Rasburicase (Fasturtec®)

Rasburicase is a drug given before and during chemotherapy to treat some types of leukaemia and lymphoma. It can help to prevent tumour lysis syndrome.

What is tumour lysis syndrome?

Tumour lysis syndrome (TLS) can be caused by some chemotherapy drugs. 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 removed from the body by the kidneys.

TLS can happen when lots of cancer cells are destroyed very quickly. The kidneys cannot cope with the increased amount of uric acid. This leads to imbalances in some chemicals (phosphate, potassium and calcium) in the blood. These imbalances can cause more serious problems affecting the kidneys and the heart.

TLS is 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.

How rasburicase works

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

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 one of the following:

  • a short, thin tube (cannula) that the nurse puts into a vein in your arm or hand
  • a fine tube that goes under the skin of your chest and into a vein close by (central line)
  • a fine tube that is put into a vein in your arm and goes up into a vein in your chest (PICC line).

The infusion is given over 30 minutes. You may have just 1 dose or a daily dose for up to 7 days. Your doctors will decide how many days of treatment you need. They will do this by taking regular blood tests to check the level of uric acid in your blood.

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.

About side effects

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 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, discuss them with 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.

More information

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.

Side effects while treatment is being given

Some people may have side effects while they are being given the chemotherapy or shortly after they have it:

Allergic reaction

Some people have an allergic reaction while having this treatment. Signs of a reaction can include:

  • feeling hot or flushed
  • a skin rash
  • itching
  • shivering
  • feeling dizzy
  • a headache
  • feeling breathless
  • 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 can happen a few hours after treatment. If you get any signs or feel unwell after you get home, contact the hospital straight away.

Possible side effects

High temperature

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.

Diarrhoea

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.

Feeling sick

You may feel sick in the first few days of your treatment. The nurses will give you anti-sickness drugs regularly. If you still feel sick, tell your nurse or doctor. They can change the anti-sickness drug to one that works better for you.

Blood changes

Rarely, rasburicase can increase the breakdown of red blood cells. You will have regular blood tests during your treatment to check for this.

Other information

Other medicines

Some medicines can affect how this treatment works or be harmful when you are having it. Always tell your cancer doctor about any drugs you are taking or planning to take, such as:

  • medicines you have been prescribed
  • medicines you buy in a shop or chemist
  • vitamins, herbal drugs and complementary therapies.

Tell other doctors, pharmacists or dentists who prescribe or give you medicines that you are having this cancer treatment.

You can visit the electronic Medicines Compendium (eMC) for more detailed information about your treatment.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that 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.

Pregnancy and breastfeeding

If you are pregnant, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Women are also advised not to breastfeed when taking this treatment. This is because the medicine may be passed to the baby through the breast milk.