The minimum amount of benzyl alcohol at which serious adverse reactions may occur is not known, Phenylalanine can be harmful to patients with phenylketonuria (PKU). 2006 Jan;40(1):58-65; quiz 169-70. doi: 10.1345/aph.1G042. contracts, darbepoetin alfa is less expensive than epoetin alfa. <>
Learn how to combine multiple dosing options for precise titration and individualize anemia management. Correct or exclude other causes of anemia (eg, vitamin deficiency, metabolic or chronic inflammatory conditions, bleeding, etc) before initiating RETACRIT. Production
Conversion from Epoetin alfa to Aranesp in patients with CKD on dialysis . In cancer patients, erythropoietic agents, including
No trial has identified a hemoglobin target level, Aranesp dose, or dosing strategy that does not increase these risks. Last updated on Jan 20, 2023. Evaluate the iron status in all patients before and during treatment. of darbepoetin alfa, the half-life is ~49 hours (a similar half-life
Redox Rep. 2016 Jan;21(1):14-23. doi: 10.1179/1351000215Y.0000000022. Northwest Kidney Centers Home Dialysis Programs Standing Orders - Erythropoietin . The optimal timing and duration of growth factor stimulation has not been determined. Evaluate the iron status in all patients before and during treatment. The safety and effectiveness of Neumega have not been established in pediatric patients. Clipboard, Search History, and several other advanced features are temporarily unavailable. Bethesda, MD 20894, Web Policies Discontinue RETACRIT therapy immediately if a severe cutaneous reaction, such as SJS/TEN, is suspected, RETACRIT from multiple-dose vials contains benzyl alcohol and is contraindicated for use in neonates, infants, pregnant women, and lactating women. Conversion from another ESA: dose once monthly based on the total weekly epoetin or darbepoetin alfa dose at the time of conversion. Questions regarding this interchange program should be directed to the CCF Department of Pharmacy Drug Information Center (216-444-6456, option #1). Conversion - Epoetin alfa (Procrit) to Darbepoetin alfa (Aranesp) #Epoetin #Darbepoetin #Erythropoietin #Conversion #Table #ESAs #Procrit #Aranesp #Pharmacology #Hematology #Nephrology. of patients receiving transfusions was similar between the groups,
IL-11 has also been shown to have non-hematopoietic activities in animals including the regulation of intestinal epithelium growth (enhanced healing of gastrointestinal lesions), the inhibition of adipogenesis, the induction of acute phase protein synthesis, inhibition of pro-inflammatory cytokine production by macrophages, and the stimulation of osteoclastogenesis and neurogenesis. However, this may result in the over treatment of uraemic anaemia. Healthcare professionals should report all serious adverse events suspected to be associated with the use of any medicine and device to FDAs MedWatch Reporting System or by calling 1-800-FDA-1088. alfa for chronic anemia of cancer and chemotherapy-induced anemia
Conversion from Epoetin alfa to Aranesp in patients with CKD not on dialysis. Maintain the route of administration (intravenous or subcutaneous injection). Pussell BA, Walker R; Australian Renal Anaemia Group. Available for Android and iOS devices. 1.4 Patients Undergoing Autologous Peripheral Blood Progenitor Cell Collection and Therapy ZARXIO is indicated for the mobilization of autologous hematopoietic progenitor cells into the peripheral blood for collection by leukapheresis [see Clinical Studies (14.4)]. In recent years, the trend has been to use higher doses of epoetin alfa (eg, 60,000 U once per week), recognizing that MDS RBC precursors may have relative intrinsic resistance to EPO. In CKD, for subcutaneous (SC) administration
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Patients were then switched to fortnightly darbepoetin alfa dosing treatments; the existing weekly dose being doubled and Hb levels fell from 125 to 110 g/L (P < 0.0001), despite an increase in the mean dose from 44.9 to 47.5 microg/week (P = 0.02). Estimate the starting weekly dose of Aranesp for adults and pediatric patients on the basis of the weekly epoetin alfa dose at the time of substitution (see Table 1). The recommended starting
Epogen is used in the dialysis area at CCF. endstream Epogen and Procrit are specialty medications used to treat anemia caused by chronic kidney disease (CKD) or chemotherapy, but they don't come cheap. Supplied Injection, solution [preservative free]: 10 mg/mL (0.6 mL) [prefilled syringe]. Adult Respiratory Distress Syndrome (ARDS) Adult respiratory distress syndrome (ARDS) has been reported in neutropenic patients with sepsis receiving Filgrastim, the parent compound of Neulasta, and is postulated to be secondary to an influx of neutrophils to sites of inflammation in the lungs. 114 (n=92 CCF) patients were included in the DUE, 59 epoetin alfa
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. Peripheral blood progenitor cell (PBPC) collection: 10 mcg/kg/day or 5-8 mcg/kg twice daily in donors. Like Epogen/Procrit, Retacrit must be dispensed with a patient Medication Guide that provides information about the drugs uses and risks. A local search option of this data can be found here. Careers. k22atr
!h~h[={;X)Sr;:2{+S&x~tlgth6_'N'F?%2 @obXCC The information provided is for educational purposes only. For adult patients with CKD not on dialysis: When treating patients who have chronic kidney disease and cancer, physicians should refer to Warnings and Precautions (5.1 and 5.2). Aranesp is the only long-acting erythropoiesis-stimulating agent (ESA) approved for both once weekly (QW) and once every three weeks (Q3W) dosing 1, 2 Aranesp dosing options of QW or Q3W may allow for synchronization with common myelosuppressive chemotherapy regimens. Neulasta should not be used for PBPC mobilization. Use the lowest OMONTYS dose sufficient to reduce the need for red blood cell (RBC) transfusions. 1022 0 obj Conversion of IV to SC EPO: a. b. Hymes J, Bickimer T, Jackson JH, Bookhart BK, Mody SH, Tak Piech C. Curr Med Res Opin. In chronic kidney disease
More specifically, 23 patients in the epoetin alfa group
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*For pediatric patients receiving a weekly epoetin alfa dose of < 1,500 Units/week, the available data are insufficient to determine an Aranesp conversion dose. Contraindication to Retacrit that is not a contraindication to Aranesp, or c. Side effect to Retacrit that would not be expected with Aranesp, or d. Patient has a religious belief objecting to treatment with a drug containing human . Please enable it to take advantage of the complete set of features! eCollection 2017. The U.S. Food and Drug Administration today approved Retacrit (epoetin alfa-epbx) as a biosimilar to Epogen/Procrit (epoetin alfa) for the treatment of anemia caused by chronic . The .gov means its official.Federal government websites often end in .gov or .mil. The effects of concomitant myelosuppressive chemotherapy, and upon initiation, there is a minimum of two additional months of planned In the near future, the Pharmacy and Therapeutics
dose of darbepoetin alfa for CIA is 200 mcg SC every-other-week
Drug class: recombinant human erythropoietins, Aranesp (Darbepoetin Alfa Prefilled Syringes), Anemia Associated with Chronic Renal Failure, If hemoglobin exceeds a level needed to avoid RBC transfusion, If hemoglobin increases by less than 1 g/dL. Resources for Information | Approved Drugs, Recalls, Market Withdrawals and Safety Alerts, Resources for Information | Approved Drugs, Oncology (Cancer) / Hematologic Malignancies Approval Notifications, Verified Clinical Benefit | Cancer Accelerated Approvals, Approved Drug Products with Therapeutic Equivalence Evaluations (Orange Book) Short Description, FDA approves Retacrit as a biosimilar to Epogen/Procrit, Drug Information Soundcast in Clinical Oncology. Committee will be exploring other patient populations for this
arena for dosing, dosing interval, hemoglobin levels, number of
In the event that ARDS occurs, Neulasta should be discontinued and/or withheld until resolution of ARDS and patients should receive appropriate medical management for this condition. An official website of the United States government, Recalls, Market Withdrawals and Safety Alerts, FDA approves first epoetin alfa biosimilar for the treatment of anemia, FDA: Office of Hematology and Oncology Products. 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. epoetin alfa and darbepoetin alfa, have been shown to decrease the
Studies of erythropoietin therapy
Adults: 50 mcg/kg once daily for 10-21 days (until postnadir platelet count >/= 50,000 cells/uL). endstream
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All orders for epoetin alfa-epbx (RETACRIT) will be converted to darbepoetin alfa using equivalent therapeutic interchange dosing listed in the table below. 500 mcg every 3 weeks subcutaneously until completion of a chemotherapy course. Sickle Cell Disease Severe sickle cell crises have been associated with the use of Neulasta in patients with sickle cell disease. Biological products are generally derived from a living organism and can come from many sources, such as humans, animals, microorganisms or yeast. Patient Name_____ NKC#_____ Revised 01/14/2016 Page 1 of 4. Unable to load your collection due to an error, Unable to load your delegates due to an error. alfa may be administered as frequently as once every 3 or 4 weeks. 2017 Jun 30;4:2054358117716461. doi: 10.1177/2054358117716461. Epogen (epoetin alfa)injection, for intravenous or subcutaneous use Initial U.S.Approval: 1989 WARNING:ESAs INCREASE THE RISK OF DEATH, MYOCARDIAL INFARCTION, STROKE, VENOUS THROMBOEMBOLISM, THROMBOSIS OF VASCULAR ACCESS AND TUMOR PROGRESSION OR RECURRENCE See full prescribing information for complete boxed warning. 2014 Mar;164(5-6):109-19. doi: 10.1007/s10354-013-0256-7. every-other-week) for darbepoetin alfa-treated patients. Generic name: DARBEPOETIN ALFA 10ug in 0.4mL of darbepoetin administered SC has been shown in cancer patients
The implementation date for the interchange program is October 11, 2004. Previous dosage of epoetin alfa: 5000-10,999 units/week,then darbepoetin alfa dosage: 25 mcg/week. Methods: All in-centre haemodialysis patients (n = 60) were converted from an existing subcutaneous epoetin alfa regimen to weekly intravenous darbepoetin alfa. _
p8"&JjyfEMeRid=D fGKD 8qwR^{c`KNp% Kvu%Q rH]Y "[/|O"1S|FVA@-G%#&DOks]Qf/YQj*$K) Aranesp Dosing and Conversion Brochure. PenTAG FINAL PROTOCOL 2 darbepoetin alfa (Aranesp [Amgen]). RETACRIT safely and effectively. (CKD) patients, darbepoetin alfa administered intravenously has
Additional warnings include high blood pressure, seizures, a condition in which the bone marrow stops making red blood cells thus causing anemia, serious allergic reactions and severe skin reactions. David McAuley, Pharm.D. Use the lowest dose of Aranesp necessary to avoid RBC transfusions. JKn&,&LzN M(aOf}c^gw+&=s=O{+h5ACmVA;8*=vSO`8dmD}a"'3L
DMr7GwG 3\\q'z .MreQlX`DWxxxnU@!TUrTng_wAMc`0N[P Si)i+j(1A%@xaB&Zx03\'O.h` &!T6. 0*ET*LQjH!z!6G OsI`~ Recommended regimens for patients undergoing elective, noncardiac, nonvascular surgery, 300 Units/kg per day SC for 15 days total: administered daily for 10 days before surgery, on the day of surgery, and for 4 days after surgery, 600 Units/kg SC in 4 doses, administered 21, 14, and 7 days before surgery and on the day of surgery. Adjust dose as follows to achieve and maintain a target hemoglobin: Inadequate response: Hemoglobin increases <1 g/dL after 6 weeks of therapy: Increase dose to 4.5 mcg/kg. in Hgb of 2 g/dL from baseline. 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. alfa is as well tolerated and efficacious as epoetin alfa even when
Before Results: Previous dosage of epoetin alfa: 18,000-33,999 units/week,then darbepoetin alfa dosage: 60 mcg/week. %%EOF Evaluation of Iron Stores and Nutritional Factors. Copyright 1993-2021 Federal government websites often end in .gov or .mil. Costs Associated With Intravenous Darbepoetin Versus Epoetin Therapy in Hemodialysis Patients: A Randomized Controlled Trial. Update Index. Epub 2014 Jan 31. Similar to endogenous
Vol. In patients receiving treatment for cancer and whose anemia is not due to CKD. Decreases in dose can occur more frequently. Epub 2004 Feb 19. Rounding doses to the nearest vial size often enhances patient convenience and reduces costs without compromising clinical response. x]Y8~w&*qq8g91YJUjUr2$u UuKf"3e&U+Wq&0Y Patient treatments were converted from subcutaneous epoetin alfa to weekly, intravenous darbepoetin alfa at month 0, at a conversion dose of 200 units epoetin alfa to 1 microg darbepoetin. 1. dvO*g%6u7Gw~A%a^7lW^{^6Vk?u^Gn"2@^n?0NS.OpJ
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RETACRIT Dosage Forms and Strengths (epoetin alfa-epbx) 3 DOSAGE FORMS AND STRENGTHS Injection: 2,000 Units/mL, 3,000 Units/mL, 4,000 Units/mL, 10,000 Units/mL, and 40,000 Units/mL of RETACRIT as a clear and colorless liquid in single-dose vials. affinity has no or little clinical relevance. This has been reported predominantly in patients with CKD receiving ESAs by subcutaneous administration. Refer to Table 1. for the erythropoietin receptors, suggesting the slower clearance
and approved an automatic therapeutic interchange to darbepoetin
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DY%--V! The intravenous route is recommended for patients on hemodialysis. RETACRIT (epoetin alfa-epbx) injection, for i ntravenous or subcutaneous use . half-life of 8.5 hours. To report SUSPECTED ADVERSE REACTIONS, contact Amgen Medical Information at 1-800-77-AMGEN (1-800-772-6436) or . Epoetin timeline: 2/2020: Switched from Procrit to Retacrit preferred. The site is secure. The number
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The products discussed in this site may have different product labeling in different countries. Nephrol Dial Transplant. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. In addition, do not mix RETACRIT with bacteriostatic saline (which also contains benzyl alcohol) when administering RETACRIT to these patient populations, Serious and fatal reactions including gasping syndrome can occur in neonates and infants treated with benzyl alcohol-preserved drugs, including RETACRIT multiple-dose vials. The recommended starting dose is 0.45 mcg/kg body weight intravenously or subcutaneously given once at four week intervals as appropriate. The agency also is responsible for the safety and security of our nations food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products. Conversion from Another ESA: dosed once monthly or once every two weeks based on total weekly epoetin alfa or darbepoetin alfa dose at time of conversion (2.2). In rare cases, allergic reactions including anaphylaxis, recurred within days after initial anti-allergic treatment was discontinued. Health care professionals should review the prescribing information in the labeling for detailed information about the approved uses. National Institutes of Health, U.S. National Library of Medicine, DailyMed Database. alfa-treated patients, respectively. adverse event to Retacrit (epoetin alfa), and the adverse event was not an expected adverse event attributed to the active ingredient as described in the prescribing information; OR For patients that are currently on treatment with Aranesp (darbepoetin alfa) they can remain on for at least 3 weeks between July 2002 and July 2003. The dose of MIRCERA , given as a single intravenous or subcutaneous injection, should be based on the total weekly ESA dose at the time of . in two ways: 1) Hgb levels > 12 g/dL or 2) an increase
hemoglobin of > 12 g/dL was reached in 47 patients (41%)
The gasping syndrome is characterized by central nervous system depression, metabolic acidosis, and gasping respirations. Monitoring Parameters Complete blood count and platelet count should be obtained prior to chemotherapy. zi){#_YD2}y5g{b_qh3d{~"/7{k~} }^?>~4LF=,q\Qnw/UUuQTN /Bu*"=rl w.WO/I:$woS'/rmG
M/d=w+6E/pB)OOq5A:P+o{ K2`._iD6vGfch>PN/VTH3|GH-a/D}-J"{6Mj9K`a2'> Iltm< Aranesp is a medicine used to treat anaemia (low red blood cell counts) that is causing symptoms. Bone marrow transplantation: 5-10 mcg/kg/day - doses may be increased by 5 mcg/kg according to the duration and severity of neutropenia; recommended steps based on neutrophil response: When ANC >1000/mm3 for 3 consecutive days: Reduce filgrastim dose to 5 mcg/kg/day If ANC remains >1000/mm3 for 3 more consecutive days: Discontinue filgrastim If ANC decreases to <1000/mm3 : Resume at 5 mcg/kg/day If ANC decreases <1000/mm3 during the 5 mcg/kg/day dose, increase filgrastim to 10 mcg/kg/day and follow the above steps. Neulasta should be permanently discontinued in patients with serious allergic reactions. Both drugs are costly: January 2003 prices posted by Medicare put reimbursement rates at $12.69 per 1000 units of Procrit (translating to about $534.32 for the Average Wholesale Price [AWP] for a once-a-week dose of 40,000 units) and $23.69 per 5 micrograms of Aranesp (about $994.98 for the AWP for a 3 mcg/kg dose every other week). If the hemoglobin level exceeds 10 g/dL, reduce or interrupt the dose of Aranesp, and use the lowest dose of Aranesp sufficient to reduce the need for RBC transfusions. SPLENIC RUPTURE, IN SOME CASES RESULTING IN DEATH, HAS ALSO BEEN ASSOCIATED WITH FILGRASTIM, THE PARENT COMPOUND OF NEULASTA. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. Bookshelf Do not re-enter vial. MeSH PMC a half-life of 25.3 hours compared to epoetin alfa, which has a
A single hemoglobin excursion may not require a dosing change. administered less frequently. The https:// ensures that you are connecting to the 5,o_2&+PA1xRAag(sRVt?jN)r!ba,cKc$Z`6@5&ql~d:P /bc
yh{fM"fCCmF6TBxgE= Vue-#x4Bi8&ZC; Following initiation of therapy and after each dose adjustment, monitor hemoglobin weekly until the hemoglobin level is stable and sufficient to minimize the need for RBC transfusion. most common dosing regimens are 40,000 units weekly for epoetin
Endogenous G-CSF is a lineage specific colony-stimulating factor which is produced by monocytes fibroblasts, and endothelial cells. Do Not Copy, Distribute or otherwise Disseminate without express permission. 2009 Oct;2(5):347-53. doi: 10.1093/ndtplus/sfp097. The assessment will also assess whether the reviewed drugs are likely to be considered good value for money for the NHS. see Tables A and B (below). PRCA has also been reported in patients receiving ESAs for anemia related to hepatitis C treatment (an indication for which RETACRIT is not approved). In addition, Hgb levels were
The dose should be titrated to meet and
Non-hematopoietic pathologic changes observed in animals include fibrosis of tendons and joint capsules, periosteal thickening, papilledema, and embryotoxicity. Both Hb and ferritin concentrations remained within the target range, but darbepoetin dosages fell from 50.8 to 42.3 microg/week by month 3 (P = 0.02). Cases A, Portols J, Calls J, Martinez-Castelao A, Munar MA, Segarra A. Int Urol Nephrol. Depending upon each patient's needs and response, dosage adjustments may be required. Hgb level. There is a potential for similar risks to fetuses and infants exposed to benzyl alcohol in utero or in breastfed milk, respectively. Avoid frequent dose adjustments. No difference in conversion dosage could be determined between patients who were epoetin sensitive (<200 units/kg per week) or resistant (>200 units/kg per week, P = NS). The
similar over the course of therapy for both groups. RETACRIT is a registered trademark of Pfizer Inc. Epogen is a registered trademark of Amgen Inc. Procrit is a registered trademark of Janssen Products, LP. 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. An official website of the United States government. Dosage form: injection, solution epoetin theta (Eporatio [Teva UK]), epoetin zeta (Retacrit [Hospira UK]), and . RETACRIT from multiple-dose vials contains benzyl alcohol and is contraindicated in: For additional details on storage and handling. Advise patients of the importance of compliance with antihypertensive therapy and dietary restrictions, Epoetin alfa products, including RETACRIT, increase the risk of seizures in patients with CKD. 2022Pfizer Inc. All rights reserved. Immediately and permanently discontinue RETACRIT and administer appropriate therapy if a serious allergic or anaphylactic reaction occurs, Blistering and skin exfoliation reactions, including erythema multiforme and Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), have been reported in patients treated with ESAs (including epoetin alfa) in the postmarketing setting. Conversion from Another ESA: dosed once every 4 weeks based on total adjustments may be required. Conversion from Epoetin alfa to Aranesp in patients with CKD on dialysis. 2. Evaluate response every 4-8 weeks thereafter and adjust the dose accordingly by 50-100 units/kg increments 3 times/week. Dosage adjustment: Goal: Dose should be adjusted to achieve and maintain a target hemoglobin not to exceed 12 g/dL. W bO? A brochure to help you understand how to dose and administer Aranesp, and to convert from epoetin alfa to Aranesp in patients with anemia due to CKD. It is used in two groups of patients: adults and children with chronic renal failure (long-term, decreasing in the ability of the kidneys to work properly); adults who are receiving chemotherapy for nonmyeloid cancer (cancer not originating in . If patient does not respond, a response to higher doses is unlikely. 1. 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). RETACRIT (epoetin alfa-epbx) is biosimilar* to EPOGEN/PROCRIT (epoetin alfa) WARNING: ESAs INCREASE THE RISK OF DEATH, MYOCARDIAL INFARCTION, STROKE . Depending upon each patient's needs and response, dosage
The recommended conversion dose for changing from epoetin alfa to darbepoetin alfa is 200 units to 1 microg. Although these images are curated, as they are sourced from the community, there is no way to guarantee a consistent standard of accuracy and quality across the library of images. Please review the latest applicable package insert for additional information and possible updates. Use caution in patients with coexistent cardiovascular disease and stroke. 1.2 Patients with Acute Myeloid Leukemia Receiving Induction or Consolidation Chemotherapy ZARXIO is indicated for reducing the time to neutrophil recovery and the duration of fever, following induction or consolidation chemotherapy treatment of patients with acute myeloid leukemia (AML) [see Clinical Studies (14.2)]. objective of the DUE was to trend usage patterns in the outpatient
2014 Oct;46(10):1983-95. doi: 10.1007/s11255-014-0800-4. 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. endobj
duration of therapy was 13.2 weeks and 13.6 weeks in the epoetin
CONTRAINDICATIONS Neulasta is contraindicated in patients with known hypersensitivity to E coli-derived proteins pegfilgrastim Filgrastim, or any other component of the product. or 100 mcg SC once weekly. An official website of the United States government, : However, this may result in the over treatment of uraemic anaemia. Zhang L, Coombes J, Pascoe EM, Badve SV, Dalziel K, Cass A, Clarke P, Ferrari P, McDonald SP, Morrish AT, Pedagogos E, Perkovic V, Reidlinger D, Scaria A, Walker R, Vergara LA, Hawley CM, Johnson DW, On Behalf Of The Hero Study Collaborative Group. If a serious allergic reaction occurs, appropriate therapy should be administered, with close patient follow-up over several days. Disclaimer. Wien Med Wochenschr. Advise patients to contact their healthcare practitioner for new-onset seizures, premonitory symptoms or change in seizure frequency, For lack or loss of hemoglobin response to RETACRIT, initiate a search for causative factors (eg, iron deficiency, infection, inflammation, bleeding). <>stream
1121 0 obj patients and 55 darbepoetin alfa patients. The average
Each 1 mL single-dose vial of 2,000, 3,000, 4,000, 10,000, and 40,000 Units of epoetin alfa-epbx injection contains 0.5 mg of phenylalanine. <>>>
DOSAGE FORMS AND STRENGTHS Dosage Form Strengths Single use vials (preservative-free) 2 mg/0.5 mL, 3 mg/0.5 mL, 4 mg/0.5 mL, 5 mg/0.5 mL, and 6 mg/0.5 mL, Single use pre-filled syringes (preservative-free) 1 mg/0.5 mL, 2 mg/0.5 mL, 3 mg/0.5 mL, 4 mg/0.5 mL, 5 mg/0.5 mL, and 6 mg/0.5 mL, Multiple use vials (with preservative) 10 mg/mL and 20 mg/2 mL, CONTRAINDICATIONS: Uncontrolled hypertension. alfa (Aranesp; Amgen) to be therapeutic equivalent products