What is Rasburicase Injection?

Rasburicase Injection is a prescription drug that is part of a group of pharmaceuticals called urate oxidase enzymes.

It is a recombinant form of an enzyme that comes from the fungus Aspergillus flavus.

It is made using genetically modified yeast and recombinant DNA technology.

Health professionals employ rasburicase to quickly lower high uric acid levels in patients, especially those getting cancer treatment that can induce a lot of tumour cell death.

Description

Uses / Indications

Preventing and treating hyperuricemia is important for both children and adults with hematologic cancers like leukemia and lymphoma.

It also applies to those with large solid tumors receiving chemotherapy that may cause tumor lysis.

Specifically advised when there is a high risk of kidney injury caused by uric acid.

Benefits

Within four hours of taking it, it quickly and effectively lowers plasma uric acid levels.

Prevents uric acid crystals from building up in the kidneys, which can cause acute renal damage or failure.

It functions better than allopurinol to get rid of uric acid that is already there because it breaks down the uric acid that has already developed instead of only stopping it from forming.

Lessens the problems that come with tumour lysis syndrome, making intensive chemotherapy regimens safer.

Side Effects

How Does It Work?

Rasburicase speeds up the chemical change of uric acid into allantoin, which is 5–10 times more soluble than uric acid and is easily flushed out of the body by the kidneys through urine.

In contrast to allopurinol, which only prevents new uric acid from being made by blocking xanthine oxidase, this quick change helps lower uric acid levels quickly.

It is very helpful in tumour lysis syndrome because it directly crush down uric acid that is in the blood.

This is because uric acid can build up very quickly and in large amounts.

Directions for Use

In a hospital setting, Rasburicase can only be given by trained medical staff.

The daily dose should be 0.15 to 0.2 mg per kg of body weight, given as a single 30-minute intravenous treatment every day for up to 5 days.

Following the manufacturer’s directions, the powder needs to be mixed back together and diluted.

To keep the enzyme from becoming less active, the fluid should not be shaken very hard but rather slowly swirled.

Use a different IV line to give the solution, or flush the IV line with water before and after giving the solution.

When Not to Use

Rasburicase has little drug-drug interactions since it does not interact with cytochrome P450 pathways.

Should not be taken with allopurinol, febuxostat, or probenecid, which have overlapping effects and provide no further benefit.

To avoid residual solution from degrading plasma uric acid, collect blood samples into pre-chilled tubes with an anticoagulant and place them on ice.

Drug Interactions

It shouldn’t be taken at the same time as allopurinol, febuxostat, or probenecid.

There were no major CYP450 associations found.

It could mess up uric acid tests in the lab if blood samples aren’t kept cold.

Safety Advice

Before beginning treatment, it is important to check each patient for a G6PD deficiency.

Rasburicase should not be administered to people who are weak in G6PD.

During and after the infusion, patients should be thoroughly monitored for any signs of hypersensitivity or anaphylaxis.

Maintain continuous monitoring. The availability of emergency equipment should not be a problem.

There are a number of symptoms that can indicate methemoglobinemia, including cyanosis, shortness of breath, and exhaustion.

When methemoglobin levels are detected, they should be measured and treated accordingly.

General Instructions

Rasburicase should only be given in a hospital or specialized treatment center. Do not give it to yourself.

Tell your doctor right away if you get a rash, itching, swelling, trouble breathing, or a change in the color of your skin.

If your doctor doesn’t tell you otherwise, finish the whole course even if your uric acid levels return to normal before the end.

Special Dietary / Lifestyle Advice

Patients on Rasburicase normally don’t need to make big adjustments to their diets, but they do need to drink a lot of water to assist their kidneys flush out allantoin, the breakdown product, and avoid kidney problems.

If their doctor says it’s okay, patients should drink a lot of water.

A light, balanced diet that helps your health while you’re getting chemotherapy is best.

Do not use any uric acid-lowering drugs or supplements on your own unless your doctor tells you to.

Always do what your oncologist says about how much fluid you should drink, how much movement you should do, and how to look for signs of tumor lysis syndrome.

Comparison with Other Treatments

Rasburicase is ideal for acute tumor lysis syndrome.

It quickly turns uric acid into allantoin, which the body can eliminate easily.

This process makes it different from other uric acid-lowering drugs like febuxostat and allopurinol.

Allopurinol and febuxostat work more slowly. They mainly treat chronic gout or help prevent long-term hyperuricemia.

They stop new uric acid from forming but don’t remove existing uric acid.

While the others are outpatient oral drugs, it works more quickly but needs close hospital supervision.

Precautions & Warnings

It’s not meant to be used for a long time. Only used for hyperuricemia associated with cancer when there is a substantial risk of tumor lysis.

Don’t repeat treatment courses unless they are specifically needed.

If blood samples are not handled carefully, rasburicase may affect laboratory testing for uric acid.

Always have emergency medical care ready during administration. This is important because of possible allergic reactions.

Can It Be Used With Other Medications?

Chemotherapy agents

Supportive treatments for cancer, such as antiemetics, antibiotics, corticosteroids

IV hydration fluids

Allopurinol or other xanthine oxidase inhibitors

Other uricosurics like probenecid during rasburicase treatment

Storage

Keep unopened vials in the fridge between 36 and 46 degrees Fahrenheit (2 and 8 degrees Celsius).

Retain in the original container until needed; shield from light.

The solution needs to be used as soon as it is reconstituted, usually within 24 hours if kept in the fridge or as the manufacturer suggests.

Properly dispose of any solution that is not used.