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Adagen (Pegademase Bovine) - Drug Interactions, Contraindications, Overdosage, etc



There are no known drug interactions with ADAGEN ® (pegademase bovine) Injection. However, Vidarabine is a substrate for ADA and 2'-deoxycoformycin is a potent inhibitor of ADA. Thus, the activities of these drugs and ADAGEN ® (pegademase bovine) Injection could be substantially altered if they are used in combination with one another.


There is no documented experience with ADAGEN ® (pegademase bovine) Injection overdosage. An intraperitoneal dose of 50,000 U/kg of ADAGEN ® (pegademase bovine) Injection in mice resulted in weight loss up to 9%.


There is no evidence to support the safety and efficacy of ADAGEN ® (pegademase bovine) Injection as preparatory or support therapy for bone marrow transplantation. Since ADAGEN ® (pegademase bovine) Injection is administered by intramuscular injection, it should be used with caution in patients with thrombocytopenia and should not be used if thrombocytopenia is severe.


  1. Hershfield MS, Buckley RH, Greenberg ML, et al. Treatment of adenosine deaminase deficiency with polyethylene glycol-modified adenosine deaminase. N Engl J Med 1987; 316:589-96.
  2. Levy Y, Hershfield MS, Fernandez-Mejia C, Polmar ST, Scudiery D, Berger M, Sorensen RU. Adenosine deaminase deficiency with late onset of recurrent infections: response to treatment with polyethylene glycol-modified adenosine deaminase. J Pediatr 1988; 113:312-17.
  3. Kredich NM, Hershfield MS. Immunodeficiency diseases caused by adenosine deaminase deficiency and purine nucleoside phosphorylase deficiency. 6th ed. In: Scriver CR, Beaudet AL, Sly WS, Valle D, eds. The metabolic basis of inherited disease. New York: McGraw Hill, 1989; 1045-75.
  4. Hirschhorn R. Inherited enzyme deficiencies and immunodeficiency: adenosine deaminase (ADA) and purine nucleoside phosphorylase (PNP) deficiencies. Clin Immunol Immunopathol 1986; 40:157-65.
  5. Hirschhorn R, Roegner-Maniscalco V, Kuritsky L, Rosen FS. Bone marrow transplantation only partially restores purine metabolites to normal adenosine deaminase-deficient patients. J Clin Invest 1981; 68:1387-93.
  6. Polmar AH, Stern RC, Schwartz AL, Wetzler EM, Chase PA, Hirschhorn R. Enzyme replacement therapy for adenosine deaminase deficiency and severe combined immunodeficiency. N Engl J Med 1976; 295:1337-43.
  7. Rubinstein A, Hirschhorn R, Sicklick M, Murphy RA. In vivo and in vitro effects of thymosin and adenosine deaminase on adenosine-deaminase-deficient lymphocytes. N Engl J Med 1979; 300:387-92.
  8. Hirschhorn R, Papageorgiou PS, Kesarwala HH, Taft LT. Amelioration of neurologic abnormalities after "enzyme replacement" in adenosine deaminase deficiency. N Engl J Med 1980; 303:377-80.
  9. Hirschhorn R, Ratech H, Rubinstein A, et al. Increased excretion of modified adenine nucleosides by children with adenosine deaminase deficiency. Pediatr Res 1982; 16:362-9.
  10. Polmar SH. Enzyme replacement and other biochemical approaches to the therapy of adenosine deaminase deficiency. In: Elliott K, Whelan J, eds. Enzyme defects and immune dysfunction. Amsterdam: Excerpta Medica, 1979; 213-30.

U.S. Patent 4,179,337 and pat. pending

©1993, ENZON Pharmaceuticals, Inc.

ENZON Pharmaceuticals, Inc.

20 Kingsbridge Road

Piscataway, NJ 08854-3969

All Rights Reserved

Issued May, 1999           200-029 b

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