epoetin alfa

associated with anemia:

Procrit, Epogen, Retacrit
Red blood cell (RBC) transfusion needs are reduced in patients with CKD and are on dialysis and those who are not
Dialysis patients with CKD
When hemoglobin (Hgb) levels fall below 10 g/dL, initiate the therapy
If the Hgb level approaches or is above 11 g/dL, reduce or discontinue the 50-100 unit/kg IV/SC dose initially, three times per week
Patients with CKD and are not on dialysis
initiate therapy when the Hbg level is below 10 g/dL, and the following conditions are met
The rate at which Hgb declines indicates the likelihood of requiring an RBC transfusion
Another goal is to reduce the risk of alloimmunization and other RBC transfusion-related risks
If the Hgb level is greater than 10 g/dL, reduce or discontinue dosing and use the lowest dose of epoetin alfa necessary to reduce the requirement for RBC transfusions
50-100 units/kg intravenous three times weekly initially
Zidovudine-Related Anemia
Procrit, Epogen, Retacrit
Anemia treatment with zidovudine less than 4200 mg/week in HIV patients with endogenous serum erythropoietin levels of less than 500 milliunits/mL
100 units/kg intravenous/subcutaneous initially, three times per week
If Hgb does not increase after the 8 weeks, increase the dose by 50-100 units/kg every 4-8 weeks until hemoglobin is high enough to avoid RBC transfusions; administer 300 units/kg alternatively.
If Hgb is greater than 12 g/dL: Withhold the dose; begin therapy at a 25% lower dose when Hgb declines to 11 g/dL
If no Hgb increase is achieved after 8 weeks at a dose of 300 Units/kg, discontinue the medication

Procrit, Epogen, Retacrit
Treatment of anemic patients with non-myeloid malignancies where anemia is caused by concomitant myelosuppressive chemotherapy, and there is a minimum of 2 months of planned treatment after beginning
Initially, 150 units/kg intravenous/subcutaneous three times per week; alternatively, 40,000 units subcutaneously once per week until the chemotherapy course is finished
Reduce the dose by 25%
Hgb levels rise by more than 1 g/dL in any two-week period
Hgb meets the required level to avoid RBC transfusion
Withhold dose if hemoglobin exceeds the level required to avoid RBC transfusion; restart at a 25% lower dose if hemoglobin approaches the level where RBC transfusions may be required
Dose increase
If Hgb increases by less than 1 g/dL after 4 weeks of therapy but continues at below 10 g/dL, it may increase the dose to 60,000 units weekly or 300 units/kg 3 times a week
If no response is obtained after 8 weeks, or if RBC transfusions are required, the dose should be discontinued
Reducing Allogeneic Red Blood Cell Transfusions in Patients Undergoing Noncardiac, Nonvascular Surgery
Procrit, Epogen, Retacrit
Indicated to decrease the need for allogeneic RBC transfusions in patients with perioperative hemoglobin greater than 10 g/dL but less than 13 g/dL who are at high risk of perioperative blood loss from noncardiac, nonvascular surgery.
For 15 days, take 300 units/kg subcutaneously once a day
Alternatively, 600 units/kg Subcutaneous in 4 doses given 21, 14, and 7 days before surgery, as well as on the day of surgery
Concurrent deep vein thrombosis (DVT) prevention is recommended

Procrit, Epogen, Retacrit
Indicated to reduce the requirement for red blood cell (RBC) transfusions in chronic renal disease patients (CKD)
Below one month: Safety and efficacy were not established
Above one month: 50 units/kg IV/SC 3 times weekly initially; if the patient is on dialysis, the Intravenous route is recommended
Initiate when the hemoglobin level is less than 10 g/dL; if the hemoglobin level reaches or exceeds 11 g/dL, reduce or discontinue the dose
Zidovudine-Related Anemia
Procrit, Epogen, Retacrit
Below eight months: Safety and efficacy were not established
8 months to 17 years: 50-400 units/kg subcutaneous/intravenous 2-3 times a week

Procrit, Epogen, Retacrit
Treatment of anaemic patients with non-myeloid malignancies where anemia is caused by concomitant myelosuppressive chemotherapy, and there is a minimum of 2 months of planned treatment after beginning
Below five years: Safety and efficacy were not established
5-18 years: 600 units/kg Intravenous once weekly; should not exceed 40,000 units
Reduce the dose by 25%.
Hgb levels rise by more than 1 g/dL in any two-week period
Hgb meets the required level to avoid RBC transfusion
Withhold dose if hemoglobin exceeds the level required to avoid RBC transfusion; restart at a 25% lower dose if haemoglobin approaches the level where RBC transfusions may be required
Dose increase
If Hgb increases by less than 1 g/dL after four weeks of therapy but continues at below 10 g/dL, it may increase the dose to 60,000 units weekly or 300 units/kg 3 times per week
If no response is obtained after 8 weeks, or if RBC transfusions are required, the dose should be discontinued