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l-asparaginase

enzyme · null

enzymenullATC null
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
—
none in our sources
PREGNANCY
X
FDA category + note

Mechanism

L-Asparaginase deaminates asparagine, inhibiting protein synthesis.

Indications

Acute lymphocytic leukemia (ALL)High-grade lymphomasAcute lymphoblastic leukaemia (inducing remission)

Dosing

Adult
Escherichia coli–derived l-ASP is given in doses of 6000 to 10,000 IU every third day for 3 to 4 weeks. Pegaspargase is administered intramuscularly every 14 days. Calaspargase pegol is administered intravenously every 21 days.

Pharmacokinetics

Half-life
1 day (E. coli-derived l-ASP); 6–7 days (pegaspargase)
Excretion
Asparaginase preparations only partially deplete CSF asparagine.

Side effects

Common
Hypersensitivity reactions (urticaria, full-blown anaphylaxis)Hyperglycemia (due to insulin deficiency)Clotting abnormalities (due to deficient clotting factors)Hypertriglyceridemia (due to effects on lipoprotein production)HypoalbuminemiaPancreatitisSuppresses immune functionHyperglycaemiaRaised triglyceride levelsLiver damageClotting defectsCNS symptomsAllergic reactions (urticaria, chills, fever, rash)
Serious
  • Hypersensitivity reactions (5% to 20% of patients, may be fatal)
  • Spontaneous thrombosis
  • Hemorrhagic episodes
  • Intracranial hemorrhage (infrequent but devastating in the first week of treatment)
  • Anaphylaxis
  • Antigenicity leading to neutralizing antibodies and rapid clearance

Pregnancy & lactation

Pregnancy

X

Drug interactions

Methotrexate
Moderate
Textbook

L-asparaginase terminates the antitumor activity of methotrexate when given shortly after the antimetabolite.

Administer l-asparaginase at appropriate intervals relative to methotrexate to avoid antagonism of antitumor effects.

Source: G&G 14e

Other Drugs
Mild
Textbook

May decrease protein binding and accelerate plasma clearance of other drugs.

Monitor levels and effects of highly protein-bound co-administered drugs and adjust dosages as necessary.

Source: G&G 14e

Related guidelines

Acne vulgaris
IADVL · Dermatology · 2023

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Sources: KD Tripathi 7e, Goodman & Gilman 14e·Verified: 2026-05-10 · House clinical team