• Anemia associated with chronic renal failure:
    • Dialysis patients: SC/IV 0.6mcg/kg/dose every 2 weeks for ESA-naive patients
      • Initiate when Hb <10g/dL
      • When Hb ≥11g/dL, reduce or interrupt dose
      • Individualize dose SC/IV every 2-4 weeks
    • Non-dialysis patients: SC/IV 0.6mcg/kg/dose every 2 weeks for ESA-naive patients
      • For patients with Hb <10g/dL and when rate of decline indicates RBC transfusion need
      • Increase dose 25% if Hb <1g/dL every 4 weeks
      • May increase every 4 weeks
      • Do not increase dose further if inadequate response by 12 weeks
      • Decrease dose 25% if Hb response >1g/dL every 2 weeks
  • Switching patients currently on other ESA:
    • Receiving epoetin <8000units/week or darbepoetin <40mcg/week:
      • IV/SC 120mcg/month OR 60mcg/2 weeks
    • Receiving epoetin 8000-1600units/week or darbepoetin 40-80mcg/week:
      • IV/SC 200mcg/month OR 100mcg/2 weeks
    • Receiving epoetin >16000units/week or darbepoetin >80mcg/week:
      • IV/SC 360mcg/month or 180mcg/2 weeks
  • Injection:
    • 50mcg/0.3mL
    • 75mcg/0.3mL
    • 120mcg/0.3mL
  • DO NOT shake vigorously or prolong exposure to light
  • Not to be mixed with any parenteral solutions
  • Administer either IV/SC in adult patients and only IV in pediatric patients
  • SC administered in the abdomen, arm or thigh

Erythropoietin stimulating agents

In response to hypoxia, it stimulates erythroid progenitor division and differentiation

  • Hypertension
  • Diarrhea
  • URI symptoms
  • Headache
  • Muscle spasm
  • Hypotension
  • Edema
  • Vomiting
  • Back pain
  • Cough
  • Constipation
  • UTI
  • Extremity pain
  • Vascular access thrombosis
  • Uncontrolled hypertension
  • ESA-associated pure red cell aplasia
  • Chemo-associated anemia

WARNING

  • Increased risk of death and serious cardiovascular events when administered to target Hb >11g/dL
  • Erythropoiesis-stimulating agents (ESAs) increase the risk of the death, myocardial infarction, stroke and venous thromboembolism, thrombosis of vascular access and tumor progression or recurrence

None restricted

                          Drug Status

Availability Prescription only
Pregnancy Category C
Breastfeeding Weigh risk vs benefit
Schedule Not controlled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Mircera 50mcg/0.3mL Pre-filled Syringe 1’s F. Hoffman-La Roche Roche Kenya
Mircera 75mcg/0.3mL Pre-filled Syringe 1’s F. Hoffman-La Roche Roche Kenya
Mircera 120mcg/0.3mL Pre-filled Syringe 1’s F. Hoffman-La Roche Roche Kenya