Pegaspargase
Pronunciation: (peg-AS-par-gase).
- Generic name
- pegaspargase
- Brand names
- Oncaspar
- Drug class
- Antineoplastic agent (Enzyme, Asparaginase)
Availability and supply rules vary by country
Trade names by country: United States
Australia: · Full directory
What pegaspargase is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how pegaspargase works
Pegaspargase is a pegylated form of L-asparaginase. It hydrolyzes circulating asparagine into aspartic acid and ammonia, depleting asparagine levels. Leukemia cells, particularly lymphoblasts, are unable to synthesize asparagine and depend on exogenous sources; thus, depletion leads to inhibition of protein synthesis and cell death. (1)
What pegaspargase is used for
Acute lymphoblastic leukemia (ALL) — first-line treatment
FDA-approved as a component of a multi-agent chemotherapy regimen for first-line treatment of pediatric and adult patients with ALL. (3)
Acute lymphoblastic leukemia (ALL) in patients hypersensitive to native (non-pegylated) asparaginase
FDA-approved as a component of a multi-agent chemotherapy regimen for pediatric and adult ALL patients who have developed hypersensitivity to native forms of L-asparaginase. (3)
Before taking pegaspargase
Do not take / not appropriate for
- Contraindicated in patients with prior serious hypersensitivity to pegaspargase or asparaginase, history of severe pancreatitis, serious thrombosis, or severe hepatic impairment. (Contraindication) (3)
Tell your clinician about
(3)How to take pegaspargase
- General Instructions: Pegaspargase is administered by a healthcare professional as an injection into a vein (IV) or muscle (IM). Do not self-administer.. Adult Dosing: The usual dose for adults is 2,500 IU/m² given every 14 days as part of a chemotherapy protocol. Dosing may be adjusted based on tolerance and side effects.. Pediatric Dosing: Children typically receive the same dose as adults, adjusted for body surface area (2,500 IU/m²), every 14 days.. Administration: Given by IV infusion over 1-2 hours or as an IM injection. Patients are monitored for allergic reactions during and after administration.. When To Stop: Treatment may be stopped if severe allergic reactions, pancreatitis, blood clots, or liver toxicity occur.. Storage: Store vials in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (3)
Missed dose
If a dose is missed, contact your healthcare provider immediately. Do not attempt to make up the dose yourself.
Overdose
In case of overdose, seek emergency medical attention. Overdose may increase the risk of severe side effects such as pancreatitis, blood clotting disorders, or liver toxicity. Supportive care and monitoring are essential. (3)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Nausea and/or vomiting
Incidence: Common
Loss of appetite
Incidence: Common
High blood sugar (hyperglycemia)
Incidence: Common; can be severe (Grade 3-4)
Elevated liver enzymes
Incidence: Common; can be severe (Grade 3-4)
High blood triglycerides (hypertriglyceridemia)
Incidence: Common; can be severe (Grade 3-4)
Blood clotting abnormalities
Incidence: Common; can be severe (Grade 3-4)
Serious warnings
May cause severe allergic reactions, including anaphylaxis — serious
Symptoms: May cause severe allergic reactions, including anaphylaxis. Risk of pancreatitis, which can be life-threatening. May increase risk of blood clots and bleeding. Can cause serious liver toxicity. Monitor for signs of infection due to immune suppression.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (3)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindicated in patients with prior serious hypersensitivity to pegaspargase or asparaginase, history of severe pancreatitis, serious thrombosis, or severe hepatic impairment. Use with caution in patients with diabetes, coagulopathies, or hepatic dysfunction. Monitor for hypersensitivity reactions, pancreatitis, thrombosis, and hepatic toxicity.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (3)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Pegaspargase can interact with medications that affect blood clotting (such as warfarin), other chemotherapy agents, and drugs that are toxic to the liver or pancreas. Always inform your healthcare provider of all medicines and supplements you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Pegaspargase may pose a risk to the fetus based on its mechanism of action as a chemotherapy agent. If you are pregnant, think you may be pregnant, or become pregnant during treatment, seek medical advice promptly to discuss the risks. (3)
Breastfeeding
Breastfeeding is not recommended during pegaspargase treatment and for 1 month after the last dose, per FDA labeling. Discuss feeding options with your healthcare provider before starting treatment. (3)
Children
Pegaspargase is FDA-approved for pediatric patients (up to and including 21 years of age) as first-line ALL therapy, using the same body-surface-area-based dose as adults (2,500 IU/m2, no more frequently than every 14 days). It is, in fact, a standard component of pediatric ALL treatment protocols. (3)
Renal_impairment
The FDA prescribing information states that the impact of renal and hepatic impairment on pegaspargase pharmacokinetics is unknown, and no formal dose-adjustment scheme exists for either. Pegaspargase is contraindicated in severe hepatic impairment. Bilirubin and liver transaminases should be checked before every dose and at least weekly during treatment cycles through 6 weeks after the last dose, with treatment held or discontinued for significant liver toxicity as directed by the treating oncologist. Renal function should also be monitored by the treating team even though no specific dose-adjustment figures exist in the sources reviewed. (3)
Hepatic_impairment
The FDA prescribing information states that the impact of renal and hepatic impairment on pegaspargase pharmacokinetics is unknown, and no formal dose-adjustment scheme exists for either. Pegaspargase is contraindicated in severe hepatic impairment. Bilirubin and liver transaminases should be checked before every dose and at least weekly during treatment cycles through 6 weeks after the last dose, with treatment held or discontinued for significant liver toxicity as directed by the treating oncologist. Renal function should also be monitored by the treating team even though no specific dose-adjustment figures exist in the sources reviewed. (3)
Monitoring
(3)Storage
This is a healthcare-professional-administered injection; storage and handling are managed by the treating facility. Vials are stored refrigerated at 2-8C (36-46F) in the original carton to protect from light, not shaken or frozen. Unopened vials may be held at room temperature (15-25C/59-77F) for no more than 48 hours.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Acute lymphoblastic leukemia (ALL), pediatric and adult, up to and including 21 years of age uses the same BSA-based dose as adults
Dose summary: Administer 2,500 IU/m² intramuscularly or intravenously no more frequently than once every 14 days.
Renal context: The FDA prescribing information states the impact of renal impairment on pegaspargase pharmacokinetics is unknown; no formal renal dose-adjustment scheme is given, and renal function should be monitored by the treating oncology team. (1) (3)
Hepatic guidance
Pegaspargase is contraindicated in severe hepatic impairment. Bilirubin and transaminases should be evaluated before every dose and at least weekly during treatment cycles through 6 weeks after the last dose; the FDA label specifies dose-hold and discontinuation guidance for significant bilirubin/transaminase elevations, to be applied by the treating oncologist. Beyond this monitoring framework, the impact of hepatic impairment on pegaspargase pharmacokinetics is described as unknown.
Frequently asked questions
What is Pegaspargase used for?
Pegaspargase is primarily used to treat acute lymphoblastic leukemia (ALL) as part of a combination chemotherapy regimen.
How is Pegaspargase administered?
It is given as an intravenous (IV) infusion or intramuscular (IM) injection by a healthcare professional in a clinical setting.
What are the most serious side effects?
Serious side effects include severe allergic reactions, pancreatitis, blood clots, liver toxicity, and increased risk of infection.
Can children receive Pegaspargase?
Yes, Pegaspargase is commonly used in pediatric patients with ALL, with dosing adjusted for body surface area.
What should I do if I miss a dose?
Contact your healthcare provider immediately. Do not attempt to administer a missed dose yourself.
Are there any foods or medicines to avoid?
Avoid alcohol, live vaccines, and any medications that may increase bleeding risk unless approved by your doctor.
How long does treatment with Pegaspargase last?
Treatment duration depends on the chemotherapy protocol and patient response. Your doctor will determine the exact schedule.
What happens if I take too much Pegaspargase?
Taking too much Pegaspargase can lead to severe adverse effects, potentially including pancreatitis, liver dysfunction, and coagulation abnormalities. If an overdose is suspected, it is crucial to seek immediate emergency medical attention. Healthcare providers will manage symptoms and provide supportive care.
Can I drink alcohol while taking Pegaspargase?
It is generally advisable to avoid or limit alcohol consumption while taking Pegaspargase. Both alcohol and Pegaspargase can affect liver function, and combining them may increase the risk of liver toxicity. Discuss alcohol use with your healthcare provider for personalized guidance.
Is Pegaspargase safe during pregnancy?
The safety of Pegaspargase during pregnancy has not been definitively established, and it is categorized as 'Consult doctor' regarding pregnancy risk. It is crucial for pregnant individuals or those planning pregnancy to discuss the potential risks and benefits with their healthcare provider before using Pegaspargase.
What is the mechanism of action of pegaspargase?
Pegaspargase is a pegylated form of L-asparaginase. It hydrolyzes circulating asparagine into aspartic acid and ammonia, depleting asparagine levels. Leukemia cells, particularly lymphoblasts, are unable to synthesize asparagine and depend on exogenous sources; thus, depletion leads to inhibition of protein synthesis and cell death. (1)
What is the generic name of Pegaspargase?
The generic name is pegaspargase. It is sold under brand names including Oncaspar.
What class of drug is pegaspargase?
Pegaspargase is classed as: Antineoplastic agent (Enzyme, Asparaginase).
References
- Pegaspargase clinician-authored medicine recordMedGuideGlobal · Internal database · accessed 2026-08-06 · source 1
- ONCASPAR (pegaspargase) prescribing informationU.S. Food and Drug Administration · United States · accessed 2026-08-06 · source 2
- Pegaspargase Side EffectsDrugs.com · United States · accessed 2026-08-06 · source 3
- Pegaspargase Injection — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 4
- ONCASPAR — FDA approval record (Drugs@FDA BLA103411)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 5
- pegaspargase — RxNorm normalized drug concept (RXCUI 34132)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 6
Brand names by country
Single-ingredient pegaspargase names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- ONCASPAR750 [iU]/mL · servier pharmaceuticals llc