Asparaginase erwinia chrysanthemi is used with other chemotherapy medications to treat acute lymphocytic leukemia (ALL; a type of cancer of the white blood cells). It is used in patients who have had some types of allergic reactions to medications similar to asparaginase erwinia chrysanthemi such as (asparaginase [Elspar] or pegaspargase [Oncaspar]). Asparaginase erwinia chrysanthemi is an enzyme that interferes with natural substances necessary for cancer cell growth. It works by killing or stopping the growth of cancer cells.

Asparaginase erwinia chrysanthemi comes as a powder to be added to fluid and injected into a muscle by a doctor or nurse in a medical facility. It is usually given three times a week.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking asparaginase erwinia chrysanthemi,

• tell your doctor and pharmacist if you are allergic to asparaginase erwinia chrysanthemi, any other medications, or any of the ingredients in asparaginase erwinia chrysanthemi powder. Ask your pharmacist for a list of the ingredients.
• Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while receiving asparaginase Erwinia chrysanthemi. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had pancreatitis (swelling of the pancreas), blood clots, or severe bleeding, especially if these happened during treatment with asparaginase (Elspar) or pegaspargase (Oncaspar). Your doctor probably will not want you to receive asparaginase Erwinia chrysanthemi.
• tell your doctor if you have or have ever had diabetes.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while receiving asparaginase erwinia chrysanthemi, call your doctor.

Unless your doctor tells you otherwise, continue your normal diet.

If you miss an appointment to receive a dose of asparaginase erwinia chrysanthemi, call your doctor right away.

Asparaginase erwinia chrysanthemi may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• fever

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

• hives
• rash
• itching
• difficulty breathing or swallowing
• ongoing pain that begins in the stomach area, but may spread to the back
• extreme thirst
• frequent urination
• extreme hunger
• weakness
• blurred vision
• headache
• arm or leg swelling
• shortness of breath
• chest pain
• unusual bleeding
• yellowing of the skin or eyes
• pain in the upper right part of the stomach
• dark colored urine
• loss of appetite
• lack of energy
• seizure

Asparaginase erwinia chrysanthemi may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body’s response to asparaginase erwinia chrysanthemi.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Erwinaze^®