{"id":3895,"date":"2025-03-31T18:11:52","date_gmt":"2025-03-31T18:11:52","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/darbepoetin-alfa-txt\/"},"modified":"2025-03-31T18:11:52","modified_gmt":"2025-03-31T18:11:52","slug":"darbepoetin-alfa-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/darbepoetin-alfa-txt\/","title":{"rendered":"Darbepoetin alfa.txt"},"content":{"rendered":"<h1> Darbepoetin alfa<\/h1>\n<p><H3>  CLINICAL USE <\/H3><br \/>\nTreatment of anaemia associated with chronic renal failure, and with non-haematological malignancies in adult cancer patients receiving chemotherapy<H3> DOSE IN NORMAL RENAL FUNCTION  <\/H3>Renal failure: 0.45 micrograms\/kg once  a week; dose is adjusted by 25% every 4 weeks according to response; maintenance every 1\u20132 weeksPatients not on dialysis: 0.75 mcg every  2 weeks; maintenance may be every 1\u20134 weeksCancer: 2.25 mcg\/kg once a week, or  6.75 mcg\/kg every 3 weeks; adjust doses by 50% every 4 weeks according to response<H3>  PHARMACOKINETICS    <\/H3><LI> Molecular weight &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp :30 000\u201337 000<\/li>\n<li>  %Protein binding  &amp;nbsp &amp;nbsp &amp;nbsp  &amp;nbsp  &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp :No data<\/li>\n<li>  %Excreted unchanged in urine &amp;nbsp &amp;nbsp : No data<\/li>\n<p><LI> Volume of distribution (L\/kg) &amp;nbsp &amp;nbsp &amp;nbsp :0.05<\/li>\n<p><LI>half-life \u2013 normal\/ESRD (hrs)&amp;nbsp &amp;nbsp &amp;nbsp :21 (IV), 73 (SC)\/Unchanged<H3>  DOSE IN RENAL IMPAIRMENT <\/H3> <H4>GFR (mL\/MIN)<\/H4><LI> 20 to 50  &amp;nbsp &amp;nbsp : Dose as in normal renal function<LI> 10 to 20  &amp;nbsp &amp;nbsp : Dose as in normal renal function<LI> &lt;10 &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp : Dose as in normal renal function<H3> DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES  <\/H3><LI> CAPD  &amp;nbsp &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp:Not dialysed. Dose as in normal renal function<\/p>\n<li> HD &amp;nbsp  &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp :Not dialysed. Dose as in normal renal function<LI>HDF\/high flux  &amp;nbsp :Not dialysed. Dose as in normal renal function<LI>CAV\/VVHD  &amp;nbsp &amp;nbsp &amp;nbsp:Not dialysed. Dose as in normal renal function<H3> IMPORTANT DRUG INTERACTIONS  <\/H3>Potentially hazardous interactions with other drugsCiclosporin and tacrolimus: monitor  ciclosporin and tacrolimus levels; since these drugs are bound to red blood cells there is a potential risk of a drug interaction as haemoglobin concentration increasesACE inhibitors and angiotensin- II antagonists: increased risk of hyperkalaemia<H3> ADMINISTRATION  <\/H3><H4> Reconstition<\/H4>\u2013<H4>  Route  <\/H4>SC, IV <H4>  Rate of Administration  <\/H4>\u2013<H4>Comments<\/H4>\u2013<H4>  OTHER INFORMATION  <\/H4>To convert to darbepoetin from epoetin,  divide total weekly epoetin dose by 200 although that may slightly overestimate the darbepoetin doseSame dose may be given either SC or IV \u2013  monitor responseUse with caution in patients with a history  of epilepsy as convulsions have been reported in patients with CKDOnce a pre-filled pen has been removed  from the fridge and brought to room temperature it must be used within 7 daysPre-treatment checks and appropriate  correction\/ treatment needed for iron, folate and B12 deficiency, infection, inflammation or aluminium toxicity to produce optimum response to therapyConcomitant iron therapy (200\u2013300 mg  elemental oral iron) needed daily. IV iron may be needed for patients with very low serum ferritin (&lt;100 nanograms\/mL)May increase heparin requirement during\n<li> HD &amp;nbsp  &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp  &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp &amp;nbsp :Reported association of pure red cell  aplasia (PRCA) with epoetin therapy.This is a very rare condition; due to failed production of red blood cell precursors in the bone marrow, resulting in profound anaemia. Possibly due to an immune response to the protein backbone of R-HuEPO. Resulting antibodies render the patient unresponsive to the therapeutic effects of all epoetins and darbepoetin<br \/>\n","protected":false},"excerpt":{"rendered":"<p>Darbepoetin alfa CLINICAL USE Treatment of anaemia associated with chronic<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-3895","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3895","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=3895"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3895\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=3895"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=3895"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=3895"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}