Asparaginase Erwinia Chrysanthemi (as-par-a-JIN-ase er-WIN-i-a kris-an-THEM-i)

Treats acute lymphoblastic leukemia (ALL).

Brand Name(s):

Erwinase

When This Medicine Should Not Be Used:

How to Use This Medicine:

Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given as a shot into a muscle or through a needle placed a vein.
• You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine.
• Missed dose: This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how Erwinase® works. Tell you doctor if you are using cytarabine, methotrexate, prednisone, vincristine, or birth control pills.

Warnings While Using This Medicine:

• This medicine may cause birth defects if either partner is using it during conception or pregnancy. Tell your doctor right away if you or your partner becomes pregnant. Use an effective form of birth control during treatment with this medicine and for at least 3 months after the last dose. Male patients with female partners should use an effective form of birth control during treatment and for 3 months after the last dose.
• Do not breastfeed during treatment and for at least 3 months after your final dose.
• Tell your doctor if you are breastfeeding, or if you have liver disease, kidney disease, bleeding or blood clotting problems, diabetes, or pancreas problems.
• This medicine may cause the following problems:
  • Pancreatitis
  • Bleeding or blood clotting problems
  • Liver problems
  • Posterior reversible encephalopathy syndrome (PRES)
  • Increase risk of infection
  • Increased blood sugar levels
• This medicine may cause some people to become dizzy, drowsy, or less alert than they are normally. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• This medicine lowers the number of white blood cells. This weakens your immune system, so you may get infections more easily. Wash your hands often. Avoid people who are sick.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain, coughing up blood, sudden or severe headache, problems with vision, speech, or walking
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Dry mouth, increased hunger, thirst, or urination
• Fever, chills, cough, sore throat, body aches
• Numbness or weakness in your arm or leg, or on one side of your body, pain or swelling in your calf
• Seizures, confusion, unusual drowsiness
• Sudden and severe stomach pain, fever, lightheadedness
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Pain, itching, burning, swelling, or a lump under your skin where the shot was given

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088