Gonadotropin Deficiency Medications

Definition of Gonadotropin Deficiency: Absent or decreased gonadal function (the male testis or the female ovary) resulting from the absence of the gonadal stimulating pituitary hormones FSH (follicle stimulating hormone) and LH (luteinizing hormone). More...

Drugs associated with Gonadotropin Deficiency

The following drugs and medications are in some way related to, or used in the treatment of Gonadotropin Deficiency. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

Learn more about Gonadotropin Deficiency

Medical Encyclopedia:

• Hypogonadotropic hypogonadism

Drug List:

Factrel

Galenphol Strong Linctus

1. Name Of The Medicinal Product

Galenphol Strong Linctus

2. Qualitative And Quantitative Composition

Active Ingredients:

Pholcodine BP 10.0mg (Per 5ml Dose)

For excipients, see 6.1.

3. Pharmaceutical Form

Oral liquid

A viscous deep orange-red coloured liquid.

4. Clinical Particulars

4.1 Therapeutic Indications

Used for the relief of an unproductive dry cough.

4.2 Posology And Method Of Administration

For oral administration.

Adults and Children over 12 years:

One 5ml spoonful every four to six hours.

Children under 12:

Not recommended.

Elderly:

Adult dose is appropriate.

Do not exceed the stated dose.

Keep out of the sight and reach of children.

4.3 Contraindications

Liver failure.

It should not be administered to patients in or at risk of developing respiratory failure or during an attack of asthma.

Patients receiving monoamine oxidase inhibitors or within 2 weeks of cessation of their use.

Patients with chronic bronchitis, COPD, bronchiolitis or bronchiectasis due to sputum retention.

Known hypersensitivity to any of the ingredients.

Not for use in children under 12 years of age.

4.4 Special Warnings And Precautions For Use

Use with caution in patients with renal, hepatic or respiratory disease, including a history of asthma. Galenphol Strong and other cough suppressants may cause sputum retention and this may be harmful in patients with chronic bronchitis and bronchiectasis.

Ask a doctor before use if you suffer from a chronic or persistent cough, if you have asthma, are suffering from an acute asthma attack or where cough is accompanied by excessive secretions.

Use of pholcodine with alcohol or other CNS depressants may increase the effects on the CNS and cause toxicity in relatively smaller doses.

This medicine contains sodium hydroxybenzoates, amaranth and sunset yellow dyes which may cause allergic reactions (possibly delayed).

Do not exceed the stated dose.

Do not take with other cough and cold medicines.

If symptoms persist consult your doctor.

Do not give to children under 12 years.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

Monoamine oxidase inhibitors: Galenphol Strong should not be used within 14 days of treatment.

Interaction with neuromuscular blocking agents (anaphylaxis) has been reported.

The reduction of blood pressure caused by antihypertensives may accentuate the hypotensive effects of pholcodine. Diuretics may have the same effect.

Pholcodine may enhance the sedative effect of central nervous system depressants including alcohol, barbiturates, hypnotics, narcotic analgesics, sedatives and tranquillisers (phenothiazines and tricyclic antidepressants).

4.6 Pregnancy And Lactation

No data available on the use of Galenphol in pregnancy or lactation.

Galenphol should be avoided during pregnancy unless considered necessary by the physician and should be avoided during the first trimester. Opioid administration near term in the third trimester may cause respiratory depression in the newborn, withdrawal effects in neonates of dependent mothers, gastric stasis and risk of inhalation pneumonia in the mother during labour.

Pholcodine has been detected in human milk but in amounts usually too small to be harmful; however mothers may vary considerably in their capacity to metabolise pholcodine with a risk of morphine overdose in the infant.

4.7 Effects On Ability To Drive And Use Machines

Using the dose recommended, it is not considered to be a hazard, however, the use of pholcodine may cause sedation, dizziness and nausea. If affected, driving or operation of machinery would not be advised.

4.8 Undesirable Effects

The following side effects may be associated with the use of pholcodine:

Occasional drowsiness, dizziness, excitation, confusion, sputum retention, vomiting, gastrointestinal disturbances (nausea and constipation) and skin reactions including rash.

Immune system disorders have been noted including hypersensitivity reactions and anaphylaxis.

4.9 Overdose

It is thought to be of low toxicity, but the effects in overdosage will be potentiated by simultaneous ingestion of alcohol and psychotropic drugs.

Symptoms of overdose include respiratory depression, restlessness, excitement, ataxia, nausea and drowsiness. Treatment should be symptomatic to maintain vital functions. Respiratory distress should be treated by supportive means. Airways protective gastric lavage may be used.

In severe cases a narcotic antagonist such as naloxone may be considered. Naloxone has been used successfully to reverse central or peripheral opioid effects in children (0.01mg/kg body weight). Other treatment option is activated charcoal (1g/kg body weight) if more than 4mg/kg has been ingested within 1 hour, provided the airway can be protected.

5. Pharmacological Properties

5.1 Pharmacodynamic Properties

R05D A08 – Opium alkaloids and derivatives.

Galenphol Strong contains Pholcodine which is a centrally acting cough suppressant. It has none of the other properties of opiate agents.

5.2 Pharmacokinetic Properties

None stated.

5.3 Preclinical Safety Data

There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the SPC.

6. Pharmaceutical Particulars

6.1 List Of Excipients

Citric acid monohydrate

Nipasept Sodium [containing: Sodium Methyl parahydroxybenzoate (E219), Sodium Ethyl Parahydroxybenzoate (E215) & Sodium Propyl Parahydroxy benzoate (E217)]

Alcohol 96%

Sunset yellow FCF (E110)

Amaranth (E123)

Carmellose sodium

Saccharin sodium

Menthol

Condensed milk flavour (F12516)

Aniseed flavour (545008E)

Glycerol BP

Purified water

6.2 Incompatibilities

None stated.

6.3 Shelf Life

Two years from the date of manufacture.

6.4 Special Precautions For Storage

Protect from light.

6.5 Nature And Contents Of Container

Amber HDPE 2 litre Winchester with a polypropylene cap.

6.6 Special Precautions For Disposal And Other Handling

None stated.

ADMINISTRATIVE DATA

7. Marketing Authorisation Holder

Thornton & Ross Ltd

Linthwaite

Huddersfield

HD7 5QH

United Kingdom

8. Marketing Authorisation Number(S)

PL 00240/0103

9. Date Of First Authorisation/Renewal Of The Authorisation

30 August 2002

10. Date Of Revision Of The Text

08/08/2011

Azitrex

Azitrex may be available in the countries listed below.

Ingredient matches for Azitrex

Azithromycin

Azithromycin dihydrate (a derivative of Azithromycin) is reported as an ingredient of Azitrex in the following countries:

• Ecuador

International Drug Name Search

Carbepsil

Carbepsil may be available in the countries listed below.

Ingredient matches for Carbepsil

Carbamazepine

Carbamazepine is reported as an ingredient of Carbepsil in the following countries:

• Romania

International Drug Name Search

Pegaspargase

Class: Antineoplastic Agents
VA Class: AN900
Chemical Name: (Monomethoxypolyethylene glycol succinimidyl)74-l-asparaginase
CAS Number: 130167-69-0
Brands: Oncaspar

Introduction

Antineoplastic agent; polyethylene-glycol (PEG) conjugated l-asparaginase.^{1 2 3 5 6}

Uses for Pegaspargase

Acute Lymphocytic Leukemia (ALL)

Component of combination chemotherapy for first-line treatment of ALL.^{1 7} Used in induction and/or intensification (consolidation) regimens.^{1 7 22 23 25 26}

Component of combination chemotherapy for treatment of ALL in patients who are hypersensitive to asparaginase.^{1 2 3 4 5 6 8 9}

Efficacy and toxicity comparable to that of asparaginase;^{22 25} preferred by many clinicians to asparaginase because requires less frequent administration.⁷

In non-high-risk childhood ALL, combination therapy with asparaginase (or pegaspargase), a corticosteroid (dexamethasone or prednisone), and vincristine is used as an induction regimen.⁷ Intensive induction regimens with ≥4 drugs, including asparaginase (or pegaspargase), an anthracycline (e.g., daunorubicin), a corticosteroid, and vincristine, with or without cyclophosphamide, may improve event-free survival but cause greater toxicity.^{7 8} Some clinicians reserve 4-drug regimens for patients with high-risk childhood ALL;^{7 8} others elect to use such regimens for all patients with childhood ALL regardless of presenting features.⁷

In adults, induction regimens typically include an anthracycline, vincristine, and prednisone; some regimens also add other drugs (e.g., asparaginase [or pegaspargase], cyclophosphamide).^{26 28 30}

Pegaspargase Dosage and Administration

General

• Hypersensitivity Reactions


• 
  

  Monitor patients for hypersensitivity reactions for 1 hour after administration of pegaspargase; be prepared to provide immediate treatment.¹ (See Sensitivity Reactions under Cautions.)

  
  

Administration

Administer by IM injection or IV infusion.¹ May be administered by sub-Q† injection.²⁶

Discard solutions that appear cloudy, contain precipitates, may have been frozen (even if there is no change in the appearance of the solution), have been stored at room temperature (15–25°C) for >48 hours, or have been shaken or vigorously agitated.^{1 21}

Vials are for single use only; discard any unused portion.¹

IM Administration

Administer undiluted by IM injection every 14 days.¹

Do not give >2 mL at one injection site.¹

IV Administration

For solution compatibility information, see Compatibility under Stability.

Administer by IV infusion.¹

Dilution

For IV infusion, dilute pegaspargase dose in 100 mL of sodium chloride injection or 5% dextrose injection.¹

Rate of Administration

Administer over 1–2 hours into tubing of a free-flowing IV infusion solution.¹

Dosage

Dosage expressed in international units (IU, units).¹ Each mL of undiluted pegasparagase injection contains 750 units of the enzyme.¹

Consult published protocols for dosage, method of administration, and administration sequence of drugs in combination regimens.¹

Pediatric Patients

ALL

Discontinue if pancreatitis, serious allergic reaction, or serious thrombotic event occurs.¹

Induction Therapy

IM or IV

2500 units/m² no more frequently than every 14 days.¹

While the optimum duration of induction remission regimen remains to be established, a 28-day, 1- or 2-dose regimen has been evaluated.^{1 4 21 22 23}

Intensification Treatment Phase

IM or IV

2500 units/m² has been given at various dosing intervals.^{1 22 25} Administer no more frequently than every 14 days.¹

Adults

ALL

Discontinue if pancreatitis, serious allergic reaction, or serious thrombotic event occurs.¹

Induction Therapy

IM or IV

2500 units/m² no more frequently than every 14 days.¹

While the optimum duration of induction remission regimen remains to be established, a 28-day, 1- or 2-dose regimen has been evaluated.^{1 4 21 22 23}

Sub-Q†

2000 units/m² (maximum 3750 units) has been administered on days 5 and 22 of a 4-week induction phase.^{26 28}

Intensification Treatment Phase

IM or IV

2500 units/m² has been given at various dosing intervals.¹ Administer no more frequently than every 14 days.¹

Sub-Q†

2000 units/m² has been administered on days 15 and 43 of an 8-week early intensification treatment phase.²⁶

Prescribing Limits

Pediatric Patients

ALL

IM or IV

Manufacturer recommends administering no more frequently than every 14 days.¹ Consult specific clinical protocols for prescribing limits for alternative dosages.

Adults

ALL

IM or IV

Manufacturer recommends administering no more frequently than every 14 days.¹ Consult specific clinical protocols for prescribing limits for alternative dosages.

Special Populations

Geriatric Patients

No specific dosage recommendations.¹ (See Geriatric Use under Cautions.)

Cautions for Pegaspargase

Contraindications

• 
  

  History of serious thrombosis associated with prior asparaginase therapy.¹

  
  


• 
  

  History of pancreatitis associated with prior asparaginase therapy.¹ (See Pancreatitis under Cautions.)

  
  


• 
  

  Clinically important hemorrhagic events associated with prior asparaginase therapy.^{1 12 19}

  
  


• 
  

  History of serious allergic reactions (e.g., urticaria, systemic rash, bronchospasm, laryngeal edema, local erythema or swelling, hypotension) to pegaspargase.^{1 12 19}

  
  

Warnings/Precautions

General Considerations

Carefully weigh potential benefits against possible risks and apprise patient of the risks.^{1 19}

Sensitivity Reactions

Hypersensitivity Reactions

Hypersensitivity reactions^{1 5 6 12 13 15 16 19 25} (e.g., acute anaphylaxis,^{1 5 12 13 19} bronchospasm,^{1 5 12 19} hypotension,¹ laryngeal edema,¹ urticaria,^{1 12 16 19} chills,^{12 16 18 19} rash,^{1 12 16 19} local erythema or swelling^{1 12 19} ) reported;¹⁹ discontinue the drug in patients with serious allergic reactions.¹

Probability of a previously hypersensitive or nonhypersensitive patient completing 8 doses of pegaspargase therapy without developing a therapy-limiting hypersensitivity reaction in clinical studies was 77 or 95%, respectively.^{19 21}

Monitor patients for 1 hour after administration of the drug;^{1 19} appropriate resuscitative equipment and agents (e.g., antihistamine, epinephrine, oxygen, IV corticosteroid) should be readily available.^{1 3 12 19}

Coagulopathy

Coagulopathy,^{15 16 29} sometimes severe, reported.¹

Perform coagulation tests (e.g., fibrinogen levels, PT, PTT) at baseline and periodically during and following therapy.¹ In patients with severe or symptomatic coagulopathy, initiate treatment with fresh frozen plasma to replace coagulation factors.¹

Hyperglycemia

Glucose intolerance, sometimes irreversible, reported.¹

Mild to severe hyperglycemia^{1 12 13 15 17 23} may occur in patients receiving pegaspargase.¹ Hyperglycemia requiring insulin therapy^{1 12 15 19} occurred in 3% of patients receiving pegaspargase in clinical trials.¹

Pancreatitis

Pancreatitis^{1 12 13 15 17 19} (sometimes fulminant and fatal) reported;^{1 19} impairment of pancreatic function^{1 12 13 15 17 19} reported frequently.^{1 12 13 15 17 19}

Evaluate patients with abdominal pain for pancreatitis; discontinue the drug in patients with pancreatitis.¹

Thrombotic Events

Thrombotic events^{1 18 19} (e.g., sagittal sinus thrombosis,^{1 12} central venous catheter thrombosis,^{23 29} stroke^{25 29} ) have been reported; discontinue the drug in patients with serious thrombotic events.¹

Hepatic Effects

Hyperbilirubinemia^{1 23} and elevated ALT and AST concentrations^{1 12 16 17 19} reported frequently.¹

Jaundice^{12 16 21} and hypoalbuminemia,^{21 29} which may be associated with peripheral edema,^{6 12 16 17} may occur.

Specific Populations

Pregnancy

Category C.¹

Lactation

Not known whether pegaspargase is distributed into milk; discontinue nursing or the drug.^{1 12 19}

Pediatric Use

Safety and efficacy evaluated in a randomized trial involving children 1–9 years of age receiving pegaspargase as first-line therapy for standard-risk ALL.¹ In addition, safety and efficacy evaluated in children with ALL and hypersensitivity to asparaginase.¹

Adult Use

Known asparaginase toxicity (except for hypersensitivity reactions) reportedly is greater in adults than in children.^{1 17 19}

Geriatric Use

Insufficient experience in patients ≥65 years of age to determine whether geriatric patients respond differently than younger patients.¹

Common Adverse Effects

Hypersensitivity reactions,^{1 5 6 12 13 15 16 19 25} coagulopathy,^{1 15 16 29} hyperglycemia,¹ elevated serum transaminase concentrations,^{1 12 16 17 19} hyperbilirubinemia,^{1 23} pancreatitis,^{1 12 13 15 17 19} CNS thrombosis.^{1 22} No apparent difference in adverse effects following IV versus IM administration.⁷

Interactions for Pegaspargase

No formal drug interaction studies to date.¹

Specific Drugs

Drug	Interaction	Comment
Methotrexate	Decreased effectiveness of methotrexate during the period of pegaspargase suppression of protein synthesis and cell replication21

Pegaspargase Pharmacokinetics

Distribution

Extent

Distributes into CSF (reportedly reducing CSF asparagine concentrations to a similar extent as asparaginase).¹

Not known whether pegaspargase is distributed into milk.¹

Elimination

Half-life

Approximately 5.8 days following IM administration in pediatric patients.¹

7 days following IV administration in adults.²³

1.4–5 and 2.5–8.9 days following IM administration in patients with relapsed ALL previously hypersensitive and non-hypersensitive to asparaginase, respectively.¹

Stability

Storage

Parenteral

Injection

2–8°C.¹ Do not store at room temperature (15–25°C) for >48 hours.¹ Do not freeze.¹

Discard any unused portion.¹

ActionsActions

• 
  

  Inactivates the amino acid asparagine, which is required by tumor cells to synthesize protein, RNA, and DNA.^{1 24}

  
  


• 
  

  Breaks down extracellular asparagine into aspartic acid and ammonia, which causes depletion of asparagine and kills leukemic cells.^{1 24 26}

  
  


• 
  

  Less immunogenic and longer acting (i.e., possesses a longer plasma half-life) than native (nonconjugated) asparaginase.^{1 22 24}

  
  

Advice to Patients

• 
  

  Risk of hypersensitivity reactions, including the possibility of life-threatening anaphylaxis; importance of patients being monitored for 1 hour after pegaspargase administration.^{1 19}

  
  


• 
  

  Importance of notifying clinicians of any adverse reactions (e.g., swelling or difficulty breathing; severe headache, arm or leg swelling, sudden shortness of breath, or chest pain; severe abdominal pain; or excessive thirst or increase in the volume or frequency of urination) that occur.¹

  
  


• 
  

  Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed.¹

  
  


• 
  

  Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses.¹⁹

  
  


• 
  

  Importance of informing patients of other important precautionary information.¹ (See Cautions.)

  
  

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Pegaspargase

Routes	Dosage Forms	Strengths	Brand Names	Manufacturer
Parenteral	Injection	750 units/ mL	Oncaspar	Enzon

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions November 2010. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

1. Enzon. Oncaspar (pegaspargase) intravenous or intramuscular injection prescribing information. Bridgewater, NJ; 2006 Sep.

2. Kurtzberg J. A new look at Peg-l-asparaginase and other asparaginases in hematological malignancies. Cancer Invest. 1994; 12(Suppl 1):59.

3. Capizzi RL, Holcenberg JS. Asparaginase. In: Holland JF, Frei E, Bast RC Jr et al, eds. Cancer medicine. 3rd ed. Philadelphia: Lea & Febiger; 1993:796-805.

4. Kurtzberg J, Ettinger LJ, Fisher A et al. Multicenter study of PEG-L-asparaginase treatment of children with ALL. ASHP Midyear Clinical Meeting Abstract. 1992; 27:369E. Abstract.

5. Ho DH, Brown NS, Yen A et al. Clinical pharmacology of polyethylene glycol-l-asparaginase. Drug Metab Dispos. 1986; 14:349-52. [IDIS 216912] [PubMed 2872037]

6. Keating MJ, Holmes R, Lerner S et al. L-Asparaginase and PEG asparaginase—past, present, and future. Leuk Lymphoma. 1993; 10(Suppl):153-7. [PubMed 8481665]

7. Childhood acute lymphoblastic leukemia. From: PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2010 Feb 12.

8. Anon. Drugs of choice for cancer. Treat Guidel Med Lett. 2003; 1:41-52.

9. Keating MJ, Estey E, Kantarjian H. Acute leukemia. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds. Cancer: principles and practice of oncology. 4th ed. Philadelphia, PA: JB Lippincott; 1993:1938-64.

10. Cao SG, Zhao Q, Ding ZT et al. Chemical modification of enzyme molecules to improve their characteristcs. Ann N Y Acad Sci. 1990; 613:460-7. [PubMed 2075996]

11. Weiss RB. Hypersensitivity reactions. Semin Oncol. 1992; 5:458-77.

12. Rhone-Poulenc Rorer Pharmaceuticals Inc. Product information form for American Hospital Formulary Service: Oncaspar (pegaspargase). Collegeville, PA: 1994 Jan.

13. Anon. Pegaspargase for acute lymphoblastic leukemia. Med Lett Drugs Ther. 1995; 37:23-4. [PubMed 7877556]

14. Kawashima K, Takeshima H, Higashi Y et al. High efficacy of monomethoxypolyethylene glycol-conjugated l-asparginase (peg₂-asp) in two patients with hematological malignancies. Leuk Res. 1991; 15:525-30. [PubMed 1861535]

15. Capizzi RL. Asparaginase revisited. Leuk Lymph. 1993; 10(Suppl):147-50.

16. Ettinger LJ, Kurtzberg J, Vote PA et al. An open-label, multicenter study of polyethylene glycol-L-asparaginase for the treatment of acute lymphoblastic leukemia. Cancer. 1995; 75:1176-81. [IDIS 342636] [PubMed 7850718]

17. Ettinger AR. Pegaspargase (Oncaspar). J Pediatr Oncol Nurs. 1995; 12:46-8. [PubMed 7893462]

18. Wada H, Imamura I, Sako M et al. Antitumor enzyme: polyethylene glycol-modified asparaginase. Ann N Y Acad Sci. 1990; 613:95-108. [PubMed 2076022]

19. Rhone-Poulenc Rorer Pharmaceuticals Inc. Oncaspar (pegaspargase) comprehensive product profile. 1994 Dec.

20. Food and Drug Administration. Orphan designations pursuant to Section 526 of the Federal Food and Cosmetic Act as amended by the Orphan Drug Act (P.L. 97-414), to June 28, 1996. Rockville, MD; 1996 Jul.

21. Enzon. Oncaspar (PEG-L-asparaginase) prescribing information. Piscataway, NJ; 1998 Nov 5.

22. Avramis VI, Sencer S, Periclou AP et al. A randomized comparison of native Escherichia coli asparaginase and polyethylene glycol conjugated asparaginase for treatment of children with newly diagnosed standard-risk acute lymphoblastic leukemia: a Children's Cancer Group study. Blood. 2002; 99:1986-94. [PubMed 11877270]

23. Douer D, Yampolsky H, Cohen LJ et al. Pharmacodynamics and safety of intravenous pegaspargase during remission induction in adults aged 55 years or younger with newly diagnosed acute lymphoblastic leukemia. Blood. 2007; 109:2744-50. [PubMed 17132721]

24. Apostolidou E, Swords R, Alvarado Y et al. Treatment of acute lymphoblastic leukaemia: a new era. Drugs. 2007; 67:2153-71. [PubMed 17927282]

25. Silverman LB, Gelber RD, Dalton VK et al. Improved outcome for children with acute lymphoblastic leukemia: results of Dana-Farber Consortium Protocol 91-01. Blood. 2001; 97:1211-8. [PubMed 11222362]

26. Wetzler M, Sanford BL, Kurtzberg J et al. Effective asparagine depletion with pegylated asparaginase results in improved outcomes in adult acute lymphoblastic leukemia: Cancer and Leukemia Group B Study 9511. Blood. 2007; 109:4164-7. [PubMed 17264295]

27. Armstrong JK, Hempel G, Koling S et al. Antibody against poly(ethylene glycol) adversely affects PEG-asparaginase therapy in acute lymphoblastic leukemia patients. Cancer. 2007; 110:103-11. [PubMed 17516438]

28. Larson RA, Dodge RK, Burns CP et al. A five-drug remission induction regimen with intensive consolidation for adults with acute lymphoblastic leukemia: cancer and leukemia group B study 8811. Blood. 1995; 85:2025-37. [PubMed 7718875]

29. Enzon Pharmaceuticals, Bridgewater, NJ: Personal communication.

30. Adult acute lymphoblastic leukemia. From: PDQ. Physician data query (database). Bethesda, MD: National Cancer Institute; 2009 Sep 10.

31. Poplack DG, Magrath IT, Kun LE et al. Leukemias and lymphomas of childhood. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds. Cancer: principles and practice of oncology. 4th ed. Philadelphia: JB Lippincott; 1993:1792-1818.

32. Preti A, Kantarjian HM. Management of adult acute lymphocytic leukemia: present issues and key challenges. J Clin Oncol. 1994; 12:1312-22. [IDIS 331854] [PubMed 8201394]

33. Pui CH, Evans WE. Treatment of acute lymphoblastic leukemia. N Engl J Med. 2006; 354:166-78. [PubMed 16407512]

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• Pegaspargase Side Effects (in more detail)
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• Pegaspargase Drug Interactions
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• Pegaspargase Professional Patient Advice (Wolters Kluwer)


• Pegaspargase MedFacts Consumer Leaflet (Wolters Kluwer)


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• pegaspargase Intramuscular, Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information


• Oncaspar Prescribing Information (FDA)

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