Rasburicase
ELITEK
What it isRecombinant urate oxidase converting uric acid to soluble allantoin; tumor-lysis hyperuricemia.
Why this oneIt destroys urate already present, unlike allopurinol, which only prevents new production.
What limits itScreen for G6PD deficiency because hemolysis and methemoglobinemia can be fatal; anaphylaxis also occurs, and blood samples must go on ice or the enzyme keeps working in the tube and falsely lowers the level.
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Initial management of plasma uric acid with tumor lysis (leukemia, lymphoma, solid tumor on anticancer therapy) | Peds ≥1 mo & adult | 0.2 mg/kg IV over 30 min QD | up to 5 days (single course) |
Renal Undefined
Hepatic Undefined
Indicated for a single course only; dosing beyond 5 days or more than one course not recommended.
Instructions
- Give as IV infusion over 30 minutes; do not administer as an IV bolus
- Single course only — do not exceed 5 days or give more than one course
- Screen patients at higher risk for G6PD deficiency before starting
- Collect uric acid blood samples in prechilled heparin tubes on ice and assay within 4 hours
Contraindications
- History of anaphylaxis, severe hypersensitivity, hemolysis, or methemoglobinemia with rasburicase.
- Glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Cautions
- Serious/fatal hypersensitivity reactions including anaphylaxis
- Hemolysis (contraindicated in G6PD deficiency)
- Methemoglobinemia
- Laboratory test interference — ex vivo uric acid degradation
Adverse reactions
- vomiting
- nausea
- fever
- peripheral edema
- anxiety
- headache
- abdominal pain
- constipation
- diarrhea
- hypophosphatemia
- pharyngolaryngeal pain
- ALT increased
Pregnancy May cause fetal harm based on animal data (heart/great vessel malformations, embryo-fetal mortality, growth alterations); human data insufficient.
Lactation No data; breastfeeding not recommended during treatment and for 2 weeks after the last dose.
⚠ BOXED WARNINGS
- Anaphylaxis
- Hemolysis (G6PD deficiency)
- Methemoglobinemia
- Uric acid assay interference
Classes and tags
Clinical profile
Mechanism of action: Rasburicase ballicule
