Rasburicase — Drug Monograph

Brand names: Elitek

Drug class: Supportive Care Agent

Mechanism of Action

Catalyzes the enzymatic oxidation of uric acid into allantoin, an inactive metabolite that is 5- to 10-times more soluble in water than uric acid and readily excreted by the kidneys, rapidly lowering plasma uric acid in tumor lysis syndrome.

FDA Indications

• Management of plasma uric acid levels in pediatric and adult patients with leukemia, lymphoma, and solid tumor malignancies who are receiving anti-cancer therapy expected to result in tumor lysis

Common Side Effects

• Nausea
• Vomiting
• Fever
• Headache
• Abdominal pain

Clinical Pearl

Recombinant urate oxidase that rapidly converts poorly soluble uric acid into highly soluble allantoin to prevent or treat acute tumor lysis syndrome (TLS), acting far faster than allopurinol (which only blocks new uric acid formation). CRITICAL CONTRAINDICATION: strictly contraindicated in G6PD deficiency due to high risk of severe hemolysis and methemoglobinemia — screen high-risk patients first. Uric acid samples must be drawn into pre-chilled heparinized tubes kept on ice and run within 4…

Related Therapies & Mechanisms

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