Rasburicase (Fasturtec ®)
Rasburicase is a drug given before and during chemotherapy for some types of leukaemia and lymphoma. It can help prevent or reduce a side effect of chemotherapy called tumour lysis syndrome.
This information describes rasbiricase, how it’s given and some of its possible side effects. If you have any further questions, you can ask the doctor, nurse or pharmacist at the hospital where you are having your treatment.
Tumour lysis syndrome (TLS) is a complication that can be caused by some chemotherapy drugs. It's more common in cancers that grow quickly and respond quickly to chemotherapy, such as acute leukaemias and high-grade lymphomas. People with other types of cancer are rarely affected by TLS.
To understand TLS, it helps to know how chemotherapy works.
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. As the cancer cells break down, they release a chemical called uric acid, which is cleared from the body by the kidneys. When lots of cancer cells are destroyed very quickly, the kidneys can't cope with the increase in uric acid. This leads to imbalances in some chemicals in the blood (phosphate, potassium and calcium). These imbalances can cause more serious problems affecting the kidneys and the heart.
Rasburicase changes uric acid so that it can be easily processed and removed from the body by the kidneys. This prevents a build-up of uric acid.
How rasburicase is given
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Rasburicase is given before or during the start of your chemotherapy treatment.
It is given by drip (infusion) into a vein through a fine tube called a cannula, or through a central or PICC line. The infusion is given over 30 minutes. You may have one dose or a daily dose for up to seven days. Your doctors will decide how many days of treatment you need by taking regular blood tests to check the level of uric acid in your blood.
You will also be given large amounts of fluids through a line into your bloodstream (called intravenous hydration) to help flush through your kidneys.
Possible side effects of rasburicase
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Each person’s reaction to any medication is different. Most people have very few side effects, while others may experience more. The side effects described here won't affect everyone who is having rasburicase and may be different if you are having more than one drug.
We explain the most common side effects of rasburicase here. But we don’t include all the rare ones that are unlikely to affect you. If you notice any side effects that aren't listed here, discuss them with your nurse or doctor.
Your nurse will monitor your temperature during treatment with chemotherapy and rasburicase. Signs of a high temperature can include feeling hot and sweaty or feeling cold and shivery. It's important to let the nurse or doctor know if you feel you have a high temperature.
Rarely, rasburicase may cause an allergic reaction while it’s being given. Your nurse will check you for this. If you have a reaction, they will treat it quickly. Signs of an allergic reaction can include: a rash; feeling itchy, feeling short of breath; and chest pain. Tell your nurse straight away if you have any of these symptoms.
This is uncommon but your doctor can prescribe drugs to control diarrhoea. Let them know if it is severe or if it doesn’t get better. Make sure you drink at least two litres (three and a half pints) of fluids every day if you have diarrhoea.
Rasburicase may cause headaches but this isn’t common. If this happens, let your doctor or nurse know. They can give you painkillers.
Rarely, rasburicase can increase the breakdown of red blood cells. You have regular blood tests during your treatment to check for this side effect.
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Rasburicase shouldn't be given to anyone who has the metabolic disorder known as Glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Some medicines can be harmful to take when you are having cancer treatment. Let your doctor know about any medication you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.
This section has been compiled using information from a number of reliable sources, including:
Coiffier B, et al. Guidelines for the Management of Pediatric and Adult Tumour Lysis Syndrome: An evidence-based review. Journal of Clinical Oncology. 2008. 26: 16, 2767–78.
Lopez-Olivo et al. Rasburicase in tumor lysis syndrome of the adult: a systematic review and meta-analysis. American Journal of Kidney Disease. 2013. 62(3):481.
electronic Medicines Compendium (eMC). www.medicines.org.uk (accessed March 2014).
Tobias & Hochauser. Cancer and its Management. 6th edition. 2010. Wiley-Blackwell.
Sweetman, et al. Martindale: The Complete Drug Reference. 37th edition. 2011. Pharmaceutical Press.
Thanks to Catherine Loughran, Lead Pharmacist Haematology, and the people affected by cancer who reviewed this edition.
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