Drug/Lab test interactions-
False positive pregnancy tests have been reported

Gaucher Disease Type 1

Adverse reactions have occurred  during or shortly after infusions-

Symptoms include-  pruritus, flushing, urticaria/angioedema, . A small number have had  upper
airway invlovement , chest discomfort, respiratory symptoms, nausea and abdominal cramping

Pretreatment with antihistamines  and rate of infusion reduced rate of infusion have allowed the
use of alglucerase in patients

Additional  adverse reactions-

CNS -   dysomia, fatigue, head ache, light headedness, weakness

GI -      diarrhea, oral ulceration

GU -     menstrual abnormalites and false positive tests have been reported

Musculoskeletal-      backache

Miscellaneous-      transcient peripheral edema, vasomotor irritability or hot flash.

Special precautions-
Antibodies-  patients with antibodies to algucerase are at a  higher risk of hypersensitivity reactions
If a patient experienced a reaction suggestive of symptoms of hypersensitivity, it is recommended
that a serum samplefor  tryptase levels and complement activiation be drawn within 2 hrs of reaction
after appropiate treatment of symptoms.

Subsequent serum for testing antibody to alglucerase would be helpful. 

Pretreatment- pretreatment with antihistamines has allowed  the use of alglucerase in  some patients

Transmission of viral disease- algucerase is prepared from pooled  human placental tissues
that may contain the causative agents of some viral diseases.Manufacturing steps have been
designed to reduce the risk of transmitting infectious agents. 
Access the benefits and risks of treatment with this product prior to use.

Hypersensitivity  reactions-  approach treatment with alglucerase with caution in patients who
have exhibited symptoms of hypersensitivity to the product.

Special risk-  use alglucerase with cautionn in patients with androgen sensitive malignancies
eg prostrae cancer and patients with known prior allergies to hCG

Pregnancy- prescribe algulcerase to a pregnant woman only if clearly needed

Lactation-  excercise caution when alglucerase is administered to a breast feeding woman

Children- safety and efficay of alglucerase have been established in children between 2 and
16 years  of age. Algulcerase has been administered to children below 2 years of age, however,
safety and efficacy in patients younger than 2 years have not been established.

Monitoring- periodically monitor patients for IgG antibody formation
A heathcare priovider knowledgeable in the management of patients with Glaucher disease 
should direct therapy with algucerase

Indication-
Gaucher Disease Type 1

Dosage-                                                                                                                                        Allucerase is administered by IV infusion over a period of 1 to 2 hours.
Dosage should be individualized for each patient..

Intial dose should be as little as 2.5 units/kg of body weight  3 times a week, and as much as
 60units/kg administered as frequently as once a week  or as infrequently as every 4 weeks

Progressive reductions can be made at intervals of 3 to 6 months while carefully monitoring the
response of the parameters

Pharmacolgy-
Algucerase catayses the hydrolysis of the glycolip glucerebroside to glucose and ceramide as
a part of normal degradation pathway for membrane and lipds

Gaucher disease is characterized by functional deficiency in beta-glucocerebrosidase enzymatic
activity and the resultant accumulation of  lipid glucocerbroside in the tissue macrophanges,
which becomes engroged and are termed as Gaucher cells.

Gaucher cells are typically found in liver, spleen, and bone marrow and occasonally in the luing,
kidney, and intestine

Pregnancy-
Prescribe algulcerase to a pregnant woman only if clearly needed

Lactation- 
Excercise caution when alglucerase is administered to a breast feeding woman

Children-
Safety and efficay of alglucerase have been established in children between 2 and
16 years  of age. Algulcerase has been administered to children below 2 years of age, however,
safety and efficacy in patients younger than 2 years have not been established.

Monitoring-
Periodically monitor patients for IgG antibody formation
A heathcare priovider knowledgeable in the management of patients with Glaucher disease 
should direct therapy with algucerase