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Sickle Cell Anemia

Updated : April 19, 2023



Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

voxelotor 

Administer 1500mg orally every day
Hydroxyurea can be used along if needed



Dose Adjustments

Renal impairment: No dosage adjustment is necessary
Hepatic impairment:
Mild to moderate: No dosage adjustment necessary (Child A pugh or B)
Severe: Reduce to 1000 mg every day or 900 mg oral suspension orally every day (Child-Pugh C)

CYP3A4 inducers
Avoid administering CYP3A4 inducers in combination, whether they are strong or mild.
Increase dosage to 2500 mg orally once a day for strong CYP3A4 inducers.
Increase to 2,000 mg orally every day for moderate CYP3A4 inducers.

lovotibeglogene autotemcel (FDA Approval Pending) 

FDA Approval Pending as one-time gene therapy for sickle cell disease in patients aged ≥12 years



hydroxycarbamide 

According to response and blood count, the Initial dose of 15 mg/kg orally daily by 2.5 to 5 mg/kg every 12 weeks. Usual dosage: 15 to 30 mg/kg every day. Maximum dose: 35 mg/kg daily



Dose Adjustments

Dosing modifications
Renal impairment: CrCl less than 60 ml/min: 7.5 mg/kg daily, titrate based on the response
Hepatic impairment: Severe (Child-Pugh score C): Contraindicated

 

hydroxyurea

initial dose :

20

mg/kg

Orally

once a day

Increase 5 mg per kg per day every eight weeks depending on the severity <>br maximum dose: 35 mg/kg per day
The blood counts need to be monitored



voxelotor 


<4 years: Safety and efficacy not established
>12 years: Administer 1500mg orally every day
4 to 11 years:
10 to <20 kg: 600mg orally every day
20 to <40kg: 900mg orally every day
≥40kg: 1500mg orally every day



Dose Adjustments


Renal impairment: No dosage adjustment is necessary
Hepatic impairment:
Mild to moderate: No dosage adjustment necessary (Child A pugh or B)
Severe: Reduce to 1000 mg orally every day or 900 mg oral suspension orally every day (Child-Pugh C)
20 kg to <40kg: Reduce the dose to 600mg orally every day
10 kg to <20kg: Reduce the dosage to 300mg orally every day

lovotibeglogene autotemcel (FDA Approval Pending) 

FDA Approval Pending as one-time gene therapy for sickle cell disease in patients aged ≥12 years



 

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Sickle Cell Anemia

Updated : April 19, 2023


voxelotor 

Administer 1500mg orally every day
Hydroxyurea can be used along if needed



Dose Adjustments

Renal impairment: No dosage adjustment is necessary
Hepatic impairment:
Mild to moderate: No dosage adjustment necessary (Child A pugh or B)
Severe: Reduce to 1000 mg every day or 900 mg oral suspension orally every day (Child-Pugh C)

CYP3A4 inducers
Avoid administering CYP3A4 inducers in combination, whether they are strong or mild.
Increase dosage to 2500 mg orally once a day for strong CYP3A4 inducers.
Increase to 2,000 mg orally every day for moderate CYP3A4 inducers.

lovotibeglogene autotemcel (FDA Approval Pending) 

FDA Approval Pending as one-time gene therapy for sickle cell disease in patients aged ≥12 years



hydroxycarbamide 

According to response and blood count, the Initial dose of 15 mg/kg orally daily by 2.5 to 5 mg/kg every 12 weeks. Usual dosage: 15 to 30 mg/kg every day. Maximum dose: 35 mg/kg daily



Dose Adjustments

Dosing modifications
Renal impairment: CrCl less than 60 ml/min: 7.5 mg/kg daily, titrate based on the response
Hepatic impairment: Severe (Child-Pugh score C): Contraindicated

hydroxyurea

initial dose :

20

mg/kg

Orally

once a day

Increase 5 mg per kg per day every eight weeks depending on the severity <>br maximum dose: 35 mg/kg per day
The blood counts need to be monitored



voxelotor 


<4 years: Safety and efficacy not established
>12 years: Administer 1500mg orally every day
4 to 11 years:
10 to <20 kg: 600mg orally every day
20 to <40kg: 900mg orally every day
≥40kg: 1500mg orally every day



Dose Adjustments


Renal impairment: No dosage adjustment is necessary
Hepatic impairment:
Mild to moderate: No dosage adjustment necessary (Child A pugh or B)
Severe: Reduce to 1000 mg orally every day or 900 mg oral suspension orally every day (Child-Pugh C)
20 kg to <40kg: Reduce the dose to 600mg orally every day
10 kg to <20kg: Reduce the dosage to 300mg orally every day

lovotibeglogene autotemcel (FDA Approval Pending) 

FDA Approval Pending as one-time gene therapy for sickle cell disease in patients aged ≥12 years



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Founded in 2014, medtigo is committed to providing high-quality, friendly physicians, transparent pricing, and a focus on building relationships and a lifestyle brand for medical professionals nationwide.

Facebook-f Twitter Instagram Youtube Linkedin Telegram

CONTACT INFORMATION

ADDRESS

MASSACHUSETTS – USA

60 Roberts Drive, Suite 313,
North Adams, MA 01247

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7, Shree Krishna, 2nd Floor,
Opp Kiosk Koffee,
Shirole Lane, Off FC Road,
Pune 411004, Maharashtra

 

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