An enzyme injection that rapidly lowers very high uric acid
Rasburicase
A hospital injection used to rapidly lower very high uric acid and prevent or treat tumour lysis syndrome.
What is Rasburicase?
Rasburicase is a specialist hospital medicine, an enzyme given by drip, that rapidly lowers very high levels of uric acid in the blood. It is used to prevent or treat tumour lysis syndrome, a serious problem that can happen when chemotherapy breaks down a lot of cancer cells quickly and floods the blood with uric acid that can harm the kidneys. The most important safety point is that it must not be used in people with the inherited condition G6PD deficiency, because it can cause severe breakdown of red blood cells. It can also cause serious allergic reactions, and blood samples must be handled in a special way or the uric-acid result will read falsely low.
Education and reference only. This is a plain-language guide to Rasburicase — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Rasburicase is an enzyme medicine given as a drip into a vein in hospital. It is used around the time of chemotherapy in people with certain cancers, especially blood cancers, who are at risk of tumour lysis syndrome. This is a condition where treatment kills many cancer cells very quickly, releasing large amounts of uric acid and other substances that can damage the kidneys and upset the body's chemistry. Rasburicase brings very high uric-acid levels down rapidly, working faster than tablet treatments, and is given under close specialist supervision.
How it works
Uric acid is a waste product that the body normally cannot break down further. Rasburicase is an enzyme that converts uric acid into a more soluble substance that the kidneys can clear easily, so the level in the blood falls quickly. By lowering uric acid fast, it helps protect the kidneys from being overwhelmed during the rapid cell breakdown caused by chemotherapy. Because it acts directly on uric acid, it works much faster than medicines that only slow uric-acid production, which is why it is chosen for people at high risk.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist hospital injection used in the UK to prevent or treat very high uric-acid levels during cancer treatment.
Practical use
How to take Rasburicase
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given as a drip into a vein in hospital by your specialist cancer team, usually around the time of chemotherapy.
- Tell your team if you or your family have the inherited condition G6PD deficiency, as rasburicase must not be used in this case.
- Report any rash, wheeze, swelling or feeling unwell during or after the drip straight away, as serious allergic reactions can occur.
- Be aware that blood samples for uric acid must be handled in a special chilled way, which the laboratory team arranges.
- Drink fluids as advised and follow any other instructions given to protect your kidneys.
Weighing it up
Advantages & disadvantages of Rasburicase
Advantages
- Lowers very high uric-acid levels rapidly, faster than tablet treatments.
- Helps prevent and treat tumour lysis syndrome and protect the kidneys during chemotherapy.
- Given as a short hospital course at a time of high risk.
Disadvantages
- Must not be used in people with G6PD deficiency because of the risk of severe red-blood-cell breakdown.
- Can cause serious allergic reactions.
- Can make uric-acid blood tests read falsely low unless samples are handled correctly.
Practical use
Good to know
The single most important safety point is that rasburicase must not be given to people with G6PD deficiency, an inherited condition more common in some populations, because it can cause severe breakdown of red blood cells (haemolysis) and a problem with the blood's oxygen-carrying called methaemoglobinaemia; testing may be done where this is a concern. It can also cause serious allergic reactions, so it is given where staff can respond quickly. A practical but important point is that once rasburicase is in the blood, it keeps acting in the test tube too, so blood samples for uric acid must be collected and handled in a special, chilled way, otherwise the result reads falsely low. It is a short-course hospital medicine used around chemotherapy, not a long-term treatment.
Who should not take it / use with caution
- People with the inherited condition G6PD deficiency must not be given rasburicase, because of the risk of severe haemolysis and methaemoglobinaemia.
- People who have had a serious allergic reaction to rasburicase or similar enzyme medicines should not receive it.
- It is used only in hospital under specialist supervision where reactions can be managed.
Monitoring
- Frequent blood tests to check uric-acid levels, kidney function and blood chemistry around chemotherapy.
- Watching for allergic reactions during and after the drip.
- Checking for signs of red-blood-cell breakdown, especially where G6PD deficiency is a concern.
Side effects
- Fever, nausea, vomiting or headache.
- Allergic-type reactions, including, rarely, severe ones.
- Severe breakdown of red blood cells (haemolysis) or methaemoglobinaemia, particularly in people with G6PD deficiency.
Key interactions
- It is used as part of a wider cancer-treatment plan, so the whole team coordinates its use.
- It does not have many routine medicine interactions, but its main concern is its effect on blood tests and on people with G6PD deficiency.
- Tell your team about all your medicines and any inherited blood conditions before treatment.
Available as: A powder made up into a solution for a drip into a vein, given in hospital.
Answers
Rasburicase: frequently asked questions
What is rasburicase used for?
It is a hospital injection used to rapidly lower very high uric-acid levels and to prevent or treat tumour lysis syndrome during cancer treatment.
Why does G6PD deficiency matter?
In people with G6PD deficiency, rasburicase can cause severe breakdown of red blood cells and a blood problem called methaemoglobinaemia, so it must not be used in this case.
What is tumour lysis syndrome?
It is a serious problem where chemotherapy breaks down many cancer cells quickly, flooding the blood with uric acid and other substances that can harm the kidneys.
Why must blood samples be handled specially?
Rasburicase keeps acting in the test tube, so uric-acid samples must be collected and kept chilled in a special way, otherwise the result reads falsely low.
How is it given?
It is given as a drip into a vein in hospital by your specialist cancer team, usually around the time of chemotherapy.
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.