Eprex Dosage/Direction for Use

Anemia or Chronic Renal Failure: Recommended Starting Dose: 50 units/kg, 3 times/week, administered as IV injection over 1-2 min or SC injection.
Dose adjustments should depend upon the initial response on hemoglobin levels (proposed rate <2 g/dL/month). If required, dose increments in steps of 25 units/kg/dose in intervals of 4 weeks are recommended.
If the rate of hemoglobin rise exceeds 2 g/dL/month at 50 units/kg, 3 times/week, downward dosage adjustments should be made in the amount administered in each dose and by omitting one of the weekly doses. Similar downward dose adjustments should be made if the Hb level exceeds 12 g/dL.
Maximum dose should generally not exceed 200 units/kg 3 times/week.
When Hb level of 10-12 g/dL (HCT 30-35%) has been achieved, the total maintenance weekly dose (average 100-300 units/kg) can be apportioned in 2 or 3 injections. The optimal level of Hb is left to the discretion of the physician, however, 10-12 g/dL has been shown to be well tolerated. Available data indicate that patients starting treatment at very low Hb levels (<6 g/dL) may require higher maintenance dosages than those starting therapy with Hb >8 g/dL; the latter group of patients may need weekly doses as low as 100 units/kg.
Iron status should be evaluated for all patients prior to and during treatment and iron supplementation administered if necessary. Non-response to r-HuEPO therapy should prompt a search for causative factors. These include iron, folate or vitamin B₁₂ deficiency; aluminum intoxication; intercurrent infections, inflammatory or traumatic episodes; occult blood loss; hemolysis; and bone marrow fibrosis of any origin.
In patients maintained on hemodialysis, r-HuEPO should always be administered after completion of dialysis.
Reduction or elimination of transfusion requirements in AZT-treated HIV-infected patients.
Prior to initiating therapy with r-HuEPO, it is recommended that endogenous serum erythropoietin is measured. It is unlikely that patients with endogenous serum erythropoietin levels >500 mU/mL will respond to r-HuEPO therapy.
The initial dose of r-HuEPO should be 150 units/kg by IV bolus or SC injection injected 3 times/week. In case of an adequate response to treatment, the dose can be escalated in a stepwise fashion to a maximum of about 500 units/kg IV or SC 3 times/week.
Administration: Parenteral drug products should be visually inspected for particulate matter and discoloration prior to administration.
Use the graduated pre-filled syringe.
Administer as IV or SC injection over 1-2 min. In patients on hemodialysis, the injection should be performed after the dialysis procedure. Slow IV or SC injection over 5 min SC injection may be preferred in those patients who experience flu-like symptoms.
Do not administer by IV infusion or in conjunction with other drug solutions.