Anaemia in zidovudine-treated HIV-infected patients, Anaemia of chronic renal failure, Anaemia of prematurity, Anaemia related to non-myeloid malignant disease chemotherapy, To reduce the need for allogenic blood tranfusion.
Drugs for Haemolytic Hypoplastic & Renal Anemia
Erythropoietin alfa is recombinant human erythropoietin (EPO). It is expressed in Chinese hamster ovary cells and has a 165 amino acid sequence identical to that of human urinary EPO; the two are indistinguishable on the basis of functional assays. The apparent molecular weight of erythropoietin is about 30,400 daltons.
Increase yield of autologous blood As epoetin alfa or zeta: 600 IU/kg twice wkly for 3 wk before surgery. Anaemia of chronic renal failure As epoetin alfa: Predialysis and haemodialysis: Initial: 50 IU/kg 3 times/wk; Peritoneal dialysis: 50 IU/kg twice wkly. Anaemia in zidovudine-treated HIV-infected patients As epoetin alfa: Initial: 100 IU/kg 3 times/wk for 8 wk. Max: 300 IU/kg 3 times/wk. Anaemia related to non-myeloid malignant disease chemotherapy As epoetin alfa or zeta: Initial: 150 IU/kg 3 times/wk, up to 300 IU/kg 3 times/wk. Anaemia of chronic renal failure: Child: As epoetin alfa: Initially, 50 IU/kg 3 times wkly. May increase dose at 4 wkly intervals in increments of 25 IU/kg 3 times wkly until a target haemoglobin concentration of 9.5-11 g/100 mL is reached. Usual maintenance dose: 30 kg: 90-300 IU/kg/wk.
There are no known clinically significant drug interactions but the effect of Erythropoietin alfa may be potentiated by the simultaneous therapeutic administration of a haematinic agent such as ferrous sulphate when a deficiency state exists.
Uncontrolled hypertension, hypersensitivity to mammalian cell products and human albumin. Chronic renal failure, ischaemic heart diseases, hypertension, pregnancy, seizures, liver dysfunction, lactation.
Hypertension, myalgia, arthralgia, flu-like syndrome, rashes and urticaria. Potentially Fatal: Hypertensive crisis with encephalopathy-like symptoms e.g. headache, confusion, generalised seizures. Thrombosis.
Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
The therapeutic margin of Erythropoietin alfa is very wide. Erythropoietin alfa overdosage can cause hemoglobin levels above the desired level, which should be managed with discontinuation or reduction of Erythropoietin alfa dosage and/or with phlebotomy, as clinically indicated. Cases of severe hypertension have been observed following overdose with ESAs.
Store at 2ºC to 8ºC. Do not freeze or shake. This temperature range should be closely maintained until administration to the patient. Store in original package in order to protect from light.
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