rasburicase at a glance
Medicine class
Recombinant urate-oxidase enzyme
Main role
Prevention or treatment of acute hyperuricaemia associated with tumour lysis
Administration
Intravenous infusion given by a specialist hospital team
Important safety check
Must not be used in G6PD deficiency because of haemolysis risk
What is rasburicase used for?
UK-licensed use:
Treatment and prevention of acute hyperuricaemia to help prevent acute kidney failure in adults and children with high-burden haematological cancer at risk of rapid tumour lysis when chemotherapy begins.
How does rasburicase work?
Rasburicase converts uric acid into allantoin, which dissolves more readily in water and is excreted by the kidneys. The reaction produces hydrogen peroxide, explaining the haemolysis risk in people with G6PD deficiency.
rasburicase preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 1.5 mg/mL
How to take rasburicase
Rasburicase is prepared and given in hospital as an intravenous infusion under specialist supervision.
Use a different intravenous line from chemotherapy where possible; otherwise flush the line with saline between infusions.
The concentrate is diluted with sodium chloride solution; glucose solutions must not be used.
Handle the prepared solution gently and do not shake it.
rasburicase side effects
Common or expected effects
- Nausea
- Vomiting
- Diarrhoea
- Headache
- Fever
- Rash or hives
Get urgent medical advice
- Severe hypersensitivity or anaphylaxis
- Haemolysis or haemolytic anaemia
- Methaemoglobinaemia
- Bronchospasm or breathing difficulty
- Low blood pressure
- Seizure
rasburicase in pregnancy
There are no adequate data from pregnant women, and fetal effects cannot be excluded. Rasburicase should be considered during pregnancy only when the specialist team judges it strictly necessary.
rasburicase while breastfeeding
It is unknown whether rasburicase enters human milk. Although infant exposure to this protein is expected to be low, breastfeeding benefits must be weighed against possible risk with the specialist team.
rasburicase interactions
Formal medicine-interaction studies have not been performed. Clinically significant metabolic interactions are considered unlikely, but administration incompatibilities are important:
Cytotoxic chemotherapy infusions
Use a separate intravenous line where possible, or flush the shared line with saline between medicines.
Glucose-containing infusion solutions
Must not be used to dilute rasburicase because of potential incompatibility.
Common questions about rasburicase
Answers are fully visible for fast scanning and source review.
Why is rasburicase given with chemotherapy?
Chemotherapy can rapidly destroy cancer cells, releasing large amounts of uric acid. Rasburicase breaks down this uric acid to reduce the risk of kidney injury.
Why is G6PD testing important before rasburicase?
Rasburicase produces hydrogen peroxide while breaking down uric acid. In G6PD deficiency this can cause dangerous red-cell breakdown, so rasburicase is contraindicated.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.