Rasburicase (Fasturtec®) is a drug given before and during chemotherapy to treat some types of cancer. It can help to prevent tumour lysis syndrome.
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. When cancer cells break down very quickly, it can cause a sudden release of large amounts of chemicals into the blood. This is called tumour lysis syndrome (TLS).
Your kidneys can usually keep these chemicals balanced. But they might not be able to cope with very large amounts. The chemical imbalance can affect how well your kidneys work and cause problems with your heart rhythm.
You will have regular blood tests to check the levels of these chemicals.
If you are at risk of TLS, your doctor can give you treatment to help prevent it. You may have:
- extra fluids through a drip
- medicines such as rasburicase or allopurinol.
Drinking at least 2 litres (3½ pints) of fluid a day will also help.
Rasburicase is given before or with your first chemotherapy treatment. You have it as a drip (infusion) into a vein.
Your nurse will give you rasburicase through 1 of the following:
- a cannula – a short, thin tube the nurse puts into a vein in your arm or hand
- a central line – a fine tube that goes under the skin of your chest and into a vein close by
- a PICC line – a fine tube that is put into a vein in your arm and goes up into a vein in your chest.
The infusion is given over 30 minutes. You may have just 1 dose or a daily dose for up to 7 days. You will have blood tests to see how much uric acid is in your blood. This helps your doctor decide how many doses of rasburicase to give you.
You will also have an infusion of fluids to help flush through your kidneys. This is called intravenous hydration. This means you pass more urine (pee) than usual.
Each person’s reaction to any medicine is different. Most people have very few side effects, while others may experience more. The side effects described here will not affect everyone who is having rasburicase.
You may also have side effects from the cancer drugs you are given. If you notice any side effects that are not listed here, tell your nurse or doctor.
Serious and life-threatening side effects
Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.
We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.
Some people have an allergic reaction while having this treatment. Signs of a reaction can include:
- feeling hot or flushed
- a skin rash
- feeling dizzy
- a headache
- feeling breathless or wheezy
- swelling of your face or mouth
- pain in your back, tummy or chest.
Your nurse will check you for signs of a reaction during your treatment. If you feel unwell or have any of these signs, tell them straight away. If you do have a reaction, it can be treated quickly.
Sometimes a reaction happens a few hours after treatment. If you develop any signs or feel unwell after you get home, contact the hospital straight away.
Your nurse will monitor your temperature during treatment. Signs of a high temperature can include feeling hot and sweaty or cold and shivery. It is important to let the nurse or doctor know if you feel you have a high temperature.
The nurses will give you anti-sickness drugs regularly to help prevent or control sickness during your treatment. If you feel sick or are sick (vomit), tell your nurse or doctor. They may change the anti-sickness drug to one that works better for you.
This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is usual for you, or having watery or loose stools. If you have a stoma, it will be more active than usual.
If you have diarrhoea:
- try to drink at least 2 litres (3½ pints) of fluids each day
- avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods
- contact the hospital for advice.
This treatment may cause headaches. If you have headaches, tell your doctor. They may give you painkillers to help.
Some medicines can affect how this treatment works or be harmful while you are having it. Always tell your cancer doctor, nurse or pharmacist about any drugs you are taking or planning to take, such as:
- medicines you have been prescribed
- medicines you buy in a shop, pharmacy or online
- vitamins or supplements
- herbal drugs and complementary or homeopathic therapies
- recreational drugs – for example, cannabis.
Pregnancy and breastfeeding
Ask your doctor or pharmacist for advice before taking this medicine if you:
- are pregnant
- think you may be pregnant
- are planning to have baby.
You are also advised not to breastfeed when taking this treatment. This is because the medicine may be passed to the baby through breast milk.
Medical and dental treatment
If you need medical treatment for any reason other than cancer, always tell the doctors and nurses you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.
If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert health professionals and people living with cancer.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.
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We want everyone affected by cancer to feel our information is written for them.
We want our information to be as clear as possible. To do this, we try to:
- use plain English
- explain medical words
- use short sentences
- use illustrations to explain text
- structure the information clearly
- make sure important points are clear.
We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
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