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Leunase medicine 10,000 KU L-asparaginase acute leukemia
- Trade name: Leunase
- Ingredients: L-Asparaginase
- Content: 10,000 KU
- Dosage form: Lyophilized powder for infusion
- Package: 1 Vial 10.00 KU
- Manufacturer: Kyowa Hakko Kogyo Co., Ltd
Pharmacological information of the drug Leunase
L-asparaginase 10,000 KU * * 1 unit KU L-asparaginase is equivalent to an enzyme yielding 1 mmol of ammonia / 1 minute when decomposing L-asparagine at 37 ° C
Prescription Leunase as declared by the manufacturer or health authority. This is for reference only. You need to consult your doctor before taking any medicine.
Mechanism of action
L-Asparaginase belongs to a group of drugs called anticancer drugs. L-Asparaginase is an enzyme that interferes with the natural processes necessary for the growth of cancer cells, thereby killing or stopping the growth of cancer cells.
- L-asparaginase is an enzyme consisting of 4 components, each containing 321 amino acids.
- A protein-degrading enzyme produced from the strain of E.coli HAP, effective against acute leukemia and malignant lymphoma.
- Intravenous and intramuscular administration are similar in serum, but after intramuscular administration, peak plasma concentrations are reached 14 to 24 hours after administration.
- The drug is not significantly distributed outside the vascular compartment, excreted in the bile and urine very little. Asparaginase was still detectable in serum 13-22 days after administration.
- The half-life of asparaginase varies from 8 to 30 hours and is independent of the dose. The apparent volume of distribution is about 70-80% of the plasma volume.
- Asparaginase was found in lymphatic fluid and cerebrospinal fluid.
The effect of Leunase
- L – asparaginase is the left rotation isomer of a large molecular protein, extracted from escherichia coli and other bacteria.
- This enzyme hydrolysates asparagine as an essential amino acid in the serum, thereby losing a necessary factor for protein synthesis of sensitive malignant lymphocytes.
- In acute leukemia, especially lymphoma-grade leukemia, malignant cells must rely on external sources of asparagine to survive; normal cells can synthesize asparagine and thus are less affected by asparagine deficiency due to asparaginase treatment. However, recently it has been found that many normal tissues are sensitive to asparaginase and can cause intoxication to varying degrees.
- In addition, human white blood cells can become resistant quickly due to the presence of lines containing asparaginase synthetase. This is also the reason people often use drugs in combination with other chemicals.
Assign Leunase 10,000 KU
- Acute leukemia (including cases of chronic leukemia), especially acute lymphoblastic leukemia.
- Malignant lymphoma, lymphoma sarcom.
- The drug is mainly used in combination with other chemotherapy drugs to induce remission in children. L – asparaginase should not be used alone unless combination therapy is not appropriate.
- Maintenance therapy with this drug is not recommended.
- Patients with a history of hypersensitivity to L – asparaginase.
- Severe pancreatitis or a history of pancreatitis, acute hemorrhagic pancreatitis.
Dosage and Administration Leunase
Usually, intravenous infusion 50-200 KU / 1 kg / 1 day, treatment every day or every other day.
This dose may be adjusted according to age and clinical condition.
How to take L-asparagine
- Leunase inj. be dissolved with 2-5 ml of distilled water for injection.
- Then dilute with 200-500 ml of infusion and use.
- Symptoms of shock may occur (even at regular doses). If you have symptoms such as overconsciousness, convulsions, hypotension, chills, fever or vomiting, discontinue the medication immediately and take appropriate management.
- If there is anaphylactic reaction, immediately use epinephrine, oxygen and corticosteroid intravenous injection.
- An overdose can cause serious side effects such as impaired bone marrow function that can be prevented. In case of lack of specific antidote, taking a large amount of drugs with SH group such as vitamine B2, B6, C and glutation will have the effect of inactivation by accelerating the metabolism of decomposition.
Warnings when using Leunase
- Prolonged use should be extremely careful because of the potential to cause serious and prolonged unwanted reactions. Particular care should be taken when bacterial infections or hemorrhages are present, or symptoms are worse.
- Medicines for children and those who are still born need to pay attention because the drug has a strong effect on the gonads. Caution should be exercised when administering to patients with liver, kidney, myelosuppression, bacterial and chicken pox disorders (which can cause generalized disorders leading to death).
- Asparaginase has an immunosuppressive effect, so it can lead to infections. Asparaginase toxicity in adults is usually more severe in children.
- Human reports are limited, but asparaginase has been found to cause teratogenicity in laboratory animals, so it is not recommended for pregnant or suspected pregnant women.
- No conclusions about safety during breastfeeding. Ideally, breastfeeding should be discontinued if the patient requires therapy.
Drug Interactions Leunase
- Using L – asparaginase intravenously simultaneously or before treatment vincristin and prednisolon may increase toxicity.
- Asparaginase can reduce or neutralize the effect of methotrexate on malignant cells. The inactivation of methotrexate lasts as long as asparagine is hydrolyzed by asparaginase, because the effect of methotrexate requires asparagine to copy cells.
- Asparaginase reduces the clearance of vincristin.
- Asparaginase affects thyroid function test results because the drug quickly and clearly reduces serum globulin concentrations associated with serum thyroxin within 2 days after the first dose. This concentration returned to pre-treatment values in 4 weeks after the last dose of asparaginase.
Attention and Caution
- Acute pancreatitis may occur. Need to monitor patients carefully. If there are symptoms such as abdominal pain, vomiting, increased pancreatic enzymes such as amylase, discontinuing the medication and appropriate management.
- Severe diabetes may occur. Patients should be carefully monitored during treatment. If there are symptoms such as dry mouth thirst, polyuria, treatment should be discontinued and appropriate management.
- Leunase inj. can cause adverse reactions such as bone marrow failure, so it is necessary to regularly monitor hematological tests, liver and kidney function tests …, if there are abnormalities, to reduce the dose or stop the drug. Long-term treatment needs to be done with close care because the above adverse reactions can be very serious and long lasting.
- Particular attention should be paid to the occurrence or worsening of the likelihood of infection and bleeding.
- Kidney during therapy in children, monitoring the early manifestations may lead to adverse reactions.
- – The treatment for children and patients with fertility need to be careful because of the influence on the genital organs.
Kidney during use
Care should be taken in the following situations:
- Pancreatitis or a history of pancreatitis (aggravation or recurrence).
- Hepatic dysfunction (hypermonia ammonia may easily occur).
- Renal dysfunction (increased blood nitrogen may occur).
- Myelosuppression (worsening in extra).
- You have a bacterial infection (the infection may get worse because of myelosuppression).
- Are suffering from chickenpox (may cause generalized disorder, risk of death).
Note when using:
- Before use: 0.1 ml of physiological saline containing 1-10 KU Leunase subcutaneously and monitoring patients for 30 minutes to 1 hour to detect abnormal reactions if any.
- Use immediately after reconstitution.
- Directions of use: Leunase inj. Used only by intravenous drip.
Side effects of Leunase
Serious side effects
- Shock: shock symptoms may occur. When experiencing any signs such as drowsiness, convulsions, hypotension, chills, fever, vomiting, to stop the drug immediately and appropriate management.
- Serious disorders of coagulation (increased Fibrinogen, Plasminogen, AT-III, Protein C ….) such as cerebral hemorrhage, cerebral infarction, and pulmonary hemorrhage may occur. Need regular monitoring with laboratory tests during treatment. If abnormalities occur, medication should be discontinued and appropriate management taken.
- Acute pancreatitis: since acute pancreatitis can occur, patients should be carefully monitored. If there are any symptoms such as abdominal pain, vomiting, increased pancreatic enzymes such as amylase, medication should be discontinued and appropriate management.
Acute pancreatitis can disrupt the secretion of the pancreas (Langerhans Island necrosis) causing diabetes. Need to monitor patients carefully. If there are any symptoms such as dry mouth, thirst, polyuria, medication should be discontinued and appropriate management.
- Increased blood ammonia: disturbed ability to consciousness. Patients should be carefully monitored with routine tests. If any abnormalities occur, medication should be discontinued and appropriate management taken.
- Coma: coma may occur, consciousness disorder, disorientation. Need to monitor patients carefully. If unusual symptoms occur, discontinue medication and appropriate management.
- Disorders of brain organization: death has been recorded because of a widespread brain disorder.
Common side effects
- Hypersensitivity: hypersensitive reactions such as rash.
- Hematology: thrombocytopenia, anemia …
- Liver: dysfunction of liver, fatty liver …
- Kidney: proteinuria, oliguria, blood nitrogen, edema.
- Gastrointestinal: anorexia, nausea, vomiting, diarrhea.
- Psychiatry: irritability, headache, drowsiness, anxiety.
- Other symptoms: fever, vasculature, abnormal glucose tolerance, hyperlipidemia.
Preserving the drug
- Store at cool temperatures (below 15 ° C).
- Unused reconstituted solution should be stored at 2 – 8 degrees C and must be removed after 8 hours or earlier if the solution is cloudy. Shelf life is 2 years.
- Reconstituted solution, if exposed to a rubber stopper, can be denatured, forming insoluble fibers.
Information on the composition, effects, usage, dosage, side effects of Leunase drugs is often updated by the manufacturer according to the latest prescription. Please consult your pharmacist or provider for the latest information on Leunase medications
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- Source of leunase Drugs at Drugs.com accessed September 19, 2019.
- References ThuocLP Vietnamese: Leunase medicine 10,000 KU L-asparaginase acute leukemia
Assoc.Prof.Dr. Tran Ngoc Anh is currently Hanoi Medical University Hospital, Associate Professor, Department of Internal Medicine, Gastroenterology and Head of Department of General-Uematology of Hanoi Medical University. Consulting doctor at ThuocLP Pharmacy.
Professional qualifications, Academic degrees – Education:
Graduated from General Practitioner System, Hanoi Medical University
Graduated with a Master degree in Internal Medicine, Hanoi Medical University
Graduated from the training program specialized in Gastrointestinal, Henri Mondor Institute Center, University of Paris 6, French Republic 1996-1997; 1999
Graduated from the training program specialized in Gastrointestinal, North Royal Sydney Hospital, Australia; 2002
Graduated from a training program specialized in chronic liver diseases, Pizza, Italy 2009
Graduated with a PhD in Gastrointestinal, Hanoi Medical University
Associate Professor, Gastroenterology, Hanoi Medical University
Training and Scientific Research:
Published more than 200 articles in domestic and international specialized journals
Editor of many monographs and participates in compiling 2 textbooks.
Guide many students and graduate students of Hanoi Medical University
Manager of many grassroots research projects
Certificate of Good Clinical Practice (GCP: 2012, 2015), Ministry of Health
Specialized certificates: General gastrointestinal endoscopy, Interventional gastrointestinal endoscopy, General gastrointestinal ultrasound, Interventional gastrointestinal ultrasound (Bach Mai BV), Chronic liver disease.