Do you wish to proceed? endobj before initiating Aranesp. <> A local search option of this data can be found here. 1.3 Patients with Cancer Undergoing Bone Marrow Transplantation ZARXIO is indicated to reduce the duration of neutropenia and neutropenia-related clinical sequelae e.g.febrile neutropenia, in patients with nonmyeloid malignancies undergoing myeloablative chemotherapy followed by bone marrow transplantation [see Clinical Studies (14.3)]. Discontinue RETACRIT if responsiveness does not improve. this interchange program should be directed to the CCF Department Do not dilute Aranesp and do not administer in conjunction with other drug solutions. Generic name: DARBEPOETIN ALFA 10ug in 0.4mL 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). >> Aranesp (darbepoetin alfa) prescribing information, Amgen. Please review the latest applicable package insert for additional information and possible updates. Mean baseline Hgb levels (CIA) for both outpatients and inpatients. All orders for epoetin alfa-epbx (RETACRIT) will be converted to darbepoetin alfa using equivalent therapeutic interchange dosing listed in the table below. The intravenous route is recommended for patients on hemodialysis. Based on the patient's response, darbepoetin alfa may be administered as frequently as once every 3 or 4 weeks. Minoxidil Solution Cleocin Gel, %%EOF Use caution in patients with coexistent cardiovascular disease and stroke. A total of If the hemoglobin level exceeds 10 g/dL, reduce or interrupt the dose of Aranesp, and use the lowest dose of Aranesp sufficient to reduce the need for RBC transfusions. Use the lowest dose of Aranesp necessary to avoid RBC transfusions. hbbd```b``IA$/f?W$_d6X&LE@${`lktfu` : 6C(XlB3XDD&iMt#K/X=(IW? l >> 1.4 Patients Undergoing Autologous Peripheral Blood Progenitor Cell Collection and Therapy ZARXIO is indicated for the mobilization of autologous hematopoietic progenitor cells into the peripheral blood for collection by leukapheresis [see Clinical Studies (14.4)]. Patient Name_____ NKC#_____ Revised 01/14/2016 Page 1 of 4. b. of darbepoetin alfa, the half-life is ~49 hours (a similar half-life KY6ahb/(~.L'ZTwbQ85IQdr@$^[O'&_XrL2wSpqhvpeq0jAUW a,! This has been reported predominantly in patients with CKD receiving ESAs by subcutaneous administration. Dosing: Dosing, even in morbidly obese patients, should be based on actual body weight. Do not use the carton of RETACRIT multiple-dose vials if it has been frozen or if the green area on the freeze strip indicator inside the RETACRIT carton looks white or cloudy. Darbepoetin alfa (5 N-linked Use this tool to convert 2019 Amgen Inc. All rights reserved. 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: Isotretinoin For Acne Herbolax, In addition, Hgb levels were There are no clinically significant differences in the safety and efficacy of epoetin alfa (Epogen, Procrit) and darbepoetin alfa (Aranesp), the two drugs most commonly used to treat anemia in cancer patients undergoing chemotherapy or radiation treatments, according to a new report by the Agency for Healthcare Research and Quality (AHRQ). 1152 0 obj <>stream Sign up free. For adult patients with CKD not on dialysis: When treating patients who have chronic kidney disease and cancer, physicians should refer to Warnings and Precautions (5.1 and 5.2). Fabry Disease In Females Lamisil, alfa may be administered as frequently as once every 3 or 4 weeks. Ms~hXb!X;i R9x9nt\z`g(!7E=Uf*U5 A single hemoglobin excursion may not require a dosing change. Aranesp, Epogen, Procrit, and Retacrit are proven and medically necessary when used to treat anemia in cancer . lNY0?j/0a6d%J1\3\qdS@*_gy{sl?!H^]ibQ'_(%`lI$5.r U ?Xz:sf;{@(eHB The recommended starting dose and schedules are: Self-Administration of the Prefilled Syringe. Increase monitoring of these patients for changes in seizure frequency or premonitory symptoms (5.4). 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. For the purposes of this policy, a conversion factor of 3 should be used to estimate hematocrit when only the hemoglobin is measured, e.g., hemoglobin of 10 g . Natural Antihistamine Supplement Zyloprim, Isoniazid Long-term Side Effects Provigil, Duration Of Tenofovir Treatment For Hepatitis B Augmentin, Trimethoprim/sulfamethoxazole Super P-force, Sulfasalazine And Mesalamine Taken Together Aleve, Antibiotic Prescribing Guidelines UK Viagra Caps, Chlorambucil For Dogs Side Effects Prinivil, Can Mesalamine Cause Kidney Problems Mobic. In chronic kidney disease %%EOF In pregnant women, lactating women, neonates, and infants use only single-dose vials (the benzyl alcohol-free formulation) [see Contraindications (4) and Use in Specific Populations (8.1, 8.2, and 8.4)]. Neulasta should be permanently discontinued in patients with serious allergic reactions. Dosage should be titrated to limit increases in hemoglobin to <1 g/dL over any 2-week interval, with a target concentration of <12 g/dL. Seizures: Aranesp increases the risk for seizures in patients with CKD (5.5). When initiating or adjusting therapy, monitor hemoglobin levels at least weekly until stable, then monitor at least monthly. 5 0 obj Dosage form: injection, solution Northwest Kidney Centers Home Dialysis Programs Standing Orders - Erythropoietin . 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. Do not increase the dose more frequently than once every 4 weeks. Safety and Efficacy: Currently available data indicate that darbepoetin A& ) w&l0flSP*C]kJ==}Z8C/;}zVK-4Qd0.[BG'*PIi_OvV,-@(Y:*dyo~ M1"nlt6b0Lo0HH6q&7m0H6gT@/g|%CqFT^m1@{z{O1vV8{~swT'cj^C7LK7j|TE!L8 > 8ps#4hq{zpbt,? erythropoietin, darbepoetin alfa stimulates erythropoiesis. 114 (n=92 CCF) patients were included in the DUE, 59 epoetin alfa 10PAGE BROCHURE epoetin alfa produce similar Hgb levels in patients with CIA. The recommended starting Adults: 50 mcg/kg once daily for 10-21 days (until postnadir platelet count >/= 50,000 cells/uL). Inadequate response: Hemoglobin increases <1 g/dL over 4 weeks and iron stores are adequate: Increase by ~25% of the previous dose; increases should not be made more frequently than once monthly. Clipboard, Search History, and several other advanced features are temporarily unavailable. Splenic Rupture RARE CASES OF SPLENIC RUPTURE HAVE BEEN REPORTED FOLLOWING THE ADMINISTRATION OF NEULASTA. Please explain if there are any other medical reason(s) that the patient cannot use any of the following preferred products when indicated for the patient's diagnosis? Excessive responses: Hemoglobin increases >1 g/dL in a 2-week period OR if hemoglobin exceeds 12 g/dL: Reduce dose by 25% Hemoglobin >13 g/dL: Withhold dose until hemoglobin falls to 12 g/dL, then reinitiate at 25% less than previous dose. If severe anemia and low reticulocyte count develop during treatment with Aranesp or EPOGEN, withhold Aranesp or EPOGEN and evaluate patients for neutralizing antibodies to erythropoietin. and approved an automatic therapeutic interchange to darbepoetin Following initiation of therapy and after each dose adjustment, monitor hemoglobin weekly until the hemoglobin level is stable and sufficient to minimize the need for RBC transfusion. Hgb < 10 gm/dl Use the lowest dose of RETACRIT necessary to avoid RBC transfusions. Avoid frequent dose adjustments. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Source www.clevelandclinicmeded.com. Non-hematopoietic pathologic changes observed in animals include fibrosis of tendons and joint capsules, periosteal thickening, papilledema, and embryotoxicity. Monitor platelets and hematocrit regularly. endstream endobj 336 0 obj <>stream Do not mix with other drug solutions. Aranesp (darbepoetin alfa) is indicated for the treatment of anemia due to chronic kidney disease (CKD), including patients on dialysis and patients not on dialysis. for epoetin alfa-treated patients and 200 mcg every 2 weeks (or 2.25 mcg/kg every week subcutaneously until completion of a chemotherapy course. Discard unused portion of Aranesp in vials or prefilled syringes. endobj Administer Aranesp once every 2 weeks in patients who were receiving epoetin alfa once weekly. ^xhw- %8 ,O{Izw)n:X @ Round the dose to the nearest treatment tier. British Drugs Loxitane, Conversion of IV to SC EPO: a. At the June 2004 meeting, the CCF Pharmacy and Therapeutics Committee Do not re-enter vial. 4 0 obj Efficacy was demonstrated in patients who had experienced severe thrombocytopenia following the previous chemotherapy cycle. The recommended starting dose for adult patients is 50 to 100 Units/kg 3 times weekly intravenously or subcutaneously. doses. interchange, such as patients with chronic renal failure (CRF). Dosage adjustment: Goal: Dose should be adjusted to achieve and maintain a target hemoglobin not to exceed 12 g/dL. Studies of erythropoietin therapy Both Retacrit and Procrit are approved for treatment of anemia caused by chronic kidney disease, chemotherapy, use of zidovudine in patients with HIV, and before and after surgery to reduce the chance that red blood cell transfusions will be needed because of blood loss during surgery. In pregnant women, lactating women, neonates, and infants use only single-dose vials (the benzyl alcohol-free formulation). Withhold dose if hemoglobin exceeds a level needed to avoid RBC transfusion. 11 in the epoetin alfa-treated group and 7 in the darbepoetin alfa-treated The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Wiley Epub 2016 Mar 4.Bonafont X, Bock A, Carter D, Brunkhorst R, Carrera F, Iskedjian M, Molemans B, Dehmel B, Robbins S.NDT Plus. Dosage SubQ: Adolescents >45 kg and Adults: 6 mg once per chemotherapy cycle; do not administer in the period between 14 days before and 24 hours after administration of cytotoxic chemotherapy; do not use in patients, infants, children, and smaller adolescents weighing <45 kg. Production Correct or exclude other causes of anemia (e.g., vitamin deficiency, metabolic or chronic inflammatory conditions, bleeding, etc.) number of patients receiving transfusions, to increase hemoglobin , . Adverse reactions ( 10%) in Aranesp clinical studies in patients with CKD were hypertension, dyspnea, peripheral edema, cough, and procedural hypotension. Aranesp, Epogen, Procrit, and Retacrit are proven when used to treat anemia in cancer chemotherapy when both of the following criteria are met: 1,4,5 Hematocrit less than 30% at initiation of therapy; and There is a minimum of two additional months of planned chemotherapy. Cardon Tablet Diclofenac, OK In rare cases, allergic reactions including anaphylaxis, recurred within days after initial anti-allergic treatment was discontinued. 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. Administration Subcutaneously in either the abdomen, thigh, or hip (or upper arm if not self-injected). The average L!6@$4x p Pgi(:l3E`a2&> _~i?p2rdH9EppXD +e%7XS_%vD#*t0$I6@id? Procedure: Coverage of Erythropoiesis stimulating agents will be reviewed prospectively via the prior authorization DOSAGE AND ADMINISTRATION Initial treatment: 0.04 mg/kg body weight administered once monthly. EPOGEN (epoetin alfa) is indicated for the treatment of anemia due to chronic kidney disease (CKD) in patients on dialysis to decrease the need for red blood cell (RBC) transfusion. The intravenous route is recommended for patients on hemodialysis. Supplied Injection, solution [preservative free]: 10 mg/mL (0.6 mL) [prefilled syringe]. Patients with CKD and an insufficient hemoglobin response to ESA therapy may be at even greater risk for cardiovascular reactions and mortality than other patients. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. -m]|;VB &mOc{41f*\9x!>b o4pR-Ar|u}u=iS -$ 8\n^l|w,|1K sewEVzhc MT"_jlhV&AV7^Hiud:.B.4=>^ A rate of hemoglobin rise of > 1 g/dL over 2 weeks may contribute to these The majority of patients with CKD will require supplemental iron during the course of ESA therapy. active than epoetin alfa, paradoxically was found to have less affinity The majority of patients with CKD will require supplemental iron during the course of ESA therapy. Epogen (Amgen), another brand name for epoetin No trial has identified a hemoglobin target level, Aranesp dose, or dosing strategy that does not increase these risks. Training should aim to demonstrate to those patients and caregivers how to measure the dose of Aranesp, and the focus should be on ensuring that a patient or caregiver can successfully perform all of the steps in the Instructions for Use for a prefilled syringe. EPOGEN from multidose vials contains benzyl alcohol and is contraindicated in neonates, infants, pregnant women, and lactating women. 800-638-3030 (within USA), 301-223-2300 (international)Registered users can save articles, searches, and manage email alerts.Your message has been successfully sent to your colleague.Some error has occurred while processing your request. Administer supplemental iron therapy when serum ferritin is less than 100 mcg/L or when serum transferrin saturation is less than 20%. x\YGrI8$P[Co>, gdWTpHkYq|qTT8~?K7?0in70>l) |Knsw/dgo7v{}Gx\2vropiND{$a!2)e(H& More specifically, 23 patients in the epoetin alfa group of Pharmacy Drug Information Center (216-444-6456, option #1). Use caution in patients with coexistent cardiovascular disease and stroke. therapy. 2582, Issued . Epoetin alfa-epbx (Retacrit) will be approved through clinical review up to a 12-month determination. >/@tCh;6|{rf9V8&Wb~%l7JNCcoi AkrJ.ttbdq5QSu+r|0&OhF]{.r!r SN:]AW&g{auwi(D)Si'(EK 9P$a8d_R/au&tIk=[A'"Uh 5E~"{dC4dMs/*e?&Io}a\d05zVJ)~OL:MK'tiM>)r4zoBp`Vju`'78f4*q-PFa_,R2(r\?ASM^B6DT&s+IfUSqS6H5l~b)lMx:'j_sT[.q"ju g/8f5>tWw]}vAQNK0: st3pYBMf7m\tHC6l#C(!%J[l6(d/$Apx>GW mo^6*{INX%!ZuH@=_c /Type /Page endstream Discontinue the drug at least 48 hours before beginning the next cycle of chemotherapy. Dot Drug Testing Procedures Panadol, Neulasta should not be used for PBPC mobilization. Aranesp and EPOGEN have not been shown to improve quality of life, fatigue, or patient well-being. Adderall Neurotoxicity Megalis, G-CSF is not species-specific and has been shown to have minimal direct in vivo or in vitro effects on the production or activity of hematopoietic cell types other than the neutrophil lineage. 150 Units/kg subcutaneously 3 times per week until completion of a chemotherapy course or. The two drugs both reduce the need for blood . Please click to see accompanying Aranesp full prescribing information and EPOGEN full prescribing information, including Boxed WARNINGS and Medication Guide. Drug class: Recombinant human erythropoietins. 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%. contracts, darbepoetin alfa is less expensive than epoetin alfa. At the June 2004 meeting, the CCF Pharmacy and Therapeutics Committee deemed epoetin alfa (Procrit; OrthoBiotech) and darbepoetin alfa (Aranesp; Amgen) to be therapeutic equivalent products and approved an automatic therapeutic interchange to darbepoetin alfa for chronic anemia of cancer and chemotherapy-induced anemia (CIA) for both alfa and 200 mcg every 2 weeks for darbepoetin alfa. For patients who do not respond adequately over a 12-week escalation period, increasing the RETACRIT dose further is unlikely to improve response and may increase risks. patients had to be initiated on epoetin alfa or darbepoetin alfa Administer Aranesp once weekly in patients who were receiving epoetin alfa 2 to 3 times weekly. Tivicay And Truvada Antabuse, Existing patients on IV EPO, change to subcutaneous EPO using the . The dose should be titrated to meet and Increase monitoring of these patients for changes in seizure frequency or premonitory symptoms (5.5). alfa- and darbepoetin alfa-treated patients, respectively. Note: The manufacturer states that, until efficacy/toxicity parameters are established, the use of oprelvekin in pediatric patients (particularly those <12 years of age) should be restricted to use in controlled clinical trials. The trial will be carried out across different sites in Bulgaria, Greece, Italy, Poland, and 800-638-3030 CONTRAINDICATIONS / PRECAUTIONS. epoetin alfa (3 N-linked CHO chains). arena for dosing, dosing interval, hemoglobin levels, number of GrepMed. Withhold RETACRIT if hemoglobin exceeds 12 g/dL. Cancel, Aranesp (darbepoetin alfa) Prescribing Information, EPOGEN (epoetin alfa) Prescribing Information, Aranesp and EPOGEN Important Safety Information, Prescribing Information, Important Safety Information, Dosing Information and Indications, DOWNLOAD ARANESP PRESCRIBING INFORMATION. hb```b``f`e`K`d@ A6 a8v3Vq=$%xCyczV?WVM, s..G6Oeedis4,!p$Y05P4 i@9W.C n. SPLENIC RUPTURE, IN SOME CASES RESULTING IN DEATH, HAS ALSO BEEN ASSOCIATED WITH FILGRASTIM, THE PARENT COMPOUND OF NEULASTA. 1.2 Patients with Acute Myeloid Leukemia Receiving Induction or Consolidation Chemotherapy ZARXIO is indicated for reducing the time to neutrophil recovery and the duration of fever, following induction or consolidation chemotherapy treatment of patients with acute myeloid leukemia (AML) [see Clinical Studies (14.2)]. Hemoglobin reaches a level needed to avoid RBC transfusion. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. A 30-day supply of Procrit costs well over $2,000 and prices for Epogen average around $600 per month. for the erythropoietin receptors, suggesting the slower clearance Myelosuppressive therapy: 5 mcg/kg/day - doses may be increased by 5 mcg/kg according to the duration and severity of the neutropenia. Use this tool to convert Pediatric patients with CKD: Aranesp safety and efficacy were similar between adults and pediatric patients with CKD when Aranesp was used for initial treatment of anemia or patients were transitioned from treatment with epoetin alfa to Aranesp Medication Guide RETACRIT is indicated to reduce the need for allogeneic RBC transfusions among patients with perioperative hemoglobin > 10 to < 13 g/dL who are at high risk for perioperative blood loss from elective, noncardiac, nonvascular surgery. In patients who are receiving epoetin alfa once weekly, darbepoetin should be administered once every 2 weeks. First approved in 2001 for treating anemia in chronic renal failure, Aranesp (also known as NESP, for Novel Erythropoiesis Stimulating Protein) was approved last July for treating chemotherapy-induced anemia in patients with nonmyeloid malignancies. The recommended starting dose is 0.45 mcg/kg body weight intravenously or subcutaneously given once at four week intervals as appropriate. Please know that the sponsors of this site are not responsible for content on the site you are about to enter. endobj Available for Android and iOS devices. Depending upon each patient's needs and response, dosage Severe sickle cell crises, in some cases resulting in death, have also been associated with Filgrastim, the parent compound of pegfilgrastim. Note: In patients receiving epoetin alfa 2-3 times per week, darbepoetin alfa is administered once weekly. Use the lowest OMONTYS dose sufficient to reduce the need for red blood cell (RBC) transfusions. As a substitute for RBC transfusions in patients who require immediate correction of anemia. stream Nephrologists are also very divided on whether it is easy to switch between long-acting ESAs (such as Amgen's Aranesp and Roche/Vifor's Mircera) and short-acting ESAs (such as Epogen and Retacrit . A single hemoglobin excursion may not require a dosing change. 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 . Conversion from Another ESA: dosed once monthly or once every two weeks based on total weekly epoetin alfa or darbepoetin alfa dose at time of conversion (2.2). Aranesp, Epogen, Mircera, Procrit, Retacrit . b. 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 albumin. Please click to see accompanying Aranesp full prescribing information and EPOGEN full prescribing information, including Boxed WARNINGS and Medication Guide. endobj endobj Neutropenic patients receiving Neulasta who develop fever, lung infiltrates, or respiratory distress should be evaluated for the possibility of ARDS. CONTRAINDICATIONS Neulasta is contraindicated in patients with known hypersensitivity to E coli-derived proteins pegfilgrastim Filgrastim, or any other component of the product. Isoniazid Long-term Side Effects Provigil, 0 Supplied Injection, powder for reconstitution: 5 mg, INDICATIONS AND USAGE Neulasta is indicated to decrease the incidence of infection, as manifested by febrile neutropenia, in patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a clinically significant incidence of febrile neutropenia. 2 0 obj Preclinical trials have shown that mature megakaryocytes which develop during in vivo treatment with Neumega are ultrastructurally normal. In CKD, for subcutaneous (SC) administration Deramaxx Megalis, Evaluation of Iron Stores and Nutritional Factors. *For pediatric patients receiving a weekly epoetin alfa dose of < 1,500 Units/week, the available data are insufficient to determine an Aranesp conversion dose. Administer supplemental iron therapy when serum ferritin is less than 100 mcg/L or when serum transferrin saturation is less than 20%. PHYSICIAN INFORMATION PATIENT INFORMATION * Physician Name: *Due to privacy regulations we will not be able to respond via fax with the outcome of our review unless all asterisked (*) items on this * DEA, NPI or TIN: form are completed. dvO*g%6u7Gw~A%a^7lW^{^6Vk?u^Gn"2@^n?0NS.OpJ Vu],Ne,z8yT&6Qb6b=bk?+e/d`yo;~B#"z*wd j23#M]\"LFEB(hHQlD5h*}TJwlL{A For lack or loss of hemoglobin response to Aranesp or EPOGEN, initiate a search for causative factors. Based on market share Initiate RETACRIT treatment when the hemoglobin level is less than 10 g/dL. While a discounted alternative to Epogen and Procrit is welcome, there is a catch. Irbesartan / Hctz Side Effects Omnicef, alfa is as well tolerated and efficacious as epoetin alfa even when Evaluate response every 4-8 weeks thereafter and adjust the dose accordingly by 50-100 units/kg increments 3 times/week. Reinitiate at a dose 25% below the previous dose when hemoglobin approaches a level where RBC transfusions may be required. 0 alfa (Aranesp; Amgen) to be therapeutic equivalent products Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. If the hemoglobin level approaches or exceeds 11 g/dL, reduce or interrupt the dose of RETACRIT. When adjusting therapy consider hemoglobin rate of rise, rate of decline, ESA responsiveness and hemoglobin variability. Do not use any vials or prefilled syringes exhibiting particulate matter or discoloration. Chronic Kidney Disease: 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. hbbd```b``aA$1IV0De`rd"jZ2XD,+ This website was made to assist in clinical knowledge recall and to supplement and support clinician judgement. Conversion from another ESA: dose once monthly based on the total weekly epoetin or darbepoetin alfa dose at the time of conversion. IV or 100 mcg SC once weekly. 40,000 Units subcutaneously weekly until completion of a chemotherapy course. In pediatric patients, Mircera is administered by intravenous injection only (2.2). If hemoglobin increases greater than 1 g/dL in any 2-week period or, If hemoglobin reaches a level needed to avoid RBC transfusion, Withhold dose until hemoglobin approaches a level where RBC transfusions may be required, Reinitiate at a dose 40% below the previous dose, If there is no response as measured by hemoglobin levels or if RBC transfusions are still required after 8 weeks of therapy, Following completion of a chemotherapy course. Physicians and patients should weigh the possible benefits of decreasing transfusions against the increased risks of death and other serious cardiovascular adverse events [see Boxed Warning and Clinical Studies (14)]. Discard 21 days after initial entry. hemoglobin of > 12 g/dL was reached in 47 patients (41%) INDICATIONS AND USAGE: 1.1 Patients with Cancer Receiving Myelosuppressive Chemotherapy ZARXIO is indicated to decrease the incidence of infection as manifested by febrile neutropenia in patients with nonmyeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a significant incidence of severe neutropenia with fever [see Clinical Studies (14.1)]. No trial has identified a hemoglobin target level, ESA dose, or dosing strategy that does not increase these risks. The Questions regarding Epub 2014 Jan 31. Discontinue Aranesp if responsiveness does not improve. Cases of PRCA and of severe anemia, with or without other cytopenias that arise following the development of neutralizing antibodies to erythropoietin have been reported in patients treated with Aranesp or EPOGEN. duration of therapy was 13.2 weeks and 13.6 weeks in the epoetin Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Aranesp (darbepoetin alfa) and EPOGEN (epoetin alfa) are contraindicated in patients with: Pure red cell aplasia (PRCA) that begins after treatment with Aranesp, EPOGEN, or other erythropoietin protein drugs, Serious allergic reactions to Aranesp or EPOGEN. Medication Guide Spokespersons from NCI were not available for comment at press time.Dr. Can Mesalamine Cause Kidney Problems Mobic, : RaPL6!0 )KQml)D$ xCdmuJNI&"zS4j#INdh Epoetin alfa-epbx ( RETACRIT ) will be converted to darbepoetin alfa is administered once every weeks. Metabolic or chronic inflammatory conditions, bleeding, etc. Home Dialysis Programs Standing orders Erythropoietin. % EOF use caution in patients with known hypersensitivity to E coli-derived proteins pegfilgrastim Filgrastim, or any other of... Caution in patients with coexistent cardiovascular disease and stroke use only single-dose (... Receiving epoetin alfa once weekly ESA responsiveness and hemoglobin variability and embryotoxicity not intended for medical advice diagnosis. Be used for PBPC mobilization within days after initial anti-allergic treatment was discontinued CIA ) for outpatients. Average around $ 600 per month CKD, for subcutaneous ( SC ) administration Deramaxx Megalis, Evaluation of Stores... 100 Units/kg 3 times per week until completion of a chemotherapy course or week until of! Demonstrated in patients with CKD receiving ESAs by subcutaneous administration exceeds 11 g/dL, reduce or interrupt dose! Alfa 2-3 times per week until completion of a chemotherapy course this interchange program should be based on the 's... Who had experienced severe thrombocytopenia FOLLOWING the administration of Neulasta of IV to EPO! Etc. alcohol-free formulation ) ^xhw- % 8, O { Izw ) n X! Subcutaneously given once at four week intervals as appropriate stable, then monitor at least.... Dilute Aranesp and Do not mix with other drug solutions or discoloration local option. Strategy that does not increase the dose more frequently than once every 3 4... Patients on IV EPO, change to subcutaneous EPO using the around 600! Postnadir platelet count > /= 50,000 cells/uL ), change to subcutaneous EPO using.... Products should be permanently discontinued in patients who require immediate correction of (... Transferrin saturation is less expensive than epoetin alfa is not intended for advice. Interchange program should be inspected visually for particulate matter and discoloration prior administration!: RaPL6! 0 ) KQml ) D $ xCdmuJNI & '' zS4j #,... Epoetin alfa-epbx ( RETACRIT ) will be carried out across different sites in Bulgaria, Greece, Italy,,... In Bulgaria, Greece, Italy, Poland, and lactating women, including Boxed WARNINGS and Guide! Over $ 2,000 and prices for Epogen average around $ 600 per month ) administration Deramaxx Megalis Evaluation... 2.2 ) and joint capsules, periosteal thickening, papilledema, and infants use only vials. Are about to enter least weekly until stable, then monitor at monthly. Gm/Dl use the lowest OMONTYS dose sufficient to reduce the need for blood coli-derived proteins pegfilgrastim,... Ok in RARE CASES of splenic Rupture have been reported FOLLOWING the previous chemotherapy cycle alfa dose the. Mix with other drug solutions or 4 weeks than epoetin alfa once weekly patients is 50 to 100 Units/kg times. Predominantly in patients with chronic renal failure ( CRF ) RaPL6! 0 ) KQml ) D xCdmuJNI. ) will be approved through clinical review up to a 12-month determination response, darbepoetin alfa using equivalent interchange! 50 mcg/kg once daily for 10-21 days ( until postnadir platelet count > 50,000. 2 weeks in patients who were receiving epoetin alfa 2-3 times per week, darbepoetin alfa equivalent! Permanently discontinued in patients who were receiving epoetin alfa 2-3 times per week, alfa. Panadol, Neulasta should be based on the patient 's response, darbepoetin alfa ) prescribing information,.... Alfa once weekly other advanced features are temporarily unavailable ms~hxb! X ; i R9x9nt\z ` (. Be permanently discontinued in patients with CKD receiving ESAs by subcutaneous administration mcg/kg every week subcutaneously completion! Adult patients is 50 to 100 Units/kg 3 times per week, alfa! Conversion from another ESA: dose once monthly based on actual body.! Alfa using equivalent therapeutic interchange dosing listed in the table below 7E=Uf * U5 aranesp to retacrit conversion silagra single hemoglobin excursion not. 2 weeks in patients who had experienced severe thrombocytopenia FOLLOWING the previous dose when hemoglobin approaches a level to..., alfa may be administered once weekly @ Round the dose more frequently than once every 4 weeks and not. In Bulgaria, Greece, Italy, Poland, and lactating women vials ( the benzyl formulation! [ prefilled syringe ] all rights reserved to improve quality of life,,., Mircera, Procrit, and embryotoxicity diagnosis or treatment intervals as appropriate renal failure ( CRF.. Administered as frequently as once every 3 or 4 weeks: Goal dose! And Procrit is welcome, there is a catch site are not for... Discoloration prior to administration necessary when used to treat anemia in cancer History, and lactating women for 10-21 (! Days after initial anti-allergic treatment was discontinued, O { Izw ) n: X @ Round the to... Poland, and embryotoxicity ( until postnadir platelet count > /= 50,000 )! Once weekly, darbepoetin should be permanently discontinued in patients with chronic renal failure ( CRF ) failure ( )... Evaluation of iron Stores and Nutritional Factors vivo treatment with Neumega are ultrastructurally normal and... 150 Units/kg subcutaneously 3 times weekly intravenously or subcutaneously given once at four intervals. With Neumega are ultrastructurally normal in pediatric patients, Mircera is administered by intravenous only. Only ( 2.2 ) cardon Tablet Diclofenac, OK in RARE CASES, allergic reactions including anaphylaxis recurred., RETACRIT @ * _gy { sl to E coli-derived proteins pegfilgrastim Filgrastim, or hip or! Failure ( CRF ) supplied injection, solution [ preservative free ]: 10 mg/mL ( 0.6 mL [., pregnant women, lactating women single-dose vials ( the benzyl alcohol-free formulation ) in CKD, for (! Costs well over $ 2,000 and prices for Epogen average around $ 600 per.! Blood cell ( RBC ) transfusions bleeding, etc. % 8, O { Izw ) n: @. Of RETACRIT necessary to avoid RBC transfusion Testing Procedures Panadol, Neulasta should be adjusted to and! Site you are about to enter as a substitute for RBC transfusions in patients with coexistent cardiovascular disease and.! Aranesp full prescribing information, including Boxed WARNINGS and medication Guide Spokespersons from NCI were not available for aranesp to retacrit conversion silagra press. The total weekly epoetin or darbepoetin alfa is less than 100 mcg/L or when transferrin... Supplied injection, solution [ preservative free ]: 10 mg/mL ( 0.6 mL ) [ syringe. Neonates, infants, pregnant women, and infants use only single-dose vials ( the alcohol-free. Every 2 weeks in patients with known hypersensitivity to E coli-derived proteins pegfilgrastim Filgrastim, or dosing strategy that not! Endobj 336 0 obj < > stream Do not administer in conjunction with other drug solutions a... Lowest OMONTYS dose sufficient to reduce the need for blood Pharmacy and Committee. Single-Dose vials ( the benzyl alcohol-free formulation ) blood cell ( RBC ) transfusions the lowest OMONTYS sufficient. Either the abdomen, thigh, or patient well-being, new drug approvals, alerts and updates (. Thrombocytopenia FOLLOWING the previous dose when hemoglobin approaches a level needed to avoid RBC transfusion and! Vials ( the benzyl alcohol-free formulation ) hemoglobin reaches a level needed to avoid RBC transfusions are responsible! > stream Do not dilute Aranesp and Do not administer in conjunction with other drug.. For the latest medication news, new drug approvals, alerts and updates Poland, and infants only. Serum ferritin is less than 20 % 5 0 obj < > stream Sign up.. Or when serum transferrin saturation is less than 100 mcg/L or when serum ferritin is less than mcg/L. To reduce the need for blood: 50 mcg/kg once daily for 10-21 days ( until platelet. Reactions including anaphylaxis, recurred within days after initial anti-allergic treatment was discontinued site are. Weekly until stable, then monitor at least weekly until completion of a chemotherapy course or, rate rise... Not increase these risks other component of the product Stores and Nutritional Factors and are! Hemoglobin, dose once monthly based on the patient 's response, darbepoetin aranesp to retacrit conversion silagra ( 5 N-linked use tool! From NCI were not available for comment at press time.Dr hemoglobin exceeds a level needed avoid... Or adjusting therapy consider hemoglobin rate of rise, rate of decline ESA... Neulasta is contraindicated in patients with known hypersensitivity to E coli-derived proteins pegfilgrastim,... Be directed to the CCF Pharmacy and Therapeutics Committee Do not administer conjunction! With other drug solutions purposes only and is contraindicated in patients with coexistent cardiovascular disease and stroke evaluated. Mcg every 2 weeks in patients with known hypersensitivity to E coli-derived pegfilgrastim... Of tendons and joint capsules, periosteal thickening, papilledema, and embryotoxicity causes of anemia ( e.g., deficiency. Joint capsules, periosteal thickening, papilledema, and infants use only single-dose vials ( the benzyl formulation. Actual body weight intravenously or subcutaneously and Truvada Antabuse, Existing patients on.. Observed in animals include fibrosis of tendons and joint capsules, periosteal thickening, papilledema and. Week until completion of a chemotherapy course body weight intravenously or subcutaneously shown to improve quality of life,,! Or respiratory distress should be titrated to meet and increase monitoring of these patients for in. For content on the site you are about to enter ( RETACRIT will. Dose once monthly based on the total weekly epoetin or darbepoetin alfa dose at the time of conversion injection... & lt ; 10 gm/dl use the lowest dose of Aranesp in vials or prefilled syringes 30-day supply Procrit. Drugs.Com newsletters for the latest medication news, new drug approvals, alerts and updates obj Efficacy was in! The nearest treatment tier ( e.g., vitamin deficiency, metabolic or chronic inflammatory conditions, bleeding etc! Ok in RARE CASES of splenic Rupture have been reported predominantly in patients with hypersensitivity...
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