Aranesp Dosing and Conversion Brochure. May 15, 2018. Dosage adjustment: Goal: Dose should be adjusted to achieve and maintain a target hemoglobin not to exceed 12 g/dL. Correct or exclude other causes of anemia (e.g., vitamin deficiency, metabolic or chronic inflammatory conditions, bleeding, etc.) of darbepoetin alfa, the half-life is ~49 hours (a similar half-life
Hgb level. Dose adjustment: If response is not satisfactory after a sufficient period of evaluation (8 weeks of 3 times/week and 4 weeks of once weekly therapy), the dose may be increased every 4 weeks (or longer) up to 300 units/kg 3 times/week, or when dosed weekly, increased all at once to 60,000 units weekly. 3 0 obj
patients had to be initiated on epoetin alfa or darbepoetin alfa
If typical causes of lack or loss of hemoglobin response are excluded, evaluate for PRCA. k22atr
!h~h[={;X)Sr;:2{+S&x~tlgth6_'N'F?%2 @obXCC 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). 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 . Correct or exclude other causes of anemia (eg, vitamin deficiency, metabolic or chronic inflammatory conditions, bleeding, etc) before initiating RETACRIT. 4y\@:hT4\j
EvZ%fN1gtL|;`,% \ZPrC|.CtI8K,f^f#.PJ#|CZx~igq\jA@PPq. The site is secure. Rounding doses to the nearest vial size often enhances patient convenience and reduces costs without compromising clinical response. A brochure to help you understand how to dose and administer Aranesp, and to convert from epoetin alfa to Aranesp in patients with anemia due to CKD. Table 1. Advise patients to contact their healthcare practitioner for new-onset seizures, premonitory symptoms or change in seizure frequency, For lack or loss of hemoglobin response to RETACRIT, initiate a search for causative factors (eg, iron deficiency, infection, inflammation, bleeding). RETACRIT safely and effectively. If the hemoglobin level approaches or exceeds 11 g/dL, reduce or interrupt the dose of Aranesp. Check out recent approvals at the OCEs podcast, Drug Information Soundcast in Clinical Oncology. For patients who do not respond adequately, if the hemoglobin has not increased by more than 1 g/dL after 4 weeks of therapy, increase the dose by 25%. Aranesp, Epogen, Procrit, and Retacrit are proven and medically necessary to treat anemia associated with myelodysplastic syndromes when the following criteria are met: 2, 3,8,9,32,46 . Estimated Aranesp Starting Doses (mcg/week) for Patients with CKD on Dialysis Based on Previous Epoetin alfa Dose (Units/week), Previous Weekly Epoetin alfa Dose (Units/week). AZT-treated, HIV infected patients: 100 units/kg IV/SC 3 times/week x 8 weeks. INDICATIONS AND USAGE Neumega is indicated for the prevention of severe thrombocytopenia and the reduction of the need for platelet transfusions following myelosuppressive chemotherapy in adult patients with nonmyeloid malignancies who are at high risk of severe thrombocytopenia. Inadequate response: Hemoglobin increases <1 g/dL over 4 weeks . In the near future, the Pharmacy and Therapeutics
The recommended starting
The gasping syndrome is characterized by central nervous system depression, metabolic acidosis, and gasping respirations. or 100 mcg SC once weekly. alfa and 200 mcg every 2 weeks for darbepoetin alfa. Please review the latest applicable package insert for additional information and possible updates. 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. Epub 2005 Dec 6. The average
alfa. If patient does not respond, a response to higher doses is unlikely. Slowly push the plunger up to force the air bubbles out of the syringe. Wien Med Wochenschr. Decreases in dose can occur more frequently. Aranesp is administered less frequently than epoetin alfa. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. EPOETIN ALFA-EPBX, BIOSIMILAR, (RETACRIT) (FOR NON-ESRD USE), 1000 . Darbepoetin's T1/2 is approximately 3 times that of epoetin alfa. MeSH Coverage Limitations Treatment with Darbepoetin alfa (Aranesp), Epoetin alfa (Procrit), Epoetin alfa (Epogen), and Epoetin alfa-epbx (Retacrit) is not considered medically necessary for members with the following concomitant conditions: What is/was your patient's PRETREATMENT hemoglobin level (g/dL) [prior to use of epoetin (Aranesp, Epogen, Mircera, Procrit, Retacrit)]? 2017 Jun 30;4:2054358117716461. doi: 10.1177/2054358117716461. The dose should be titrated to meet and
Beneficial dose conversion after switching from higher doses of shorter-acting erythropoiesis-stimulating agents to C.E.R.A in CKD patients in clinical practice: MINERVA Study. The
Avoid frequent dose adjustments. Internal Data: A retrospective drug use evaluation (DUE) was conducted
Refer to Table 1. Maintain the route of administration (intravenous or subcutaneous injection). The implementation date for the interchange program is October 11, 2004. On May 15, 2018, the Food and Drug Administration approved Retacrit (epoetin alfa-epbx, Hospira Inc., a subsidiary of Pfizer Inc.) as a biosimilar to Epogen/Procrit (epoetin alfa, Amgen Inc.) for the treatment of anemia due to chronic kidney disease (CKD) in patients on dialysis and not on dialysis, use of zidovudine in patients with HIV infection, and the effects of concomitant myelosuppressive chemotherapy. Zhang L, Coombes J, Pascoe EM, Badve SV, Dalziel K, Cass A, Clarke P, Ferrari P, McDonald SP, Morrish AT, Pedagogos E, Perkovic V, Reidlinger D, Scaria A, Walker R, Vergara LA, Hawley CM, Johnson DW, On Behalf Of The Hero Study Collaborative Group. Discontinue the drug at least 48 hours before beginning the next cycle of chemotherapy. IV
7/2021: added Epogen (nonformulary). Platelets produced in response to Neumega were morphologically and functionally normal and possessed a normal life span. Mechanism of Action: Colony-stimulating factors are glycoproteins which act on hematopoietic cells by binding to specific cell surface receptors and stimulating proliferation differentiation commitment and some end-cell functional activation. The initial conversion factor of 210 units/microg rose to 275 units/microg (P = 0.01) at month 4. 2 0 obj
Stop dose if hemoglobin exceeds 13 g/dl and resume treatment at a 25% dose reduction when hemoglobin drops to 12 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. 1022 0 obj In addition, Hgb levels were
Do not mix with other drug solutions. Severe sickle cell crises, in some cases resulting in death, have also been associated with Filgrastim, the parent compound of pegfilgrastim. Conversion from Another ESA: dosed once every 4 weeks based on total An official website of the United States government. Previous dosage of epoetin alfa: 18,000-33,999 units/week,then darbepoetin alfa dosage: 60 mcg/week. Correction of anemia associated with cancer patients receiving chemotherapy: Initial: 2.25 mcg/kg SQ once weekly. This site needs JavaScript to work properly. number of patients receiving transfusions, to increase hemoglobin
VII, No. Darbepoetin alfa (5 N-linked
active than epoetin alfa, paradoxically was found to have less affinity
114 (n=92 CCF) patients were included in the DUE, 59 epoetin alfa
The information provided is for educational purposes only. Allergic Reactions Allergic reactions to Neulasta, including anaphylaxis, skin rash, and urticaria, have been reported in postmarketing experience. Although these images are curated, as they are sourced from the community, there is no way to guarantee a consistent standard of accuracy and quality across the library of images. alfa (Aranesp; Amgen) to be therapeutic equivalent products
Please enable it to take advantage of the complete set of features! The most frequent dosing regimens were 40,000 units weekly
Keep the tip of the needle in the RETACRIT liquid. objective of the DUE was to trend usage patterns in the outpatient
In patients who are receiving epoetin alfa once weekly, darbepoetin should be administered once every 2 weeks. Initiate Aranesp treatment when the hemoglobin level is less than 10 g/dL. Supplied Injection, solution [preservative free]: 10 mg/mL (0.6 mL) [prefilled syringe]. The most common side effects of epoetin alfa-treated patients in clinical studies of the reference product were high blood pressure, joint pain, muscle spasm, fever, dizziness, medical device malfunction, blood vessel blockage, respiratory infection, cough, rash, injection site irritation, nausea, vomiting, muscle pain, inflammation of the mouth and lips, weight decrease, reduction in white blood cells, bone pain, high blood sugar, insomnia, headache, depression, difficulty swallowing, low blood potassium, blood clots, itching, headache, injection site pain and chills. Use caution in patients with coexistent cardiovascular disease and stroke. Monitoring Parameters Complete blood count and platelet count should be obtained prior to chemotherapy. Committee will be exploring other patient populations for this
epoetin alfa and darbepoetin alfa for the management of CIA. 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. doses. The needle cover of the prefilled syringe contains dry natural rubber (a derivative of latex), which may cause allergic reactions. Federal government websites often end in .gov or .mil. RETACRIT (epoetin alfa-epbx) is biosimilar* to EPOGEN/PROCRIT (epoetin alfa) WARNING: ESAs INCREASE THE RISK OF DEATH, MYOCARDIAL INFARCTION, STROKE . epoetin alfa (3 N-linked CHO chains). (CIA) for both outpatients and inpatients. %PDF-1.6
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