From the Guidelines
Rasburicase can cause several side effects, including severe allergic reactions, hemolytic anemia, and methemoglobinemia, particularly in patients with G6PD deficiency, as reported in the study by 1. The most common side effects of rasburicase include:
- Nausea
- Vomiting
- Fever
- Headache
- Abdominal pain
- Constipation
- Diarrhea More serious side effects that require immediate medical attention include:
- Severe allergic reactions (anaphylaxis)
- Hemolytic anemia
- Methemoglobinemia Rasburicase works by converting uric acid to allantoin, which is more soluble and easily excreted by the kidneys, making it effective for treating or preventing tumor lysis syndrome, as described in the study by 1. However, this rapid breakdown of uric acid can sometimes cause kidney problems, especially if adequate hydration is not maintained during treatment. Patients should be monitored for signs of kidney dysfunction, electrolyte abnormalities, and blood disorders during treatment with rasburicase, as recommended in the guidelines by 1. It is also important to note that rasburicase is contraindicated in patients with a known G6PD deficiency, and G6PD testing is recommended before administration, as stated in the study by 1. Additionally, patients may develop antibodies against rasburicase, potentially reducing its effectiveness with repeated use, as reported in the study by 1. Overall, the use of rasburicase should be carefully considered and monitored to minimize the risk of side effects and ensure effective treatment, as recommended in the guidelines by 1.
From the FDA Drug Label
Most common adverse reactions (incidence ≥20%), when used concomitantly with anticancer therapy are vomiting, nausea, fever, peripheral edema, anxiety, headache, abdominal pain, constipation, diarrhea, hypophosphatemia, pharyngolaryngeal pain, and increased alanine aminotransferase. (6.1) The side effects of rasburicase include:
- Vomiting
- Nausea
- Fever
- Peripheral edema
- Anxiety
- Headache
- Abdominal pain
- Constipation
- Diarrhea
- Hypophosphatemia
- Pharyngolaryngeal pain
- Increased alanine aminotransferase 2
From the Research
Side Effects of Rasburicase
The side effects of rasburicase include:
- Haematological adverse events 3
- Hypersensitivity reactions 3
- Methemoglobinemia, which is a serious rare adverse effect, more common in patients with G6PD deficiency 4, 5, 6
- Hemolytic anemia, which can occur in patients with G6PD deficiency 4, 7, 6
- Cyanosis, pallor, and oxygen saturation gap, which are clinical presentations of methemoglobinemia 4
- Acute renal failure and ARDS, which can be complications of rasburicase-induced hemolysis and methemoglobinemia 6
Patients at Risk
Patients at risk of developing side effects from rasburicase include:
- Those with G6PD deficiency, who are at high risk of methemoglobinemia and hemolytic anemia 4, 7, 6
- Those with a history of haemolysis or methaemoglobinaemia 3
- Those with glucose-6-phosphate dehydrogenase deficiency, who are contraindicated for rasburicase treatment 3
Management of Side Effects
Management of side effects includes: