Oncaspar Dosage/Direction for Use

Oncaspar should be prescribed and administered by physicians and/or health care personnel experienced in the use of antineoplastic products. It should only be given in a hospital setting where appropriate resuscitation equipment is available. Patients should be closely monitored for any adverse reactions throughout the administration period (see Precautions).
Posology: Oncaspar is usually administered as part of combination chemotherapy protocols with other antineoplastic agents (see also Interactions).
Recommended premedication: Premedicate patients with paracetamol, an H-1 receptor blocker (e.g. diphenhydramine), and an H-2 receptor blocker (e.g. famotidine) 30-60 minutes prior to administration of Oncaspar to decrease the risk and severity of both infusion and hypersensitivity reactions (see Precautions).
Paediatric patients and adults ≤21 years: The recommended dose in patients with a body surface area (BSA) ≥0.6 m² and who are ≤21 years of age is 2,500 U of pegaspargase (equivalent to 3.3 ml Oncaspar)/m² body surface area every 14 days.
Children with a body surface area <0.6 m² should receive 82.5 U of pegaspargase (equivalent to 0.1 ml Oncaspar)/kg body weight every 14 days.
Adults >21 years: Unless otherwise prescribed, the recommended posology in adults aged >21 years is 2,000 U of pegaspargase (equivalent to 2.67 ml Oncaspar)/m² body surface area every 14 days.
Treatment may be monitored based on the trough serum asparaginase activity measured before the next administration of pegaspargase. If asparaginase activity values fail to reach target levels, a switch to a different asparaginase preparation could be considered (see Precautions).
Special populations: Renal impairment: As pegaspargase is a protein with a high molecular weight, it is not excreted renally, and no dose adjustment is necessary in patients with renal impairment.
Hepatic impairment: No dose adjustment is necessary in patients with hepatic impairment.
Elderly: There are limited data available for patients older than 65 years.
Method of administration: Oncaspar can be given by intramuscular (IM) injection or intravenous (IV) infusion.
For smaller volumes, the preferred route of administration is intramuscular. When Oncaspar is given by intramuscular injection the volume injected at one site should not exceed 2 ml in children and adolescents and 3 ml in adults. If a higher volume is given, the dose should be divided and given at several injection sites.
Intravenous infusion of Oncaspar is usually given over a period of 1 to 2 hours in 100 ml sodium chloride 9 mg/ml (0.9%) solution for injection or 5% glucose solution.
The diluted solution can be given together with an already-running infusion of either sodium chloride 9 mg/ml or 5% glucose. Do not infuse other medicinal products through the same intravenous line during administration of Oncaspar.
For instructions on reconstitution and dilution of this medicinal product before administration, see Special precautions for disposal and other handling under Cautions for Usage.