Darbepoetin alfa: Indication, Dosage, Side Effect, Precaution

Generic Medicine Info Patient Medicine Information

This information is not country-specific. Please refer to the Myanmar prescribing information.

Generic Medicine Info

Indications and Dosage

Parenteral
Anaemia of chronic renal failure

Adult: Initially, 0.45 mcg/kg SC/IV once weekly. Alternatively, 0.75 mcg/kg every 2 weeks or 1.5 mcg/kg once monthly via SC inj in patients not on dialysis. Dose may be increased or decreased by 25% once every 4 weeks, according to Hb level. Maintenace dose: 0.45 mcg/kg SC/IV once weekly or once every 2 weeks. Titrate dose to maintain target Hb level.
Child: Same as adult dose.

Subcutaneous
Anaemia in chemotherapy patients

Adult: Initially, 500 mcg once every 3 weeks. Alternatively, 2.25 mcg/kg once weekly. Dose reduction up to 50%, dosing interruption, or discontinuation may be required according to Hb level (refer to detailed product guideline). Discontinue therapy approx 4 weeks after the end of chemotherapy.

Contraindications

Hypersensitivity, uncontrolled hypertension.

Special Precautions

Pregnancy and lactation, children. Hypertension; history of seizures; hepatic impairment; sickle cell anaemia; sudden stabing migraine-like pain (warning sign of hypotensive crisis); exclude other causes of anaemia; ischaemic vascular disease; thrombocytosis; epilepsy; malignant disease; increase in heparin dose may be needed; increased risk of thrombosis when used for anaemia before orthopedic surgery; CV disease including recent MI/cerebrovascular accident. Monitor haemoglobin, BP and electrolytes; platelet count for 1st 8 wk.

Adverse Reactions

Hypertension, hypotension, chest pain, fatigue, fever, headache, dizziness, GI effects; myalgia, arthralgia, limb pain; skin reactions; shunt reactions, hyperkalaemia; dyspnea, cough, bronchitis; infection; transient increase in platelet count; influenza-like symptoms; peripheral oedema; Inj site pain.

Pregnancy Category (US FDA)

IV/Parenteral/SC: C

Overdosage

No overdosage symptoms reported so far as it has wide therapeutic margin. In the event of polycythaemia, treatment may be temporarily withheld. Phlebotomy may be performed if clinically indicated.

Drug Interactions

Antagonism of hypotensive effect and increased risk of hyperkalemia with ACE inhibitors and angiotensin II receptor antagonists. Ethanol.

Action

Description: Darbepoetin alfa is a biosynthetic form of erythropoietin. It stimulates the division and differentiation of erythroid progenitor cells; reticulocytes are released from the bone marrow and matures into erythrocytes thereby regulating erythropoiesis.
Pharmacokinetics:
Absorption: IM admin: Slow absorption and bioavailability is about 37%.
Excretion: Terminal half-lives: 21 hr (IV admin) and 49 hr (SC admin).

Storage

Store at 2-8°C.

MIMS Class

Haematopoietic Agents

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