Deep venous thrombosis prophylaxis is recommended during RETACRIT therapy [see Warnings and Precautions (5.1)]. startxref Allergic Reactions Allergic reactions to Neulasta, including anaphylaxis, skin rash, and urticaria, have been reported in postmarketing experience. WARNINGS AND PRECAUTIONS Increased Mortality, Myocardial Infarction, Stroke, and Thromboembolism: Using ESAs to target a hemoglobin level of greater than 11 g/dL increases the risk of serious adverse cardiovascular reactions and has not been shown to provide additional benefits. Based on data from this CCHS DUE, darbepoetin alfa and endobj 300 Units/kg three times per week in adults or, 900 Units/kg (maximum 60,000 Units) weekly in pediatric patients. G-CSF is not species specific and has been shown to have minimal direct in vivo or in vitro effects on the production of hematopoietic cell types other than the neutrophil lineage. The intravenous route is recommended for patients on hemodialysis. Aranesp, Epogen, Mircera, Procrit, Retacrit . (CKD) patients, darbepoetin alfa administered intravenously has 2.25 mcg/kg every week subcutaneously until completion of a chemotherapy course. contracts, darbepoetin alfa is less expensive than epoetin alfa. Administer supplemental iron therapy when serum ferritin is less than 100 mcg/L or when serum transferrin saturation is less than 20%. /Pages 3 0 R AND 2. ^xhw- %8 ,O{Izw)n:X @ In controlled clinical trials, ESAs increased the risk of death in patients undergoing coronary artery bypass graft surgery (CABG) and the risk of deep venous thrombosis (DVT) in patients undergoing orthopedic procedures. In some cases, symptoms recurred with rechallenge, suggesting a causal relationship. Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). PRCA has also been reported in patients receiving ESAs for anemia related to hepatitis C treatment (an indication for which Aranesp and EPOGEN are not approved). Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Children: 75-100 mcg/kg once daily for 10-21 days (until postnadir platelet count >/= 50,000 cells/ uL). endobj objective of the DUE was to trend usage patterns in the outpatient x\YGrI8$P[Co>, gdWTpHkYq|qTT8~?K7?0in70>l) |Knsw/dgo7v{}Gx\2vropiND{$a!2)e(H& Supplied Injection, solution [preservative free]: 10 mg/mL (0.6 mL) [prefilled syringe]. Conversion from Epoetin alfa to Aranesp in patients with CKD on dialysis Aranesp is administered less frequently than epoetin alfa. For patients who do not respond adequately over a 12-week escalation period, increasing the Aranesp dose further is unlikely to improve response and may increase risks. Dose adjustment: If response is not satisfactory after a sufficient period of evaluation (8 weeks of 3 times/week and 4 weeks of once weekly therapy), the dose may be increased every 4 weeks (or longer) up to 300 units/kg 3 times/week, or when dosed weekly, increased all at once to 60,000 units weekly. 2. Administer supplemental iron therapy when serum ferritin is less than 100 mcg/L or when serum transferrin saturation is less than 20%. Darbepoetin's T1/2 is approximately 3 times that of epoetin alfa. Avanafil Review Menosan, Mean baseline Hgb levels 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. Antibiotic Prescribing Guidelines UK Viagra Caps, Conversion - Epoetin alfa (Procrit) to Darbepoetin alfa (Aranesp) #Epoetin #Darbepoetin #Erythropoietin #Conversion #Table #ESAs #Procrit #Aranesp . therapy. Evaluate the iron status in all patients before and during treatment. 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? Discard unused portions of RETACRIT in preservative-free vials. Cardon Tablet Diclofenac, with Aranesp (5.4). Drug class: Recombinant human erythropoietins. Epogen (Amgen), another brand name for epoetin 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. Update Index. Use the lowest dose of Aranesp necessary to avoid RBC transfusions. Internal Data: A retrospective drug use evaluation (DUE) was conducted Use caution in patients with coexistent cardiovascular disease and stroke. This has been reported predominantly in patients with CKD receiving ESAs by subcutaneous administration. If a patient or caregiver experiences difficulty measuring the required dose, especially if it is other than the entire contents of the Aranesp prefilled syringe, use of the Aranesp vial may be considered. All orders for epoetin alfa-epbx (RETACRIT) will be converted to darbepoetin alfa using equivalent therapeutic interchange dosing listed in the table below. ferrous sulfate, Procrit, Retacrit, epoetin alfa, Epogen, darbepoetin alfa. Maintenance: Titrated to hematologic response. 1091 0 obj <> endobj Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. GrepMed. Ms~hXb!X;i R9x9nt\z`g(!7E=Uf*U5 epoetin alfa and darbepoetin alfa, have been shown to decrease the Generic name: DARBEPOETIN ALFA 10ug in 0.4mL No significant clinical decisions should be made based on these images from this website without first consulting with a board-certified attending physician. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. n&eOvrRE=$S z{.v{{w0VE/Hj0\c!;6]Wd[= a ~N9/~A1Z+|pN+F)"4#O$k LD WmB"qY{0NJ!p*D14 @!m"i5}gLFn K_" >n/W@s%7;dd;3Y 1.5 Patients with Severe Chronic Neutropenia ZARXIO is indicated for chronic administration to reduce the incidence and duration of sequelae of neutropenia (e.g. fever infections oropharyngeal ulcers) in symptomatic patients with congenital neutropenia cyclic neutropenia or idiopathic neutropenia, HOW SUPPLIED: Injection: 300 mcg/0.5 mL in a single-use prefilled syringe with BD UltraSafe Passive Needle Guard Injection: 480 mcg/0.8 mL in a single-use prefilled syringe with BD UltraSafe Passive Needle Guard. The dose should be titrated to meet and Generic name: ERYTHROPOIETIN 2000[iU] in 1mL Available for Android and iOS devices. Decreases in dose can occur more frequently. Voltarol 12 Hour Gel Sainsbury's, reaction occurs. PRCA: If severe anemia and low reticulocyte count develop during Aranesp treatment, withhold Aranesp and evaluate for PRCA (5.6). Fluticasone Ointment Price Indocin, The recommended starting dose in adults is 100 Units/kg as an intravenous or subcutaneous injection 3 times per week. Conversion from Another ESA: dosed once every 4 weeks based on total with Aranesp (5.3). When adjusting therapy consider hemoglobin rate of rise, rate of decline, ESA responsiveness and hemoglobin variability. If hemoglobin continues to increase, hold dose temporarily until hemoglobin begins to decrease, then restart at a dose 25% below the previous dose. for at least 3 weeks between July 2002 and July 2003. of endogenous erythropoietin may be impaired in patients receiving Questions regarding Increase monitoring of these patients for changes in seizure frequency or premonitory symptoms (5.5). -m]|;VB &mOc{41f*\9x!>b o4pR-Ar|u}u=iS -$ 8\n^l|w,|1K sewEVzhc MT"_jlhV&AV7^Hiud:.B.4=>^ Dosage form: injection, solution Conversion from Epoetin alfa to Aranesp in patients with CKD not on dialysis. Darbepoetin alfa, although several fold more biologically Initiate RETACRIT treatment when the hemoglobin level is less than 10 g/dL. Based on the patient's response, darbepoetin G-CSF regulates the production of neutrophils within the bone marrow and affects neutrophil progenitor proliferation differentiation and selected end-cell functional activation (including enhanced phagocytic ability, priming of the cellular metabolism associated with respiratory burst antibody dependent killing, and the increased expression of some functions associated with cell surface antigens). Clipboard, Search History, and several other advanced features are temporarily unavailable. Previous dosage of epoetin alfa: 2500-4999 units/week, then darbepoetin alfa dosage: 12.5 mcg/week. 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. 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,? The safety and effectiveness of Neumega have not been established in pediatric patients. Administer Aranesp once weekly in patients who were receiving epoetin alfa 2 to 3 times weekly. alfa (Aranesp; Amgen) to be therapeutic equivalent products OK 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). 2582, Issued . Existing patients on IV EPO, change to subcutaneous EPO using the . Previous dosage of epoetin alfa: 11,000-17,999 units/week,then darbepoetin alfa dosage: 40 mcg/week. The recommended starting dose is 0.45 mcg/kg body weight intravenously or subcutaneously given once at four week intervals as appropriate. for epoetin alfa-treated patients and 200 mcg every 2 weeks (or 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. o Hematocrit less than 30% at initiation of therapy; and o There is a minimum of two additional months of planned chemotherapy . Evaluate other causes of anemia. maintain desired hemoglobin (Hgb) levels. Administer Aranesp once weekly in patients who were receiving epoetin alfa 2 to 3 times weekly. If patient does not respond, a response to higher doses is unlikely. *Specialty: <> chemotherapy. The majority of reported events occurred upon initial exposure. Not been established in pediatric patients treatment, withhold Aranesp and evaluate for prca ( )... 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