RASBURICASE
Background and Date of Approval
Rasburicase is a uricolytic agent used to manage elevated uric acid levels in patients undergoing chemotherapy. It was approved by the U.S. FDA on 12 July 2002 for this indication.
Uses
Rasburicase is used to prevent or treat hyperuricemia that can occur as a result of cancer chemotherapy.
How is it administered?
The medicine will be administered to you by a healthcare professional in a hospital setting. Rasburicase is given as an injection into a vein (intravenous infusion) over a period of 30 minutes, once a day for up to 5 days. The dose, route of administration, and frequency will be decided by your doctor based on your disease condition and other factors.
Side Effects
The common side effects that are likely to occur while you are on the treatment with Rasburicase are swelling of face, wheezing problems, headache, anxiety, abdominal pain, constipation and rashes. Some serious side effects also include high levels of liver enzymes in the blood and hypersensitivity reactions. If you experience any allergic or unusual reactions after taking this medicine, report to your doctor immediately.
Warnings
It is not recommended to take Rasburicase injection if you are allergic to Rasburicase or any of its ingredients. In patients with G6PD deficiency, rasburicase can trigger hemolysis(destruction of RBC) by generating reactive oxygen species that damage red blood cells. As a result, rasburicase is generally contraindicated in patients with G6PD deficiency. If you are diagnosed with this deficiency, inform your physician before taking this medicine because you will be more likely to experience severe haemolytic anaemia or methemoglobinemia(an abnormal form of haemoglobin).
Precautions
Children who are undergoing chemotherapy for leukaemia, lymphoma, or solid tumor malignancies are at risk for developing hyperuricemia, which can lead to kidney damage, seizures, and other complications. This drug helps to treat hyperuricemia by rapidly reducing the levels of uric acid in the blood.It is important to closely monitor children who are receiving rasburicase for any signs of allergic reactions, hemolysis (breakdown of red blood cells), or any other side effects. This medicine is not recommended during pregnancy as it causes harm to the unborn baby. Tell your healthcare provider before beginning this treatment if you are pregnant or planning to have a baby. It is advised for both men and women to follow proper contraceptive methods during and for 3 months after the last dose of Rasburicase.
Word of Advice
Avoid driving and operating heavy machinery if you experience tiredness or weakness during this treatment. Certain activities or conditions that can trigger gout attacks—such as fasting, rapid weight loss, and stress—should be avoided while taking Rasburicase. Foods high in purines should be avoided, including red meat, organ meats, and some seafood, as these can increase uric acid levels and reduce Rasburicase effectiveness. It is important to avoid or limit consumption of these foods during treatment. Dehydration can reduce medication effectiveness and increase the risk of side effects; therefore, drink plenty of fluids, particularly water, while taking this medicine. Smoking can cause oxidative stress in the body, leading to increased uric acid levels. Avoid smoking and tobacco products during Rasburicase treatment.
References
Sanofi-aventis groupe, Electronic Medicines Compendium (EMC), [Revised on Jun 2021] [Accessed on 27th March 2023], https://www.medicines.org.uk/emc/files/pil.12870.pdf Sanofi-aventis U.S. LLC (no date) ELITEK., ELITEK (rasburicase) Powder for solution, for intravenous infusion. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/103946s5083lbl.pdf [Accessed on 27th March 2023]. Sanofi S.p.A, Fasturtec name of the medicinal product qualitative and quantitative, Available at: https://www.sanofi.com.sg/dam/jcr:e21c742b-05a1-4b24-9d3b-a7d4c646b3bb/143%20Fasturtec%20SG%20FAS%200718%20CCDSv6.pdf [Accessed on 27th March 2023]. Ueng, S. (2005) Rasburicase (Elitek): A novel agent for tumor lysis syndrome, Proceedings (Baylor University. Medical Center). U.S. National Library of Medicine. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200736/ [Accessed on27th March 2023]. Goodman & Gilmanâs, The Pharmacological Basis of Therapeutics, Inflammation, Immunomodulation and Hematopoiesis, pharmacotherapy of gout, 12th edition, 2011, 998. KD Tripathi, Essentials of Medical Pharmacology, Antirheumatoid and antigout drugs, 7th edition, 2013, 217.
Frequently Asked Questions
Whether rasburicase helps to protect people who are at high risk for tumor lysis syndrome (TLS)?
Yes, it is often used prophylactically in individuals who are at high risk for TLS due to their cancer chemotherapy.
How does Rasburicase Injection work?
Rasburicase works by converting uric acid into allantoin, a more soluble compound that can be easily excreted by the kidneys. This reduces the levels of uric acid in the blood and prevents the development of hyperuricemia.
What should I avoid while taking Rasburicase Injections?
It is advised to avoid certain medications, such as allopurinol, which is used to lower uric acid levels. Using allopurinol with Rasburicase together can reduce the effectiveness of rasburicase.
Who should not use Rasburicase Injections?
Rasburicase injections are not indicated for those who have already developed acute gout or hyperuricemia due to conditions other than cancer chemotherapy.
Is Rasburicase Injection supportive therapy?
Yes, it is an important supportive therapy for patients undergoing chemotherapy to reduce the risk of complications associated with high levels of uric acid in the blood.
What is the purpose of Rasburicase Injection?
Rasburicase is used to prevent or treat hyperuricemia (high levels of uric acid in the blood) in patients who are undergoing cancer chemotherapy for leukemia, lymphoma, and solid tumor malignancies.