Drug General Information (ID: DDILMOK4FG)
Drug Name			Asparaginase Erwinia chrysanthemi		Drug Info		Betrixaban		Drug Info
Drug Type		Protein/peptide				Small molecule
Therapeutic Class		Antineoplastics				Anticoagulants/Factor Xa Inhibitors

Mechanism of Asparaginase Erwinia chrysanthemi-Betrixaban Interaction (Severity Level: Moderate)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Asparaginase Erwinia chrysanthemi				Betrixaban
Mechanism		Risk of bleeding Anticoagulant effects				Risk of bleeding Anticoagulant
Key Mechanism Factor 1
		Factor Name		Bleeding
		Factor Description		Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
Mechanism Description		Increased risk of bleeding by the combination of Asparaginase Erwinia chrysanthemi and Betrixaban

Recommended Action
Management		Coagulation parameters should be monitored at baseline and periodically during concomitant treatment with asparaginase and anticoagulants such as heparin, dipyridamole, aspirin and nonsteroidal anti-inflammatory drugs. Patients should be advised to promptly report any signs and symptoms of bleeding.

References
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8	Product Information. Asparlas (calaspargase pegol). Servier, Boston, MA.
9	Product Information. Elspar (asparaginase). Merck & Co, Inc, West Point, PA.
10	Product Information. Erwinaze (asparaginase Erwinia chrysanthemi). EUSA Pharma, Newtown, PA.
11	Product Information. Oncaspar (pegaspargase). Rhone-Poulenc Rorer, Collegeville, PA.
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