Epoetin beta
CLINICAL USE
Anaemia associated with renal impairment in pre-dialysis and dialysis patients, and in patients receiving cancer chemotherapy
DOSE IN NORMAL RENAL FUNCTION
Renal: CORRECTION PHASE: (To raise —haemoglobin to target level) 60 u/kg SC or 40 u/kg IV 3 times weekly for 4 weeks; increase, according to response, in steps of 20 u/kg 3 times weekly at monthly intervals. Maximum dose 720 u/kg weekly. Target haemoglobin usually 10–12 g/100mLMAINTENANCE DOSE: (To maintain —haemoglobin at target level) Half correction phase dose, then adjust according to response at intervals of 1–2 weeksCancer: Initially 450 u/kg weekly in 3–7 divided doses and adjust according to response
PHARMACOKINETICS
DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsRisk of hyperkalaemia with ACE inhibitors and angiotensin-II antagonists
ADMINISTRATION
Reconstition
Reconstitute using diluent provided only for multidose vial and penfill cartridges
Route
SC, IV
Rate of Administration
2 minutes
Comments
May also be given IV, but higher doses are needed to produce required response
OTHER INFORMATION
Pre-treatment checks and appropriate correction/treatment needed for iron, folate and B12 deficiencies, infection, inflammation or aluminium toxicity to produce optimum response to therapyConcomitant iron therapy (200–300 mg elemental oral iron) needed daily. IV iron may be needed for patients with very low serum ferritin (<100 nanograms/mL)May increase heparin requirement during