Applies to pegaspargase: parenteral injection.

Side effects include:

Grade 3 or 4 reactions: Hypoalbuminemia, elevated serum aminotransferase concentrations, febrile neutropenia, hypertriglyceridemia, hyperglycemia, hyperbilirubinemia, pancreatitis, clotting study abnormalities, embolic and thrombotic events, hypersensitivity reactions.

No apparent difference in adverse effects following IV versus IM administration.

For Healthcare Professionals

Applies to pegaspargase: injectable solution.

General

The most commonly reported side effects were elevated transaminases and clinical allergic reactions to asparaginase (including bronchospasm, hypotension, laryngeal edema, local erythema or swelling, systemic rash, and urticaria).^[Ref]

Hypersensitivity

Very common (10% or more): Hypersensitivity, urticaria, anaphylactic reaction^[Ref]

Nervous system

Common (1% to 10%): Central nervous system thrombosis/hemorrhage, seizure, peripheral motor neuropathy, syncope

Rare (less than 0.1%): Posterior reversible leukoencephalopathy syndrome

Frequency not reported: Somnolence, tremor^[Ref]

Cardiovascular

Common (1% to 10%): Thrombosis, embolism^[Ref]

Gastrointestinal

Very common (10% or more): Pancreatitis, diarrhea, abdominal pain, nausea

Common (1% to 10%): Vomiting, stomatitis, ascites

Rare (less than 0.1%): Pancreatitis necrotizing, pancreatitis hemorrhagic

Frequency not reported: Pancreatic pseudocyst, parotitis^[Ref]

Hematologic

Very common (10% or more): Febrile neutropenia

Common (1% to 10%): Coagulopathy (prolonged prothrombin time or partial thromboplastin time; or hypofibrinogenemia), anemia

Frequency not reported: Bone marrow failure^[Ref]

Hepatic

Very common (10% or more): Elevated transaminases

Common (1% to 10%): Hyperbilirubinemia, hepatotoxicity, fatty liver

Rare (0.01% to 0.1%): Hepatic necrosis, jaundice, cholestasis, hepatic failure^[Ref]

Metabolic

Common (1% to 10%): Hyperglycemia, weight decreased, decreased appetite

Frequency not reported: Glucose intolerance, hyperlipidemia, hypercholesterolemia, diabetic ketoacidosis, hypoglycemia^[Ref]

Immunologic

Common (1% to 10%): Infections, sepsis^[Ref]

Musculoskeletal

Common (1% to 10%): Pain in extremities^[Ref]

Psychiatric

Frequency not reported: Confusion^[Ref]

Respiratory

Common (1% to 10%): Hypoxia^[Ref]

Other

Frequency not reported: Pyrexia^[Ref]

Renal

Frequency not reported: Acute renal failure^[Ref]

Dermatologic

Very common (10% or more): Rash

Frequency not reported: Toxic epidermal necrolysis (TEN), cerebrovascular accident, hemorrhage, superior sagittal sinus thrombosis^[Ref]