Dosage/Direction for Use
Parenteral Anaemia of chronic renal failure Adult: Initially, 0.45 mcg/kg SC/IV once weekly. Alternatively, 0.75 mcg/kg every 2 weeks or 1.5 mcg/kg once monthly via SC inj in patients not on dialysis. Dose may be increased or decreased by 25% once every 4 weeks, according to Hb level. Maintenace dose: 0.45 mcg/kg SC/IV once weekly or once every 2 weeks. Titrate dose to maintain target Hb level. Child: Same as adult dose. Subcutaneous Anaemia in chemotherapy patients Adult: Initially, 500 mcg once every 3 weeks. Alternatively, 2.25 mcg/kg once weekly. Dose reduction up to 50%, dosing interruption, or discontinuation may be required according to Hb level (refer to detailed product guideline). Discontinue therapy approx 4 weeks after the end of chemotherapy. |
Contraindications
Hypersensitivity, uncontrolled hypertension.
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Special Precautions
Pregnancy and lactation, children. Hypertension; history of seizures; hepatic impairment; sickle cell anaemia; sudden stabing migraine-like pain (warning sign of hypotensive crisis); exclude other causes of anaemia; ischaemic vascular disease; thrombocytosis; epilepsy; malignant disease; increase in heparin dose may be needed; increased risk of thrombosis when used for anaemia before orthopedic surgery; CV disease including recent MI/cerebrovascular accident. Monitor haemoglobin, BP and electrolytes; platelet count for 1st 8 wk.
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Adverse Reactions
Hypertension, hypotension, chest pain, fatigue, fever, headache, dizziness, GI effects; myalgia, arthralgia, limb pain; skin reactions; shunt reactions, hyperkalaemia; dyspnea, cough, bronchitis; infection; transient increase in platelet count; influenza-like symptoms; peripheral oedema; Inj site pain.
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Overdosage
No overdosage symptoms reported so far as it has wide therapeutic margin. In the event of polycythaemia, treatment may be temporarily withheld. Phlebotomy may be performed if clinically indicated.
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Drug Interactions
Antagonism of hypotensive effect and increased risk of hyperkalemia with ACE inhibitors and angiotensin II receptor antagonists. Ethanol.
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Action
Darbepoetin alfa is a biosynthetic form of erythropoietin. It stimulates the division and differentiation of erythroid progenitor cells; reticulocytes are released from the bone marrow and matures into erythrocytes thereby regulating erythropoiesis.
Absorption: IM admin: Slow absorption and bioavailability is about 37%. Excretion: Terminal half-lives: 21 hr (IV admin) and 49 hr (SC admin). |
Storage
Parenteral: Store at 2-8°C. Subcutaneous: Store at 2-8°C.
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CIMS Class
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ATC Classification
B03XA02 - darbepoetin alfa ; Belongs to the class of other antianemic preparations.
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