Rasburicase (Fasturtec®)
Rasburicase (Fasturtec®) is a drug given before and during chemotherapy to treat some types of cancer. It can help to prevent tumour lysis syndrome.
What is tumour lysis syndrome?
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. When cancer cells break down very quickly, it can cause a sudden release of large amounts of chemicals into the blood. This is called tumour lysis syndrome (TLS).
Your kidneys can usually keep these chemicals balanced. But they might not be able to cope with very large amounts. The chemical imbalance can affect how well your kidneys work and cause problems with your heart rhythm.
You will have regular blood tests to check the levels of these chemicals.
If you are at risk of TLS, your doctor can give you treatment to help prevent it. You may have:
- extra fluids through a drip
- medicines such as rasburicase or allopurinol.
Drinking at least 2 litres (3½ pints) of fluid a day will also help.
More information about this treatment
This information is correct at time of publishing. But sometimes the types of cancer this treatment is used for, or treatment side effects, may change between revision dates.
You can talk to your cancer team if you want more detailed information about this treatment. Or visit the electronic Medicines Compendium (eMC) website, which has patient information leaflets (PIL) for individual drugs.
How rasburicase is given
Rasburicase is given before or with your first chemotherapy treatment. You have it as a drip (infusion) into a vein.
Your nurse will give you rasburicase through 1 of the following:
- a cannula – a short, thin tube the nurse puts into a vein in your arm or hand
- a central line – a fine tube that goes under the skin of your chest and into a vein close by
- a PICC line – a fine tube that is put into a vein in your arm and goes up into a vein in your chest.
The infusion is given over 30 minutes. You may have just 1 dose or a daily dose for up to 7 days. You will have blood tests to see how much uric acid is in your blood. This helps your doctor decide how many doses of rasburicase to give you.
You will also have an infusion of fluids to help flush through your kidneys. This is called intravenous hydration. This means you pass more urine (pee) than usual.
About side effects
Each person’s reaction to any medicine is different. Most people have very few side effects, while others may experience more. The side effects described here will not affect everyone who is having rasburicase.
You may also have side effects from the cancer drugs you are given. If you notice any side effects that are not listed here, tell your nurse or doctor.
Serious and life-threatening side effects
Some cancer treatments can cause serious side effects. Sometimes, these may be life-threatening. Your doctor, nurse or pharmacist can explain the risk of these side effects to you.
Contact the hospital
Your doctor, nurse or pharmacist will give you 24-hour contact numbers for the hospital. If you feel unwell or need advice, you can call at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.
Side effects while treatment is being given
Allergic reaction
Some people have an allergic reaction while having this treatment. Signs of a reaction can include:
- feeling hot or flushed
- shivering
- itching
- a skin rash
- feeling dizzy or sick
- a headache
- feeling breathless or wheezy
- swelling of your face or mouth
- pain in your back, tummy or chest.
Your nurse will check you for signs of a reaction during your treatment. If you feel unwell or have any of these signs, tell them straight away. If you do have a reaction, they can treat it quickly.
Sometimes a reaction happens a few hours after treatment. If you develop any of these signs or feel unwell after you get home, contact the hospital straight away on the 24-hour number.
Always call 999 if swelling happens suddenly or you are struggling to breathe.
Common side effects
High temperature
Your nurse will monitor your temperature during treatment. Signs of a high temperature can include feeling hot and sweaty or cold and shivery. It is important to let the nurse or doctor know if you feel you have a high temperature.
Feeling sick
The nurses will give you anti-sickness drugs regularly. This will help prevent or control sickness during your treatment in hospital. If you feel sick or are sick (vomit), tell your nurse or doctor straight away. They can change the anti-sickness treatment. Or they might change the way you have it to something that works better for you.
Diarrhoea
This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is normal for you, or having watery or loose stools. You may also have stomach cramps. If you have a stoma, it may be more active than usual.
If you are passing loose stools 3 or more times a day and this is not normal for you, contact the hospital as soon as possible on the 24-hour number. Follow the advice they give you about:
- taking anti-diarrhoea medicines
- drinking enough fluids to keep you hydrated and to replace lost salts and minerals
- any changes to your diet that might help.
They might also ask you for a specimen of your stool to check for infection.
Headaches
This treatment may cause headaches. If you have headaches, tell your doctor, nurse or pharmacist. They can give you advice about painkillers that may help. Tell them if the headache does not get better, or gets worse.
Less common side effects
Blood changes
Rarely, rasburicase can increase the breakdown of red blood cells. You will have regular blood tests during your treatment to check for this side effect.
Other information
Other medicines
Some medicines can affect how this treatment works or be harmful while you are having it. Always tell your cancer doctor, nurse or pharmacist about any drugs you are taking or planning to take, such as:
- medicines you have been prescribed
- medicines you buy in a shop, pharmacy or online
- vitamins or supplements
- herbal drugs and complementary or homeopathic therapies
- recreational drugs – for example, cannabis.
Pregnancy and breastfeeding
Ask your doctor or pharmacist for advice before taking this medicine if you:
- are pregnant
- think you may be pregnant
- are planning to have baby.
You are also advised not to breastfeed when taking this treatment. This is because the medicine may be passed to the baby through breast milk.
Medical and dental treatment
If you need medical treatment for any reason other than cancer, always tell the healthcare professional that you are having cancer treatment. Give them the contact details for your cancer doctor or cancer team so they can ask for advice.
If you have appointments with a dentist, always tell them you are having cancer treatment. Talk to your cancer team before you have any dental treatment.
About our information
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References
Visit the electronic Medicines Compendium (eMC) to download a Patient Information Leaflet (PIL) for more detailed information. The leaflet lists all known side effects.
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert health professionals and people living with cancer.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.
The language we use
We want everyone affected by cancer to feel our information is written for them.
We want our information to be as clear as possible. To do this, we try to:
- use plain English
- explain medical words
- use short sentences
- use illustrations to explain text
- structure the information clearly
- make sure important points are clear.
We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
You can read more about how we produce our information here.
Date reviewed
Our cancer information meets the PIF TICK quality mark.
This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.
How we can help
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