Overview
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- Treatment of anaemia associated with CKD
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- Hypersensitivity to the active substance or to any of the excipients
- Uncontrolled hypertension
- Patients who develop pure red cell aplasia (PRCA) following treatment with erythropoietin
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- Hypertension, Pure Red Cell Aplasia (PRCA; McCoy, 2008), headache, venous and arterial thrombosis, vascular access (fistula or graft) thrombosis
- Hb > 12 g/dl increased risk of cardiovascular events and death, CVA
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- As in normal renal function, not dialysed
- EPOETIN ALFA (EPREX)#3000 units#see prescribing section#IV#
Epoetin Alfa (Eprex®)
- Treatment of anaemia associated with CKD
- An Erythropoiesis-Stimulating Agent (ESA)
- Epoetin alfa injection = Eprex®, prefilled syringe 1000, 2000, 3000, 4000, 5000, 6000, 8000, 10000 units
- Hypersensitivity to the active substance or to any of the excipients
- Uncontrolled hypertension
- Patients who develop pure red cell aplasia (PRCA) following treatment with erythropoietin
- Monitor FBC (aim Haemoglobin 10-12 g/dl), avoid a sustained haemoglobin level of greater than 12 g/dl
- Monitor BP
- Ensure patients have sufficient iron stores. Keep ferritin >100 ng/ml and TSAT >20%
- Antibody-mediated pure red cell aplasia (PRCA) has been reported after months to years of subcutaneous epoetin treatment mainly in CKD patients
- Epoetin alfa is less effective when the patient is deficient in vitamin B12, during periods of infection or raised PTH
- Hypertension, Pure Red Cell Aplasia (PRCA; McCoy, 2008), headache, venous and arterial thrombosis, vascular access (fistula or graft) thrombosis
- Hb > 12 g/dl increased risk of cardiovascular events and death, CVA
- Correction phase: Eprex ®: 50 units/kg 2-3 times per week. Increase dose according to response every 4 weeks until target Hb is obtained. Then adjust dose to maintain required target Hb. Reduce dose if Hb rises too quickly or above target. Rise in Hb should not exceed 2 g/dl per month. The increase or reduction in dose should be of 25 IU/kg, 3 times per week
- Maintenance phase: Eprex ®: recommended total weekly dose is between 75 and 300 IU/kg
- When given IV, a higher dose is usually needed to produce the required response. The bioavailability of subcutaneous injectable Eprex ®, is approximately 20% lower than that of the intravenous drug
- Give injections IV if patient is on haemodialysis, SC for patients not on HD
- As in normal renal function, not dialysed
- If given with ACEi, increased risk of hyperkalaemia
- May affect ciclosporin and tacrolimus levels
EPOETIN ALFA (EPREX)#3000 units#see prescribing section#IV#
- Target Haemoglobin (Hb) = 10-12 g/dl
- Rotate the injection sites and inject slowly to avoid discomfort at the site of injection
- Store in the fridge
The information provided in this pdf is only a guideline. It should not be used as a basis for the diagnosis or treatment of any medical condition. Your patient may be different