If you forget a dose of Erwinaze, contact your healthcare provider or treatment team as soon as possible for guidance. They will advise you on the appropriate course of action, which may involve rescheduling the missed dose or adjusting your treatment plan as needed. It’s crucial not to double the dose to make up for a missed one unless specifically instructed by your healthcare provider. Consistency in following the prescribed dosing schedule is essential for the effectiveness of Erwinaze treatment.

What side effects can this medication cause?

Erwinaze (asparaginase Erwinia chrysanthemi) can cause various side effects, which can vary in severity from person to person. Some of the common side effects associated with Erwinaze treatment include:

• Allergic Reactions: Allergic reactions are possible, which may manifest as rash, itching, hives, swelling of the face, lips, or tongue, difficulty breathing, or tightness in the chest. Severe allergic reactions can be life-threatening and require immediate medical attention.
• Pancreatitis: Inflammation of the pancreas (pancreatitis) can occur, leading to symptoms such as severe abdominal pain, nausea, vomiting, and fever. Pancreatitis requires prompt medical evaluation and may necessitate discontinuation of Erwinaze treatment.
• Liver Toxicity: Erwinaze can cause liver toxicity, which may manifest as elevated liver enzymes (AST, ALT), jaundice (yellowing of the skin or eyes), abdominal pain, dark urine, or pale stools. Regular monitoring of liver function tests is recommended during Erwinaze treatment.
• Blood Clotting Abnormalities: Erwinaze may affect blood clotting function, leading to an increased risk of bleeding or thrombosis (blood clot formation). Symptoms of blood clotting abnormalities may include easy bruising, nosebleeds, prolonged bleeding from cuts, chest pain, shortness of breath, or swelling in the legs.
• Changes in Blood Glucose Levels: Erwinaze can affect blood glucose levels, leading to hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar). Symptoms of hyperglycemia may include increased thirst, frequent urination, fatigue, and blurred vision, while symptoms of hypoglycemia may include sweating, trembling, confusion, and fainting.
• Gastrointestinal Symptoms: Common gastrointestinal side effects of Erwinaze may include nausea, vomiting, diarrhea, or abdominal discomfort. These symptoms can often be managed with supportive care measures such as anti-nausea medications or dietary adjustments.
• Fatigue: Some patients may experience fatigue or weakness during Erwinaze treatment, which can impact daily activities. Adequate rest and proper nutrition may help alleviate these symptoms.
• Infections: Erwinaze can suppress the production of white blood cells, increasing the risk of infections. Patients should promptly report any signs of infection, such as fever, chills, cough, or sore throat, to their healthcare provider.

It’s essential for patients to communicate openly with their healthcare provider about any side effects or concerns they experience during Erwinaze treatment. Prompt reporting of side effects allows for timely intervention and management to optimize patient safety and treatment outcomes.

What should I know about storage and disposal of this medication?

Storage and Disposal:

• Storage: Erwinaze should be stored in the refrigerator between 36°F to 46°F (2°C to 8°C). Do not freeze Erwinaze, and protect it from light. Keep it in its original carton until ready for use to shield it from light. Do not use Erwinaze if it has been frozen or exposed to excessive heat.
• Disposal: Dispose of unused or expired Erwinaze properly according to local regulations or as instructed by your healthcare provider or pharmacist. Do not dispose of medications in wastewater or household trash unless instructed to do so. Contact your pharmacist or local waste disposal company for proper disposal procedures.

In case of emergency/overdose

In case of an emergency or overdose with Erwinaze, seek immediate medical attention or contact a poison control center (1-800-222-1222 in the United States). Symptoms of overdose may include severe allergic reactions, pancreatitis, liver toxicity, or blood clotting abnormalities. Do not attempt to treat an overdose without professional medical assistance.

What other information should I know?

• Keep all appointments for laboratory tests and follow-up visits with your healthcare provider while receiving Erwinaze treatment.
• Inform all healthcare providers involved in your care about your Erwinaze treatment, including dentists and pharmacists, as it may interact with other medications or procedures.
• Avoid receiving live vaccines during treatment with Erwinaze, as the weakened immune system may not respond adequately to vaccination.
• Follow your healthcare provider’s instructions regarding dietary restrictions, activity level, and other lifestyle modifications during Erwinaze treatment.
• Keep Erwinaze and all medications out of the reach of children and pets.
• Store Erwinaze syringes and vials away from food, beverages, and other medications to prevent contamination.

Always consult your healthcare provider or pharmacist if you have any questions or concerns about the storage, disposal, administration, or side effects of Erwinaze. They can provide personalized guidance based on your individual circumstances and medical history.