Rasburicase

ELITEK

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Pronunciation: ras-BYOOR-i-kays

Rasburicase ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Rasburicase ballicule

What it isRecombinant urate oxidase converting uric acid to soluble allantoin; tumor-lysis hyperuricemia.

Why this oneIt destroys urate already present, unlike allopurinol, which only prevents new production.

What limits itScreen for G6PD deficiency because hemolysis and methemoglobinemia can be fatal; anaphylaxis also occurs, and blood samples must go on ice or the enzyme keeps working in the tube and falsely lowers the level.

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Serious and fatal hypersensitivity reactions including anaphylaxis; hemolysis (do not use in G6PD deficiency); methemoglobinemia — discontinue permanently if any occur; interferes with uric acid measurements (handle samples on ice).

FDA dosing	Population	Start	Target	Max
Initial management of plasma uric acid with tumor lysis (leukemia, lymphoma, solid tumor on anticancer therapy)	Peds ≥1 mo & adult	0.2 mg/kg IV over 30 min QD		up to 5 days (single course)

Renal Undefined

Hepatic Undefined

Indicated for a single course only; dosing beyond 5 days or more than one course not recommended.

Instructions

Give as IV infusion over 30 minutes; do not administer as an IV bolus
Single course only — do not exceed 5 days or give more than one course
Screen patients at higher risk for G6PD deficiency before starting
Collect uric acid blood samples in prechilled heparin tubes on ice and assay within 4 hours

Available strengths

inj 1.5, 7.5 mg

Contraindications

History of anaphylaxis, severe hypersensitivity, hemolysis, or methemoglobinemia with rasburicase.
Glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Cautions

Serious/fatal hypersensitivity reactions including anaphylaxis
Hemolysis (contraindicated in G6PD deficiency)
Methemoglobinemia
Laboratory test interference — ex vivo uric acid degradation

Adverse reactions

vomiting
nausea
fever
peripheral edema
anxiety
headache
abdominal pain
constipation
diarrhea
hypophosphatemia
pharyngolaryngeal pain
ALT increased

Pregnancy May cause fetal harm based on animal data (heart/great vessel malformations, embryo-fetal mortality, growth alterations); human data insufficient.

Lactation No data; breastfeeding not recommended during treatment and for 2 weeks after the last dose.

Cost

Rasburicase (ELITEK)

Strength		#/mo	generic $/unit	CostPlus
1.5 mg	inj	per unit		not offered
7.5 mg	inj	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Rasburicase is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

⚠ BOXED WARNINGS

Anaphylaxis
Hemolysis (G6PD deficiency)
Methemoglobinemia
Uric acid assay interference

Classes and tags

Clinical profile

Direct muscarinic antagonism0 / 4

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