Epovax

Epoetin α (recombinant human erythropoietin)

Management of anemia in adults w/ chronic renal failure; HIV +ve in zidovudine therapy & those receiving concurrent chemotherapy for non-myeloid malignant diseases. Increase the yield of autologous blood.

Anemia of chronic renal failure May be given SC or IV (over at least 1 min) or slow IV inj (over 5 min). Target Hb conc: 10-12 g/100 mL; haematocrit: 30-36%. Max rate of Hb rise: 2 g/100 mL/mth. Predialysis & hemodialysis patient Initially 50 IU/kg thrice wkly. May be increased at 4-wk intervals in increments of 25 U/kg thrice wkly. Total wkly maintenance dose: 50-100 U/kg (in predialysis patients) & 75-300 U/kg given in 3 divided doses (in hemodialysis patients). In predialysis patients, a total wkly dose of 600 U/kg should not be exceeded. Patient on peritoneal dialysis IV Initially 50 U/kg twice wkly. Total wkly maintenance dose: 50-100 U/kg IV in 2 divided doses. Childn on hemodialysis IV Initially 50 U/kg thrice wkly, may be increased at 4-wk intervals in increments of 25 U/kg thrice wkly. Target Hb conc: 9.5-11 g/100 mL. Total wkly maintenance dose: Patient weighing >30 kg 90-300 U/kg in 3 divided doses, 10-30 kg 180-450 U/kg in 3 divided doses, <10 kg 225-450 U/kg in 3 divided doses. Non-myeloid malignant disease receiving chemotherapy SC Initially 150 U/kg thrice wkly, may be increased after 4 or 8 wk to 300 U/kg thrice wkly. Discontinue treatment if the response is still inadequate after 4 wk. Alternatively, total wkly dose may be given as single or in 3-7 divided doses. May also be given in once-wkly doses of 450 U/kg or 40,000 U, may be increased to 60,000 U after 4 wk if necessary. Max rate of Hb rise: 2 g/100 mL/mth. Target Hb conc: Not >12 g/100 mL. HIV +ve patient on zidovudine therapy IV/SC Initially 100 U/kg thrice wkly for 8 wk, may be increased 4-8 wkly by 50-100 U/kg thrice wkly according to response. To increase the yield of autologous blood May be used w/ Fe. Suggested regimen: 600 U/kg IV twice wkly starting 3 wk prior to surgery. May be increased to 800 U/kg IV or up to 600 U/kg SC twice wkly for 4 wk prior to surgery. Reduction of allogenic blood transfusion SC 600 U/kg once wkly starting 3 wk prior to surgery, w/ a 4th dose given on the day of surgery. Alternatively, when the time prior to surgery is short, 300 U/kg SC daily may be given for 10 days prior to, during & for 4 days after of surgery.

Hypersensitivity to epoetin α & other prep derived from mammalian cells & human serum albumin. Uncontrolled severe HTN; complicated infections.

Periodically monitor hematocrit during treatment. Adjust dose if elevation of serum K occurs. Patients w/ MI, pulmonary & cerebral infarction, allergic history & tendency. Initiate Fe prep supplementation if serum ferritin is <100 mg/mL or transferrin saturation is <20%. Folic acid or vit B₁₂ deficiency, serious excessive Al. Athletes. Pregnancy & lactation. Childn. Elderly.

Flu-like symptoms eg, fever, chills, headache, arthralgias, myalgias, asthenia, dizziness & tiredness; rashes, urticaria, nausea & vomiting, diarrhea, hyperkalemia, inj site reactions; HTN; thromboembolism including myocardial ischemia, MI, transient ischemic attacks, CVA, DVT, pulmonary embolism.

Haematopoietic Agents

B03XA01 - erythropoietin ; Belongs to the class of other antianemic preparations. Used in the treatment of anemia.

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