{"id":4561,"date":"2025-03-31T18:12:12","date_gmt":"2025-03-31T18:12:12","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/mircera-txt\/"},"modified":"2025-03-31T18:12:12","modified_gmt":"2025-03-31T18:12:12","slug":"mircera-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/mircera-txt\/","title":{"rendered":"mircera.txt"},"content":{"rendered":"<p><H3>  CLINICAL USE <\/H3><br \/>\nManagement of anaemia associated with renal impairment in pre-dialysis and dialysis patients<H3> DOSE IN NORMAL RENAL FUNCTION  <\/H3>ESA-naive patients: 0.6 mcg\/kg every 2  weeks, changing by 25% according to response; once stable change to monthly dosingTarget haemoglobin usually 10\u201312 g\/dL If previously on an ESA: 120\u2013360 mcg  monthly depending on previous ESA dose, and adjust 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 :60 000<\/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 : Unlikely<\/li>\n<p><LI> Volume of distribution (L\/kg) &amp;nbsp &amp;nbsp &amp;nbsp :3\u20135.4 litres<\/li>\n<p><LI>half-life \u2013 normal\/ESRD (hrs)&amp;nbsp &amp;nbsp &amp;nbsp :IV: 134\/UnchangedSC: 139 (142 if not on dialysis)\/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 drugsRisk of hyperkalaemia with ACE inhibitors  and angiotensin-II antagonists<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>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\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 \u2013 very rare; 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>CLINICAL USE Management of anaemia associated with renal impairment in<\/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-4561","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\/4561","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=4561"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4561\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4561"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4561"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4561"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}