Drug General Information (ID: DDIW4CJOZT)
Drug Name			Prednisone		Drug Info		Asparaginase Erwinia chrysanthemi		Drug Info
Drug Type		Small molecule				Protein/peptide
Therapeutic Class		Antiinflammatory Agents				Antineoplastics

Mechanism of Prednisone-Asparaginase Erwinia chrysanthemi Interaction (Severity Level: Moderate)
Increased risk of hyperglycemia Click to Show/Hide Mechanism Graph
Drug Name		Prednisone				Asparaginase Erwinia chrysanthemi
Mechanism 1		Hyperglycemia				Hyperglycemia
Key Mechanism Factor 1
		Factor Name		Hyperglycemia
		Factor Description		Drugs can induce hyperglycemia through a variety of mechanisms, including altered insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells, and increased glucose production. Hyperglycemia may increase the risk of microvascular and macrovascular complications, infection, metabolic coma and even death.
Mechanism Description		Increased risk of hyperglycemia by the combination of Prednisone and Asparaginase Erwinia chrysanthemi
Mechanism 2		Hyperglycemic effects				Hyperglycemia
Key Mechanism Factor 2
		Factor Name		Hyperglycemia
		Factor Description		Drugs can induce hyperglycemia through a variety of mechanisms, including altered insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells, and increased glucose production. Hyperglycemia may increase the risk of microvascular and macrovascular complications, infection, metabolic coma and even death.
Mechanism Description		Increased risk of hyperglycemia by the combination of Prednisone and Asparaginase Erwinia chrysanthemi
Mechanism 3		Hyperglycemia				Hyperglycemic effects
Key Mechanism Factor 3
		Factor Name		Hyperglycemia
		Factor Description		Drugs can induce hyperglycemia through a variety of mechanisms, including altered insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells, and increased glucose production. Hyperglycemia may increase the risk of microvascular and macrovascular complications, infection, metabolic coma and even death.
Mechanism Description		Increased risk of hyperglycemia by the combination of Prednisone and Asparaginase Erwinia chrysanthemi
Mechanism 4		Hyperglycemic effects				Hyperglycemic effects
Key Mechanism Factor 4
		Factor Name		Hyperglycemia
		Factor Description		Drugs can induce hyperglycemia through a variety of mechanisms, including altered insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells, and increased glucose production. Hyperglycemia may increase the risk of microvascular and macrovascular complications, infection, metabolic coma and even death.
Mechanism Description		Increased risk of hyperglycemia by the combination of Prednisone and Asparaginase Erwinia chrysanthemi

Recommended Action
Management		Close monitoring for clinical and laboratory evidence of hyperglycemia and/or altered coagulation is also recommended at baseline and periodically throughout concurrent treatment with corticosteroids and asparaginase-derived products. Patients should be advised to promptly report any signs and symptoms of hyperglycemia, bleeding, blood clots or bone pain.

References
1	Product Information. Erwinaze (asparaginase Erwinia chrysanthemi). EUSA Pharma, Newtown, PA.
2	Product Information. Oncaspar (pegaspargase). Rhone-Poulenc Rorer, Collegeville, PA.
3	Kawedia JD, Liu C, Pei D, Cheng C, Fernandez CA, Howard SC, Campana D, Panetta JC, Bowman WP, Evans WE, Pui CH, Relling MV. Dexamethasone exposure and asparaginase antibodies affect relapse risk in acute lymphoblastic leukemia. Blood. 2012 Feb 16;119(7):1658-64.