Rasburicase

Rasburicase is a prescription medication used to reduce high uric acid levels in adults and children with leukemia, lymphoma, and solid tumor malignancies who are receiving chemotherapy medications.

When cancer cells are destroyed by chemotherapy, certain substances are released. As the body breaks these substances down, uric acid levels increase and may be harmful. Rasburicase is in a class of medications called urate oxidase enzymes. It works by breaking down uric acid so that the body can eliminate it.

This medication comes in an injectable form to be given directly into a vein (IV) once daily for up to 5 days.

Common side effects include nausea, vomiting, anxiety, and stomach pain.

Rasburicase is a prescription medication used for the initial management of plasma uric acid levels in pediatric and adult patients with leukemia, lymphoma, and solid tumor malignancies who are receiving anti-cancer therapy expected to result in elevation of plasma uric acid.

Limitation of use: Rasburcase is indicated only for a single course of treatment.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Rasburicase may be found in some form under the following brand names:

• Elitek

Common side effects include:

• nausea
• vomiting
• anxiety
• stomach pain
• mouth sores
• throat pain
• fever
• headache
• swelling of the hands, feet, ankles, or lower legs

Tell your doctor about any side effect that bothers you or that does not go away. 

These are not all the possible side effects with rasburicase. For more information, ask your doctor or pharmacist.

No drug interactions have been studied. However, you should tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Not all drug interactions are known or reported and new drug interactions are continually being reported.

Serious side effects have been reported with rasburicase.

• Rasburicase may cause a severe allergic reaction. If you experience any of the following symptoms, contact your doctor immediately: chest pain or tightness, shortness of breath, lightheadedness, faintness, or hives.
• Rasburicase injection may cause serious blood problems. Tell your doctor if you have glucose-6-phosphate dehydrogenase (G6PD) deficiency (an inherited blood disease). Your doctor will probably tell you that you cannot receive rasburicase. Also tell your doctor if you are of African or Mediterranean descent. If you experience any of the following symptoms, contact your doctor immediately: headache; shortness of breath; lightheadedness; weakness; confusion; fast, pounding, or irregular heartbeat; seizures; pale or blue-gray skin color; yellowing of the skin or eyes; chills; extreme tiredness; and dark urine.
• Rasburicase can result in methemoglobinemia in some patients. This is a blood disorder in which an abnormal amount of methemoglobin (a protein in the blood) is made. This medication should be stopped if methemoglobinemia occurs. Signs of methemoglobinemia are a bluish coloring of the skin, headache, fatigue, shortness of breath, and lack of energy.

Do not take this medication if you:

• are allergic to rasburicase or to any of its ingredients
• have developed blood disorders or methemoglobinemia while on rasburicase
• have a glucose-6-phosphate dehydrogenase (G6PD)

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of this medication, there are no specific foods that you must exclude from your diet.

Before receiving rasburicase injection,

• tell your doctor and pharmacist if you are allergic to rasburicase, any other medications, or any of the ingredients in rasburicase injection.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
• tell your doctor if you have or have ever had any medical condition.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving rasburicase.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if rasburicase crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using this medication.

Rasburicase comes as a solution (liquid) to be injected intravenously (into a vein) by a healthcare professional. It is usually given over a period of 30 minutes once a day for up to 5 days. This medication is given as a single course of treatment that will not be repeated.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your weight
• your height
• your age
• your gender

The recommended dose is 0.2 mg/kg injected over 30 minutes daily for up to 5 days.

Since this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.
 

Tell your doctor and the laboratory personnel that you are receiving rasburicase before having any laboratory test.

WARNING: ANAPHYLAXIS, HEMOLYSIS, METHEMOGLOBINEMIA, AND INTERFERENCE WITH URIC ACID MEASUREMENTS