Anaphylaxis; Hemolysis; Methemoglobinemia; Uric Acid Measure Interference

Anaphylaxis

• May cause serious hypersensitivity reactions including anaphylaxis. Should be immediately and permanently discontinued in any patient developing clinical evidence of a serious hypersensitivity reaction.

Hemolysis

• When administered to patients with G6PD deficiency, this agent can cause severe hemolysis. Should be immediately and permanently discontinued in any patient developing hemolysis. It is recommended that patients at a higher risk for G6PD deficiency (e.g., patients of African or Mediterranean ancestry) be screened prior to starting rasburicase.

Methemoglobinemia

• Rasburicase use has been associated with methemoglobinemia. Should be immediately and permanently discontinued in any patient developing methemoglobinemia.

Interference with Uric Acid Measurements

• Rasburicase will cause enzymatic degradation of the uric acid within blood samples left at room temperature, resulting in spuriously low uric acid levels. To ensure accurate measurements, blood must be collected into prechilled tubes containing heparin anticoagulant and immediately immersed and maintained in an ice water bath; plasma samples must be assayed within 4 hours of sample collection.