Anemia associated to chronic renal failure, including both dialysis & pre-dialysis patients. Anemia in patients w/ non-myeloid malignancies where anemia is due to effect of concomitantly administered chemotherapy for at least 2 mth.
Chronic renal failure IV Initially 40 IU/kg 3 times wkly. SC Initially 20 IU/kg 3 times wkly. Patients on dialysis Administer as IV bolus. Maintenance dose: 60 IU/kg 3 times wkly. Cancer patients on chemotherapySC Initially 150 IU/kg 3 times wkly or 40,000 IU wkly. May be increased in 50 or 100 IU 3 times wkly & re-evaluate response after 4-8 wk if response is not satisfactory in terms of reducing transfusion requirements or increasing hematocrit after 8 wk of therapy. Max dose: Further increase from 50-100 IU is needed only up to 300 IU/kg, if needed.
Discontinue treatment if either unexplained loss of effect or pure red cell aplasia (PRCA) is suspected. Not a substitute for emergency transfusions. Preventive use is not recommended in patient w/ normal Hb levels at the beginning of treatment w/ chemotherapy &/or RT. Seizure. Increased incidence of thrombotic vascular reactions. Increased risk of tumoral progression or recurrence in patients w/ cancer. Fe deficiency; underlying infectious, inflammatory or malignant processes; loss of occult blood; underlying hematological diseases eg, thalassemia, refractory anemia or other myelodysplastic disorders; vit or folic acid deficiency; hemolysis; Al intoxication; cystic fibrous osteitis; secondary hyperparathyroidism. Ab-mediated PRCA in chronic renal failure patients & patients w/ hepatitis C treated concomitantly w/ interferon & ribavirin. Patients w/ porphyria. Control arterial HTN in patients w/ renal disease. May require increased anticoagulation during hemodialysis. Evaluate Fe stores including transferrin saturation & ferritin prior to therapy initiation. Determine hematocrit every wk until target value & maintenance dose are established. Pregnancy & lactation.
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