• CKD-associated anemia:
    • On haemodialysis: Initially IV/SC 50 units/kg 3 times a week
      • Adjusted by 25 units/kg 3 times a week according to response at intervals of at least 4 weeks
      • Maintenance: 75-300 units/kg once weekly
    • On peritoneal dialysis: Initially 50 units/kg twice weekly
      • Maintenance 25-50 units/kg twice weekly
      • IV route preferred, to be given over 1-5 minutes
    • Not on dialysis: Initially 50 units/kg 3 times a week
      • Adjusted by 25 units/kg 3 times a week according to response at intervals of at least 4 weeks
      • Maintenance 17-33 units/kg 3 times a week
      • Max per dose 200 units/kg 3 times a week
    • SC max 1mL per injection site
    • Maintenance dose given as a single dose or in divided doses
    • Reduce dose by approx 25% if rise in Hb >2g/100mL over 4 weeks or 12g/100mL
    • Stop treatment if Hb continues to rise until it decreases and then restart at a dose approximately 25% lower than the previous dose
  • Zidovudine-related anemia for patients with endogenous EPO levels <500 milliunits/mL and zidovudine dose <4200 mg/week: Initially IV/SC 100 units/kg IV/SC 3 times weekly
    • Max: 300 units/kg/dose 3 times weekly
    • If Hb does not increase after 8 weeks, increase dose by 50-100 units/kg every 4-8 weeks until Hb reaches level sufficient to avoid RBC transfusions
    • Alternatively, administer 300 units/kg
    • If Hb >12g/dL, withhold dose and resume therapy at a dose 25% below the previous dose when Hb declines to <11g/dL
    • If no Hb increase is achieved at a dose of 300 units/kg for 8 weeks, discontinue dose
  • Chemotherapy-related anemia: Initially SC 150 units/kg 3 times a week OR 450 units/kg once weekly increased to 300 units/kg 3 times a week
    • Increased if appropriate rise in Hb (or reticulocyte count)not achieved after 4 weeks
    • Discontinue if inadequate response after 4 weeks at higher dose
    • SC max 1mL per injection site
    • Maintenance dose given as a single dose or in divided doses
    • Reduce dose by approx 25% if rise in Hb >2g/100mL over 4 weeks or 12g/100mL
    • Stop treatment if Hb continues to rise until it decreases and then restart at a dose approximately 25% lower than the previous dose
    • Discontinue approximately 4 weeks after ending chemotherapy
  • Reduction of allogeneic red blood cell transfusions in patients undergoing elective, noncardiac or nonvascular surgery with perioperative Hb >10g/dL but ≤13 g/dL who are at high risk for perioperative blood loss: SC 300 units/kg OD *15/7 (10 days preceding surgery, day of surgery, 4 days following surgery)  OR SC 600 units/kg in 4 doses administered 21, 14 and 7 days before surgery and on day of surgery
    • Concomitant DVT prophylaxis is recommended
  • Injection:
    • 2,000 IU
    • 4,000 IU
    • 10,000 IU
  • Administer by direct injection without dilution
  • Do not mix with other drugs
  • Vigorous shaking may denature the drug

Hematopoietic Growth Factors

It stimulates erythropoiesis via division & differentation of progenitor cells in the bone marrow to induce the release of reticulocytes into the bloodstream to become erythrocytes

  • Hypertension
  • Headache
  • Arthralgia
  • Tachycardia
  • Nausea
  • Diarrhea
  • Fever
  • Vomiting
  • Vascular access thrombosis
  • Dyspnea
  • Edema
  • Rash
  • Dizziness
  • Fatigue
  • Asthenia
  • Paresthesia
  • Cough
  • Congestion
  • Hypersensitivity to epoetin alfa or albumin or mammalian cell-derived products
  • Cancer patients whose anemia is caused by factors other than chemotherapy
  • Uncontrolled hypertension
  • Pure red-cell aplasia that begins after treatment with any EPO drugs
  • Use of multidose vials containing benzyl alcohol in neonates, infants, pregnant or nursing females

WARNING:

  • Increased risk of death and serious cardiovascular events when administered to target Hb >11 g/dL
  • Erythropoiesis-Stimulating Agents (ESAs) shortened overall survival and/or increased the risk of tumor progression in some clinical studies in patients with breast, head and neck, lymphoid, non-small cell lung and cervical cancers

None restricted

                          Drug Status

Availability Prescription only
Pregnancy Avoid using benzyl alcohol-containing forms, otherwise benefits outweigh risks
Breastfeeding Avoid using benzyl alcohol-containing forms, otherwise benefits outweigh risks
Schedule Not controlled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Cadicrit 4,000 IU Injection 1’s Cadila Pharm Cadila Pharm
Cadicrit 2,000 IU Injection 1’s Cadila Pharm Cadila Pharm
Epofit 2,000 IU Injection 1’s Intas Pharma Accord Healthcare
Epofit 4,000 IU Injection 1’s Intas Pharma Accord Healthcare
Epon 2,000 IU Injection 1’s Shandong Kexing Crown Healthcare
Epotin 4,000 IU Injection 1’s Julphar Pharma Pharmamed Solution
Epotin 2,000 IU Injection 1’s Julphar Pharma Pharmamed Solution
Eprex Protecs 2,000 IU/0.5mL Pre-Filled Syringe 6’s Janssen-Cilag Phillips Therapeutics
Eprex Protecs 4,000 IU/0.4mL Pre-Filled Syringe 6’s Janssen-Cilag Phillips Therapeutics
Eprex Protecs 10,000 IU/0.5mL Pre-Filled Syringe 6’s Janssen-Cilag Phillips Therapeutics
Hemax 2,000 IU Injection 1’s Cosmos Ltd Cosmos Ltd
Hemax 3,000 IU Injection 1’s Cosmos Ltd Cosmos Ltd
Hemax 4,000 IU Injection 1’s Cosmos Ltd Cosmos Ltd
Recormon 2,000 IU Pre-Filled Syringe 6’s F. Hoffman-La Roche Roche Kenya
Recormon 5,000 IU Pre-Filled Syringe 6’s F. Hoffman-La Roche Roche Kenya
Relipoietin 2,000 IU Pre-Filled Syringe 1’s Galaxy Pharma Galaxy Pharma
Relipoietin 4,000 IU Pre-Filled Syringe 1’s Galaxy Pharma Galaxy Pharma
Repoitin 4000 IU/0.5 mL Injection 1’s Serum Institute of India Sai Pharma
Repoitin 2000 IU/0.5 mL Injection 1’s Serum Institute of India Sai Pharma
Vintor 2,000 IU/mL Pre-Filled Syringe 1’s Emcure Pharma Lazor Pharma
Vintor 4,000 IU/mL Pre-Filled Syringe 1’s Emcure Pharma Lazor Pharma
Vintor 4,000 IU/mL Pre-Filled Syringe 1’s Centaur Pharma Lazor Pharma
Wepox 2,000 IU Pre-Filled Syringe 1’s Wockhardt Ltd Pharma Specialities
Wepox 4,000 IU Pre-Filled Syringe 1’s Wockhardt Ltd Pharma Specialities