Darbepoe

Details About Generic Salt ::  Darbepoe

Main Medicine Class::    

(dahr-bee-POE-eh-tin AL-fah)
Aranesp
Solution for injection
25 mcg/mL
Solution for injection
40 mcg/mL
Solution for injection
60 mcg/mL
Solution for injection
100 mcg/mL
Solution for injection
150 mcg/0.75 mL
Solution for injection
200 mcg/mL
Solution for injection
300 mcg/mL
Solution for injection
500 mcg/mL
Class: Recombinant human erythropoietin

 

Drugs Class ::

 Action Stimulates red blood cell production.

Indications for Drugs ::

 Indications Treatment of anemia associated with chronic renal failure, whether or not the patient is on dialysis. Treatment of anemia in patients with nonmyeloid malignancies where anemia is caused by coadministered chemotherapy.

Drug Dose ::

 Route/Dosage

Anemia Associated with Chronic Renal Failure Adults: IV/SC Initial dose 0.45 mcg/kg once weekly.

Maintenance: Individually titrate to a target hemoglobin not to exceed 12 g/dL.

Conversion from Epoetin Alfa Adults: IV/SC If weekly epoetin dose is less than 2500 units/wk, start with darbepoetin 6.25 mcg/wk; if weekly epoetin dose is 2500 to 4999 units/wk, start with darbepoetin 12.5 mcg/wk; if weekly epoetin dose is 5000 to 10,999 units/wk, start with darbepoetin 25 mcg/wk; if weekly epoetin dose is 11,000 to 17,999 units/wk, start with darbepoetin 40 mcg/wk; if weekly epoetin dose is 18,000 to 33,999 units/wk, start with darbepoetin 60 mcg/wk; if weekly epoetin dose is 34,000 to 89,999 units/wk, start with darbepoetin 100 mcg/wk; if weekly epoetin dose is greater than 90,000 units/wk, start with darbepoetin 200 mcg/wk.

Maintenance: Individually titrate to a target hemoglobin not to exceed 12 g/dL.

Dosage Adjustment Do not increase dose of darbepoetin alfa more frequently than once a month. If the hemoglobin is increasing and approaching 12 g/dL, reduce dose approximately 25%. If hemoglobin continues to increase, withhold doses temporarily until hemoglobin begins to decrease, then reinstate dose approximately 25% below the previous dose. If hemoglobin increases by more than 1 g/dL in a 2-wk period, decrease dose approximately 25%.

Cancer Patients Receiving Chemotherapy Adults: SC Initial dose: 2.25 mcg/kg/wk.

Maintenance: Individually titrate to achieve a target hemoglobin. If there is less than a 1 g/dL increase in hemoglobin after 6 wk of therapy, increase the dose up to 4.5 mcg/kg. If hemoglobin increases more than 1 g/dL in a 2-wk period or if the hemoglobin exceeds 12 g/dL, reduce the dose approximately 25%. If the hemoglobin exceeds 13 g/dL, temporarily withhold doses until the hemoglobin falls to 12 g/dL. Reinitiate therapy at a dose approximately 25% below the previous dose.

Contraindication ::

 Contraindications Uncontrolled hypertension; hypersensitivity to the active substance or the excipients.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Dialysis management: Increased red blood cell production and decreased plasma volume because of darbepoetin treatment may reduce dialysis efficiency; it may be necessary to adjust the dialysis prescription in patients who are marginally dialyzed. Hypersensitivity: Anaphylactic reactions, skin rashes, and urticaria may occur. Seizures: Seizures may occur; however, relationship to drug is uncertain.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CARDIOVASCULAR: Thrombosis, CHF; cardiac arrhythmias; hypertension; hypotension; cardiac arrest; angina pectoris; cardiac chest pain; stroke; acute MI; transient ischemic attack. CNS: Headache; dizziness; seizure. DERMATOLOGIC: Pruritus. GI: Diarrhea; nausea; vomiting; abdominal pain; constipation. RESPIRATORY: Upper respiratory tract infection; dyspnea; cough; bronchitis. OTHER: Sepsis; infection; myalgia; fever; chest pain; arthralgia; limb pain; back pain; peripheral edema; fatigue; injection site pain; fluid overload; access infection; flu-like symptoms; access hemorrhage; asthenia; death.

Drug Mode of Action ::  

 Action Stimulates red blood cell production.

Drug Interactions ::

 Interactions

None well documented.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note uncontrolled hypertension.
  • Ensure that BP is controlled in hypertensive patients before initiating therapy.
  • Ensure that hemoglobin is determined weekly until stable when initiating therapy or changing the dose.
  • Ensure that serum ferritin or transferrin saturation is determined before and during therapy.
  • Closely monitor BP during therapy. Report elevations in BP to health care provider.
  • Monitor patient for signs and symptoms of anaphylactic or serious allergic reactions. Be prepared to treat appropriately.
  • Assess patient for CV, CNS, GI, RESP, musculoskeletal, and general body side effects. Report to health care provider if noted and significant.
OVERDOSAGE: SIGNS & SYMPTOMS
  Polycythemia

Drug Storage/Management ::

 Administration/Storage

  • Do not shake or vigorously agitate medication vial to prevent inactivation of medication.
  • Do not administer if particulate matter, cloudiness, or discoloration are noted.
  • Withdraw prescribed dose into syringe for injection. Do not dilute solution.
  • Vials contain no preservative. Discard any unused portion. Do not combine unused portions.
  • Administer via IV or SC route only.
  • Do not administer in conjunction with other drug solutions.
  • Prescribed dose is administered once weekly.
  • Rotate SC injection sites.
  • Dose will be slowly adjusted based on hemoglobin levels.
  • Store vials in refrigerator (36° to 46°F). Do not freeze or shake. Protect from light.

Drug Notes ::

 Patient/Family Education

  • Explain name, dose, action, and potential side effects of drug. If patient or caregiver will be administering at home, review Information for Patients and Caregivers insert with the patient or caregiver. Ensure that the patient or caregiver understands how to store, prepare, and administer the dose, and dispose of used equipment and supplies.
  • Remind patient that injection is administered once a week.
  • Advise patient that dose will be adjusted based upon measured hemoglobin level.
  • Advise patient to continue to follow their dietary and dialysis prescriptions while taking this medication.
  • Advise patient to notify the health care provider immediately if any of the following occur: rash; hives; shortness of breath; swelling of the eyes, mouth, or throat; palpitations; severe headache; signs of infection (eg, fever, chills); swelling of feet or ankles; intolerable GI effects (eg, nausea, vomiting, diarrhea).
  • Instruct women to notify health care provider if pregnant, planning on becoming pregnant, or breastfeeding.
  • Instruct patient not to take any prescription or OTC medications or dietary supplements unless advised by the health care provider.
  • Remind patient that office visits and laboratory tests will be required to monitor therapy and to keep appointments.

Disclaimer ::

The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.

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