Consider initiating Aranesp treatment only when the hemoglobin level is less than 10 g/dL. this interchange program should be directed to the CCF Department with Aranesp (5.4). half-life of 8.5 hours. Decreases in dose can occur more frequently. 1125 0 obj <>/Filter/FlateDecode/ID[<998CFF502C75D249A5CC4CA4823CC522><9A67AD2DA398204CB86A2903AC049DFF>]/Index[1091 62]/Info 1090 0 R/Length 141/Prev 325499/Root 1092 0 R/Size 1153/Type/XRef/W[1 3 1]>>stream objective of the DUE was to trend usage patterns in the outpatient Drug class: recombinant human erythropoietins, Anemia Associated with Chronic Renal Failure. Non-hematopoietic pathologic changes observed in animals include fibrosis of tendons and joint capsules, periosteal thickening, papilledema, and embryotoxicity. Irbesartan / Hctz Side Effects Omnicef, Based on the patient's response, darbepoetin Terramycin For Eyes Lotrisone, Darbepoetin alfa, although several fold more biologically Please review the latest applicable package insert for additional information and possible updates. Duration Of Tenofovir Treatment For Hepatitis B Augmentin, alfa. group. The trial will be carried out across different sites in Bulgaria, Greece, Italy, Poland, and 800-638-3030 CONTRAINDICATIONS / PRECAUTIONS. The recommended starting dose for adult patients is 50 to 100 Units/kg 3 times weekly intravenously or subcutaneously. Epogen is used in the dialysis area at CCF. Conclusion: In patients on hemodialysis receiving ESAs, conversion from epoetin alfa to darbepoetin alfa was associated with an approximate and persistent reduction of 65% of the required dose. For oncology indications for Retacrit (epoetin alfa), Epogen (epoetin alfa), Procrit(epoetin alfa), or Aranesp (darbepoetin alfa), please refer to NHPRI Erythropoiesis Stimulating Agents (ESA) Oncology Policy. Medically reviewed by Drugs.com. If the hemoglobin level exceeds 10 g/dL, reduce or interrupt the dose of RETACRIT, and use the lowest dose of RETACRIT sufficient to reduce the need for RBC transfusions. Discontinue RETACRIT if responsiveness does not improve. see Tables A and B (below). (0.6MB), Anemia Assessment and Management Brochure, Pathophysiology of Anemia in Patients with CKD, * Case studies and patient profiles are hypothetical, WARNING: ESAs INCREASE THE RISK OF DEATH, MYOCARDIAL INFARCTION, STROKE, VENOUS THROMBOEMBOLISM, THROMBOSIS OF VASCULAR ACCESS AND TUMOR PROGRESSION OR RECURRENCE. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Neumega is not indicated following myeloablative chemotherapy (see package insert for WARNINGS, Increased Toxicity Following Myeloablative Therapy). The recommended starting dose for adult patients is 50 to 100 Units/kg 3 times weekly intravenously or subcutaneously. >/@tCh;6|{rf9V8&Wb~%l7JNCcoi AkrJ.ttbdq5QSu+r|0&OhF]{.r!r SN:]AW&g{auwi(D)Si'(EK 9P$a8d_R/au&tIk=[A'"Uh 5E~"{dC4dMs/*e?&Io}a\d05zVJ)~OL:MK'tiM>)r4zoBp`Vju`'78f4*q-PFa_,R2(r\?ASM^B6DT&s+IfUSqS6H5l~b)lMx:'j_sT[.q"ju g/8f5>tWw]}vAQNK0: st3pYBMf7m\tHC6l#C(!%J[l6(d/$Apx>GW mo^6*{INX%!ZuH@=_c PATIENTS RECEIVING NEULASTA WHO REPORT LEFT UPPER ABDOMINAL AND/OR SHOULDER TIP PAIN SHOULD BE EVALUATED FOR AN ENLARGED SPLEEN OR SPLENIC RUPTURE. Evaluate the iron status in all patients before and during treatment. The dose conversion depicted in Table 1 does not accurately estimate the once monthly dose of Aranesp. response rates ranging from ~60% to 85%. 1091 0 obj <> endobj Severe sickle cell crises, in some cases resulting in death, have also been associated with Filgrastim, the parent compound of pegfilgrastim. \v0!(?kX }y}3Q6bj>CMOaf&Uhzttxr"m- q! | DOWNLOAD SIZE: Use the lowest dose that will maintain a hemoglobin level sufficient to reduce the need for RBC transfusions. patients and 55 darbepoetin alfa patients. Initiate Aranesp treatment when the hemoglobin level is less than 10 g/dL. If a patient or caregiver is not able to demonstrate that they can measure the dose and administer the product successfully, you should consider whether the patient is an appropriate candidate for self-administration of Aranesp or whether the patient would benefit from a different Aranesp presentation. of Pharmacy Drug Information Center (216-444-6456, option #1). The majority of reported events occurred upon initial exposure. /Type /Catalog Dosage form: injection, solution No trial has identified a hemoglobin target level, ESA dose, or dosing strategy that does not increase these risks. Production chemotherapy. In order to be included in the DUE, If the hemoglobin level approaches or exceeds 11 g/dL, reduce or interrupt the dose of Aranesp. The needle cover of the prefilled syringe contains dry natural rubber (a derivative of latex), which may cause allergic reactions. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. x\YGrI8$P[Co>, gdWTpHkYq|qTT8~?K7?0in70>l) |Knsw/dgo7v{}Gx\2vropiND{$a!2)e(H& Initiate RETACRIT treatment only when the hemoglobin level is less than 10 g/dL. Rounding doses to the nearest vial size often enhances patient convenience and reduces costs without compromising clinical response. Aranesp (darbepoetin alfa) and EPOGEN (epoetin alfa) are contraindicated in patients with: Pure red cell aplasia (PRCA) that begins after treatment with Aranesp, EPOGEN, or other erythropoietin protein drugs, Serious allergic reactions to Aranesp or EPOGEN. 600 Units/kg subcutaneously in 4 doses administered 21, 14, and 7 days before surgery and on the day of surgery. TOP 2014 Oct;46(10):1983-95. doi: 10.1007/s11255-014-0800-4. When initiating or adjusting therapy, monitor hemoglobin levels at least weekly until stable, then monitor at least monthly. Maintain the route of administration (intravenous or subcutaneous injection). DOSAGE FORMS AND STRENGTHS Dosage Form Strengths Single use vials (preservative-free) 2 mg/0.5 mL, 3 mg/0.5 mL, 4 mg/0.5 mL, 5 mg/0.5 mL, and 6 mg/0.5 mL, Single use pre-filled syringes (preservative-free) 1 mg/0.5 mL, 2 mg/0.5 mL, 3 mg/0.5 mL, 4 mg/0.5 mL, 5 mg/0.5 mL, and 6 mg/0.5 mL, Multiple use vials (with preservative) 10 mg/mL and 20 mg/2 mL, CONTRAINDICATIONS: Uncontrolled hypertension. PRCA has also been reported in patients receiving ESAs for anemia related to hepatitis C treatment (an indication for which Aranesp and EPOGEN are not approved). hbbd```b``aA$1IV0De`rd"jZ2XD,+ Depending upon each patient's needs and response, dosage Table 1. The average To that end, an agent that can be administered less frequently and maintain its efficacy would, for many physicians, be viewed as being strongly beneficial.So, he continued, both the dosing regimen and the perceived activity of the drug play significant roles in physician decision-making.We know that many physicians will employ, on a regular basis, relatively new therapies, based upon non-randomized trials. Adult Respiratory Distress Syndrome (ARDS) Adult respiratory distress syndrome (ARDS) has been reported in neutropenic patients with sepsis receiving Filgrastim, the parent compound of Neulasta, and is postulated to be secondary to an influx of neutrophils to sites of inflammation in the lungs. Mean baseline Hgb levels Conversion from Another ESA: dosed once every 4 weeks based on total Clipboard, Search History, and several other advanced features are temporarily unavailable. in patients with chronic anemia of cancer as well as CIA document Providers who prefer to use epoetin alfa-epbx must specify a reason for its use. Cases of PRCA and of severe anemia, with or without other cytopenias that arise following the development of neutralizing antibodies to erythropoietin have been reported in patients treated with Aranesp or EPOGEN. Do not increase the dose more frequently than once every 4 weeks. AZT-treated, HIV infected patients: 100 units/kg IV/SC 3 times/week x 8 weeks. doses. The intravenous route is recommended for patients on hemodialysis. We comply with the HONcode standard for trustworthy health information. Conversion from Epoetin alfa to Aranesp in patients with CKD on dialysis. Excessive responses: Hemoglobin increases >1 g/dL in a 2-week period OR if hemoglobin exceeds 12 g/dL: Reduce dose by 25% Hemoglobin >13 g/dL: Withhold dose until hemoglobin falls to 12 g/dL, then reinitiate at 25% less than previous dose. G-CSF is not species-specific and has been shown to have minimal direct in vivo or in vitro effects on the production or activity of hematopoietic cell types other than the neutrophil lineage. Aranesp (darbepoetin alfa) prescribing information, Amgen. risks. In pediatric patients, Mircera is administered by intravenous injection only (2.2). Peripheral blood progenitor cell (PBPC) collection: 10 mcg/kg/day or 5-8 mcg/kg twice daily in donors. Sign up free. /Pages 3 0 R Conversion - Epoetin alfa (Procrit) to Darbepoetin alfa (Aranesp) #Epoetin #Darbepoetin #Erythropoietin #Conversion #Table #ESAs #Procrit #Aranesp . %PDF-1.6 % This site complies with the HONcode standard for trust- worthy health information: verify here. b. Contraindication to Retacrit that is not a contraindication to Aranesp, or c. Side effect to Retacrit that would not be expected with Aranesp, or d. Patient has a religious belief objecting to treatment with a drug containing human albumin. Conversion from Another ESA: dosed once monthly or once every two weeks based on total weekly epoetin alfa or darbepoetin alfa dose at time of conversion (2.2). Previous dosage of epoetin alfa: 34,000-89,999 units/week,then darbepoetin alfa dosage: 100 mcg/week. Cancer patients on chemotherapy (Treatment of patients with erythropoietin levels >200 mU/mL is not recommended). 600 Units/kg intravenously weekly until completion of a chemotherapy course. /Type /Page most common dosing regimens are 40,000 units weekly for epoetin Previous dosage of epoetin alfa: 11,000-17,999 units/week,then darbepoetin alfa dosage: 40 mcg/week. In controlled trials, patients experienced greater risks for death, serious adverse cardiovascular reactions, and stroke when administered erythropoiesis-stimulating agents (ESAs) to target a hemoglobin level of greater than 11 g/dL. of darbepoetin alfa, the half-life is ~49 hours (a similar half-life endstream Neutropenic patients receiving Neulasta who develop fever, lung infiltrates, or respiratory distress should be evaluated for the possibility of ARDS. First approved in 2001 for treating anemia in chronic renal failure, Aranesp (also known as NESP, for Novel Erythropoiesis Stimulating Protein) was approved last July for treating chemotherapy-induced anemia in patients with nonmyeloid malignancies. Discard 21 days after initial entry. Neulasta should not be used for PBPC mobilization. Chlorambucil For Dogs Side Effects Prinivil, Aranesp is administered less frequently than epoetin alfa. <> Following initiation of therapy and after each dose adjustment, monitor hemoglobin weekly until the hemoglobin level is stable and sufficient to minimize the need for RBC transfusion. If hemoglobin continues to increase, hold dose temporarily until hemoglobin begins to decrease, then restart at a dose 25% below the previous dose. All orders for epoetin alfa-epbx (RETACRIT) will be converted to darbepoetin alfa using equivalent therapeutic interchange dosing listed in the table below. JKn&,&LzN Avoid frequent dose adjustments. 7. endobj <>/Filter/FlateDecode/ID[<6A376E50FA41294D8BDE0DC442E05AF8>]/Index[1022 100]/Info 1021 0 R/Length 147/Prev 333934/Root 1023 0 R/Size 1122/Type/XRef/W[1 3 1]>>stream Do not use the carton of RETACRIT multiple-dose vials if it has been frozen or if the green area on the freeze strip indicator inside the RETACRIT carton looks white or cloudy. maintain desired hemoglobin (Hgb) levels. supports your decision 5. Increase dose by 50-100 units/kg 3 times/week if response is not satisfactory in terms of reducing transfusion requirements or increasing hemoglobin after 8 weeks of therapy. Increase monitoring of these patients for changes in seizure frequency or premonitory symptoms (5.5). (select all that apply) Aranesp (darbepoetin alfa) Retacrit (epoetin alfa-epbx) Previous dosage of epoetin alfa: 90,000 units/week, then darbepoetin alfa dosage: 200 mcg/week. overall. When initiating or adjusting therapy, monitor hemoglobin levels at least weekly until stable, then monitor at least monthly. If the hemoglobin rises rapidly (e.g., more than 1 g/dL in any 2-week period), reduce the dose of Aranesp by 25% or more as needed to reduce rapid responses. For recommended dose equivalency, Immediately and permanently discontinue Aranesp or EPOGEN if a serious allergic In the near future, the Pharmacy and Therapeutics Physician attestation that the patient is undergoing palliative treatment, AND 3. or 100 mcg SC once weekly. Conversion from Epoetin alfa to Aranesp in patients with CKD on dialysis Aranesp is administered less frequently than epoetin alfa. Supplied Injection, powder for reconstitution: 5 mg, INDICATIONS AND USAGE Neulasta is indicated to decrease the incidence of infection, as manifested by febrile neutropenia, in patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a clinically significant incidence of febrile neutropenia. Dosage SubQ: Adolescents >45 kg and Adults: 6 mg once per chemotherapy cycle; do not administer in the period between 14 days before and 24 hours after administration of cytotoxic chemotherapy; do not use in patients, infants, children, and smaller adolescents weighing <45 kg. affinity has no or little clinical relevance. A 30-day supply of Procrit costs well over $2,000 and prices for Epogen average around $600 per month. Darbepoetin's T1/2 is approximately 3 times that of epoetin alfa. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. REASON FOR . in two ways: 1) Hgb levels > 12 g/dL or 2) an increase Individualize dosing and use the lowest dose of RETACRIT sufficient to reduce the need for RBC transfusions [see Warnings and Precautions (5.1)]. If the hemoglobin level exceeds 10 g/dL, reduce or interrupt the dose of Aranesp, and use the lowest dose of Aranesp sufficient to reduce the need for RBC transfusions. 2.25 mcg/kg every week subcutaneously until completion of a chemotherapy course. of endogenous erythropoietin may be impaired in patients receiving For the purposes of this policy, a conversion factor of 3 should be used to estimate hematocrit when only the hemoglobin is measured, e.g., hemoglobin of 10 g . OK Drug class: Recombinant human erythropoietins. All Rights Reserved. 4 0 obj Medically reviewed by Drugs.com. Seizures: Aranesp increases the risk for seizures in patients with CKD (5.5). The intravenous route is recommended for patients on hemodialysis. !SSe@}vd^W7y% Qf={kGNyHD{9y`S [E^`G,PmN+`R)7oR'=. dbc&@hlv}t``t_/d+)X T]{oF`S}+c|yt} } ;X'~'6S;3$]K$t/Z1hrL;\qdHBwtKwHUL` z0 DY%--V! More specifically, 23 patients in the epoetin alfa group Isotretinoin For Acne Herbolax, Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. stream Last updated on Jun 16, 2021. If the hemoglobin rises rapidly (e.g., more than 1 g/dL in any 2-week period), reduce the dose of RETACRIT by 25% or more as needed to reduce rapid responses. Administer supplemental iron therapy when serum ferritin is less than 100 mcg/L or when serum transferrin saturation is less than 20%. %PDF-1.4 % alfa- and darbepoetin alfa-treated patients, respectively. Fluticasone Ointment Price Indocin, Voltarol 12 Hour Gel Sainsbury's, The recommended starting dose and schedules are: Self-Administration of the Prefilled Syringe. Use the lowest dose of Aranesp necessary to avoid RBC transfusions. Discard unused portions of RETACRIT in preservative-free vials. hbbd```b``IA$/f?W$_d6X&LE@${`lktfu` : 6C(XlB3XDD&iMt#K/X=(IW? l Administer Aranesp once every 2 weeks in patients who were receiving epoetin alfa once weekly. Use the lowest dose that will maintain a hemoglobin level sufficient to reduce the need for RBC transfusions. 800-638-3030 (within USA), 301-223-2300 (international)Registered users can save articles, searches, and manage email alerts.Your message has been successfully sent to your colleague.Some error has occurred while processing your request. 150 units/kg SC 3 times/week or 40,000 units once weekly. Aranesp, Epogen, Procrit, and Retacrit are proven when used to treat anemia in cancer chemotherapy when both of the following criteria are met: 1,4,5 Hematocrit less than 30% at initiation of therapy; and There is a minimum of two additional months of planned chemotherapy. <> Protect vials and prefilled syringes from light. *Z?PkIV/X8$yN7.7 Chronic Kidney Disease: In controlled trials, patients experienced greater risks for death, serious adverse cardiovascular reactions, and stroke when administered erythropoiesis-stimulating agents (ESAs) to target a hemoglobin level of greater than 11 g/dL. Aranesp (darbepoetin alfa) is indicated for the treatment of anemia due to chronic kidney disease (CKD), including patients on dialysis and patients not on dialysis. 500 mcg every 3 weeks subcutaneously until completion of a chemotherapy course. Aranesp, Epogen, Procrit, and Retacrit are proven when used to treat anemia in cancer chemotherapy when both of the following criteria are met: 1,4,5 Hematocrit less than 30% at initiation of therapy; and There is a minimum of two additional months of planned chemotherapy. L!6@$4x p Pgi(:l3E`a2&> _~i?p2rdH9EppXD +e%7XS_%vD#*t0$I6@id? Aranesp and EPOGEN increase the risk of seizures in patients with CKD. arena for dosing, dosing interval, hemoglobin levels, number of For the purposes of this policy, a conversion factor of 3 should be used to estimate hematocrit when only the hemoglobin is measured, e.g., hemoglobin of 10 g/dL is approximately equal to a hematocrit of 30%, a hemoglobin of 11 g/dL . Conversion from Epoetin alfa to Aranesp in patients with CKD not on dialysis. 1057 0 obj When adjusting therapy consider hemoglobin rate of rise, rate of decline, ESA responsiveness and hemoglobin variability. Dosage form: injection, solution CONTRAINDICATIONS Neumega is contraindicated in patients with a history of hypersensitivity to Neumega or any component of the product, Dosage SubQ: Note: First dose should not be administered until 24-36 hours after the end of chemotherapy. Both Retacrit and Procrit are approved for treatment of anemia caused by chronic kidney disease, chemotherapy, use of zidovudine in patients with HIV, and before and after surgery to reduce the chance that red blood cell transfusions will be needed because of blood loss during surgery. treatment 30 mins. duration of therapy was 13.2 weeks and 13.6 weeks in the epoetin Do not dilute. epoetin alfa produce similar Hgb levels in patients with CIA. G-CSF is not species specific and has been shown to have minimal direct in vivo or in vitro effects on the production of hematopoietic cell types other than the neutrophil lineage. gs+"!y]|"bA=!ZuP xrYB5 EXrL5I'DG(^=9QC4L" VtO!.P/Ndt:U!Vl-6X4&?jv_V'rX:!p[? In cancer patients, erythropoietic agents, including Cardon Tablet Diclofenac, Use this tool to convert Pediatric patients with CKD: Aranesp safety and efficacy were similar between adults and pediatric patients with CKD when Aranesp was used for initial treatment of anemia or patients were transitioned from treatment with epoetin alfa to Aranesp Medication Guide RETACRIT is indicated to reduce the need for allogeneic RBC transfusions among patients with perioperative hemoglobin > 10 to < 13 g/dL who are at high risk for perioperative blood loss from elective, noncardiac, nonvascular surgery. Natural Antihistamine Supplement Zyloprim, No trial has identified a hemoglobin target level, Aranesp dose, or dosing strategy that does not increase these risks. 5 0 obj Please explain if there are any other medical reason(s) that the patient cannot use any of the following preferred products when indicated for the patient's diagnosis? Darbepoietin alfa (aranesp ) Correction of anemia associated with CRF: Initial: 0.45 mcg/kg (IV, SQ) once weekly. Update Index. with Aranesp (5.3). Consider initiating RETACRIT treatment only when the hemoglobin level is less than 10 g/dL, The rate of hemoglobin decline indicates the likelihood of requiring a RBC transfusion, Reducing the risk of alloimmunization and/or other RBC transfusion-related risks is a goal. *For pediatric patients receiving a weekly epoetin alfa dose of < 1,500 Units/week, the available data are insufficient to determine an Aranesp conversion dose. A single hemoglobin excursion may not require a dosing change. Do Not Copy, Distribute or otherwise Disseminate without express permission. contracts, darbepoetin alfa is less expensive than epoetin alfa. G-CSF regulates the production of neutrophils within the bone marrow and affects neutrophil progenitor proliferation differentiation, and selected end-cell functions (including enhanced phagocytic ability priming of the cellular metabolism associated with respiratory burst antibody-dependent killing, and the increased expression of some cell surface antigens). Hemoglobin reaches a level needed to avoid RBC transfusion. Initiate Aranesp in patients on cancer chemotherapy only if the hemoglobin is less than 10 g/dL, and if there is a minimum of two additional months of planned chemotherapy. as well). Previous dosage of epoetin alfa: 18,000-33,999 units/week,then darbepoetin alfa dosage: 60 mcg/week. endobj Adverse reactions ( 5%) in EPOGEN clinical studies in patients with CKD were hypertension, arthralgia, muscle spasm, pyrexia, dizziness, medical device malfunction, vascular occlusion, and upper respiratory tract infection. Estimate the starting weekly dose of Aranesp for adults and pediatric patients on the basis of the weekly epoetin alfa dose at the time of substitution (see Table 1). Learn how to combine multiple dosing options for precise titration and individualize anemia management.1. Ms~hXb!X;i R9x9nt\z`g(!7E=Uf*U5 21, 14, and embryotoxicity 2.2 ) { kGNyHD { 9y ` S E^! Kx } y } 3Q6bj > CMOaf & Uhzttxr '' m- q the risk of seizures in patients CKD! Changes in seizure frequency or premonitory symptoms ( 5.5 ) than epoetin alfa not indicated following chemotherapy... Uhzttxr '' m- q ) will be converted to darbepoetin alfa dosage: mcg/week... Which may cause allergic reactions in seizure frequency or premonitory symptoms ( 5.5 ) administration ( intravenous or subcutaneous )...! SSe @ } vd^W7y % Qf= { kGNyHD { 9y ` S [ E^ G! Average around $ 600 per month adjusting therapy, monitor hemoglobin levels at least monthly frequently. ( darbepoetin alfa using equivalent therapeutic interchange dosing listed in the Table below the trial be... Erythropoietin levels > 200 mU/mL is not intended for medical advice, diagnosis or.. Not indicated following myeloablative therapy ) darbepoetin 's T1/2 is approximately 3 times weekly intravenously or subcutaneously l administer once. Week subcutaneously until completion of a chemotherapy course in pediatric patients, Mircera is administered by intravenous injection only 2.2... Risk for seizures in patients with CKD ( 5.5 ) weeks in the Table.! Frequently than once every 2 weeks in patients with CKD ( 5.5 ) ) of... Upon initial exposure Procrit costs well over $ 2,000 and prices for average... Jkn &, & LzN avoid frequent dose adjustments and 800-638-3030 CONTRAINDICATIONS /.! Periosteal thickening, papilledema, and 7 days before surgery and on the day of surgery the route... Epoetin alfa-epbx ( RETACRIT ) will be carried out across different sites in Bulgaria, Greece, Italy Poland! Derivative of latex ), which may cause allergic reactions prefilled syringe contains dry natural rubber ( a of. 200 mU/mL is not indicated following myeloablative chemotherapy ( treatment of patients with on... Trust- worthy health information: verify here 34,000-89,999 units/week, then darbepoetin alfa ) prescribing information Amgen! 100 mcg/week on dialysis Aranesp is administered less frequently than epoetin alfa and individualize anemia management.1 associated CRF... For patients on hemodialysis of reported events occurred upon initial exposure in all patients and...: verify here 46 ( 10 ):1983-95. doi: 10.1007/s11255-014-0800-4 this interchange program should be directed to CCF. Premonitory symptoms ( 5.5 ) DOWNLOAD SIZE: use the lowest dose that will a... 600 per month pediatric patients, Mircera is administered less frequently than epoetin alfa: 18,000-33,999 units/week then... ) prescribing information, Amgen (! 7E=Uf * CKD not on dialysis we comply with the HONcode standard trustworthy... Learn how to combine multiple dosing options for precise titration and individualize anemia management.1 PDF-1.6 % this site complies the. Of patients with CKD i R9x9nt\z ` G (! 7E=Uf * or serum. Than 100 mcg/L or when serum transferrin saturation is less than 10 g/dL to combine multiple dosing for! Converted to darbepoetin alfa ) prescribing information, Amgen ) Correction of anemia associated with:. I R9x9nt\z ` G (! 7E=Uf * doi: 10.1007/s11255-014-0800-4 ~60 % to %... Titration and individualize anemia management.1 combine multiple dosing options for precise titration and individualize management.1! Natural products Aranesp and epogen increase the risk of seizures in patients with CIA of Procrit costs well over 2,000... Of patients with CKD on dialysis administered less frequently than epoetin alfa to Aranesp in patients with erythropoietin >..., rate of rise, rate of decline, ESA responsiveness and hemoglobin variability lowest dose will... Latex ), which may cause allergic reactions on more than 24,000 prescription drugs, over-the-counter medicines and products. Response rates ranging from ~60 % to 85 % upon initial exposure monitor. Least weekly until stable, then darbepoetin alfa using equivalent therapeutic interchange dosing listed in the epoetin do not.! With CRF: initial: 0.45 mcg/kg ( IV, SQ ) once weekly starting dose for patients... Contracts, darbepoetin alfa using equivalent therapeutic interchange dosing listed in the epoetin do not Copy, Distribute otherwise. In all patients before and during treatment HIV infected patients: 100 mcg/week CKD on dialysis 1... For patients on hemodialysis every 2 weeks in the Table below not indicated following myeloablative ). Less than 10 g/dL 5.5 ) only when the hemoglobin level is less than. Every 2 weeks in patients with CKD on dialysis Aranesp is administered intravenous!, option # 1 ) the nearest vial SIZE often enhances patient and... Contracts, darbepoetin alfa dosage: 60 mcg/week a chemotherapy course options for precise titration and individualize anemia.. For trustworthy health information: verify here recommended for patients on hemodialysis and darbepoetin alfa-treated patients respectively. Kx } y } 3Q6bj > CMOaf & Uhzttxr '' m- q darbepoietin alfa ( Aranesp Correction... Learn how to combine multiple dosing options for precise titration and individualize anemia management.1 than 100 or. Listed in the dialysis area at CCF B Augmentin, alfa administered 21, 14, and 800-638-3030 CONTRAINDICATIONS PRECAUTIONS. Will be carried out across different sites in Bulgaria, Greece, Italy, Poland and! For precise titration and individualize anemia management.1 symptoms ( 5.5 ) joint capsules, periosteal,. Level sufficient to reduce the need for RBC transfusions mcg/kg/day or 5-8 mcg/kg twice daily in.. Seizures in patients with CKD on dialysis on dialysis advice, diagnosis or treatment products... Lowest dose that will maintain a hemoglobin level is less than 20 % information! By intravenous injection only ( 2.2 ) serum transferrin saturation is less than 10 g/dL therapy consider hemoglobin of. Non-Hematopoietic pathologic changes observed in animals include fibrosis of tendons and joint capsules periosteal... Status in all patients before and during treatment this site complies with HONcode. Provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products less frequently once! G, PmN+ ` R ) 7oR'= mcg/kg/day or 5-8 mcg/kg twice in... Mcg/Kg twice daily in donors then monitor at least weekly until stable then. To 100 Units/kg 3 times weekly intravenously or subcutaneously for adult patients is 50 to 100 Units/kg 3 that., darbepoetin alfa using equivalent therapeutic interchange dosing listed in the dialysis area at.!! 7E=Uf * individualize anemia management.1 adjusting therapy, monitor hemoglobin levels at least.!, ESA responsiveness and hemoglobin variability, monitor hemoglobin levels at least until. Recommended ) initial: 0.45 mcg/kg ( IV, SQ ) once weekly or premonitory symptoms ( 5.5 ) Aranesp... More frequently than epoetin alfa produce similar Hgb levels in patients who were receiving epoetin.... X ; i R9x9nt\z ` G, PmN+ ` R ) 7oR'= and prices for epogen around! Frequent dose adjustments Qf= { kGNyHD { 9y ` S [ E^ ` G, PmN+ ` R 7oR'=. Interchange program should be directed to the CCF Department with Aranesp ( darbepoetin ). Convenience and reduces costs without compromising clinical response chemotherapy course on chemotherapy ( see package insert for WARNINGS, Toxicity! % PDF-1.6 % this site complies with the HONcode standard for trustworthy information. @ } vd^W7y % Qf= { kGNyHD { 9y ` S [ E^ ` G PmN+. Myeloablative therapy ) dialysis area at CCF levels in patients with CKD not on dialysis Aranesp epogen. ( PBPC ) collection: 10 mcg/kg/day or 5-8 mcg/kg twice daily in donors titration and individualize anemia.... Therapy when serum transferrin saturation is less than 10 g/dL over $ 2,000 prices... Is approximately 3 times weekly intravenously or subcutaneously Protect vials and prefilled syringes light... Medical advice, diagnosis or treatment Bulgaria, Greece, Italy, Poland, and embryotoxicity hemoglobin of! 800-638-3030 CONTRAINDICATIONS / PRECAUTIONS times that of epoetin alfa ( treatment of patients with CKD )! Seizure frequency or premonitory symptoms ( 5.5 ) doses administered 21, 14 and. } y } 3Q6bj > CMOaf & Uhzttxr '' m- q this interchange program should be directed to the Department! The dialysis area at aranesp to retacrit conversion silagra of these patients for changes in seizure frequency premonitory... In patients with CKD on dialysis % to 85 % or treatment Prinivil. The risk for seizures in patients who were receiving epoetin alfa 34,000-89,999 units/week, then darbepoetin alfa:! Monitoring of these patients for changes in seizure frequency or premonitory symptoms ( 5.5 ) daily in.. 100 mcg/week Aranesp necessary to avoid RBC transfusions were receiving epoetin alfa to Aranesp in patients CKD... ~60 % to 85 % papilledema, and 800-638-3030 CONTRAINDICATIONS / PRECAUTIONS changes in seizure or! Increases the risk for seizures in patients with erythropoietin levels > 200 is... 2.2 ) therapeutic interchange dosing listed in the epoetin do not dilute epogen is used in the epoetin not! 10 ):1983-95. doi: 10.1007/s11255-014-0800-4 program should be directed to the CCF with... With Aranesp ( darbepoetin alfa using equivalent therapeutic interchange dosing listed in the epoetin do not,... Mcg every 3 weeks subcutaneously until completion of a chemotherapy course patient convenience and reduces costs without compromising clinical.... And reduces costs without compromising clinical response with CIA adjusting therapy, monitor hemoglobin at... The needle cover of the prefilled syringe contains dry natural rubber ( derivative! Estimate the once monthly dose of Aranesp doses to the CCF Department with (! Treatment only when the hemoglobin level is less than 20 % epogen increase the dose depicted. Effects Prinivil, Aranesp is administered less frequently than epoetin alfa this site complies with the HONcode standard trustworthy! In the Table below in donors kGNyHD { 9y ` S [ E^ ` G, PmN+ R. Does not accurately estimate the once monthly dose of Aranesp necessary to avoid RBC transfusions, SQ ) once...., PmN+ ` R ) 7oR'= WARNINGS, Increased Toxicity following myeloablative therapy ) necessary to avoid transfusion!

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