Asparaginase Erwinia chrysanthemi is a cancer medicine.

Erwinase is used to treat acute lymphoblastic leukemia in adults and children at least 4 months old who have become allergic to other forms of asparaginase such as Elspar, Oncaspar or Rylaze.

Rylaze is used to treat acute lymphoblastic leukemia and lymphoblastic lymphoma in adults and children at least 1 month old who have become allergic to other forms of asparaginase such as Elspar, Oncaspar or Erwinase.

Asparaginase Erwinia chrysanthemi may also be used for purposes not listed in this medication guide.

Use only as directed. Tell your doctor if you use other medicines or have other medical conditions or allergies.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Asparaginase Erwinia chrysanthemi is injected into a muscle or into a vein. Erwinase is usually given every 48 hours. Rylaze can be given every 48 hours or given 3 times per week.

Read and carefully follow any Instructions for Use provided with the medicine. Ask your doctor or pharmacist if you don't understand how to use an injection.

Your healthcare provider will show you where to inject asparaginase Erwinia chrysanthemi. Do not inject into the same place two times in a row.

Do not shake the medication bottle or you may ruin the medicine.

Prepare an injection only when you are ready to give it. Call your pharmacist if the medicine has changed colors or has particles in it.

Do not reuse a needle or syringe. Place them in a puncture-proof "sharps" container and dispose of it following state or local laws. Keep out of the reach of children and pets.

Your blood will need to be tested often and your dose or medication schedule may be changed based on the results.

Doses are based on body surface area (height and weight). Your dose may change if you gain or lose weight or if you are still growing.

You may be given other medications to help prevent serious side effects or allergic reaction. Keep taking these medicines for as long as your doctor has prescribed.

Throw away a vial (bottle) after one use, even if there is still medicine left inside.

Follow all storage instructions provided with asparaginase Erwinia chrysanthemi. Your pharmacist can provide more information about how to store this medicine.

You should not use asparaginase Erwinia chrysanthemi if you have received any form of asparaginase in the past and it caused you to have:

• a serious allergic reaction;

• serious pancreas problems;

• a life-threatening blood clot; or

• serious bleeding problems.

Tell your doctor if you have ever had:

• problems with your liver or pancreas;

• bleeding problems;

• a blood clot; or

• diabetes.

May harm an unborn baby. You may need a pregnancy test to make sure you are not pregnant. Use birth control while using this medicine and for at least 3 months after your last dose. Tell your doctor if you become pregnant.

Asparaginase Erwinia chrysanthemi can make hormonal birth control less effective, including birth control pills, injections, implants, skin patches, and vaginal rings. Use barrier birth control to prevent pregnancy: condom, diaphragm, cervical cap, or contraceptive sponge.

Do not breastfeed while using this medicine, and for at least 3 months after your last dose of Erwinase or 1 week after your last dose of Rylaze.

Call your doctor for instructions if you miss a dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Asparaginase Erwinia chrysanthemi may cause serious side effects. Call your doctor at once if you have:

• easy bruising or bleeding (nosebleeds, bleeding gums);

• any bleeding that will not stop;

• blisters or ulcers in your mouth, red or swollen gums, trouble swallowing;

• signs of liver or pancreas problems--severe stomach pain (that may spread to your back), nausea or vomiting, jaundice (yellowing of the skin or eyes);

• signs of a blood clot--sudden numbness or weakness (especially on one side of the body), severe headache, chest pain, feeling short of breath, pain or swelling in an arm or leg;

• low white blood cell counts--fever, mouth sores, skin sores, sore throat, cough; or

• high blood sugar--increased thirst, increased urination, dry mouth, fruity breath odor.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common side effects of asparaginase Erwinia chrysanthemi may include:

• liver or pancreas problems;

• bleeding or blood clots;

• high blood sugar;

• stomach pain, loss of appetite, nausea, vomiting, diarrhea;

• fever, headache, tiredness, mouth sores;

• bone pain, muscle or joint pain;

• allergic reaction, skin rash; or

• abnormal liver function tests.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other drugs may affect asparaginase Erwinia chrysanthemi, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.