Epoetin beta

Epoetin beta is an erythropoiesis-stimulating agent (ESA) that stimulates red blood cell production in the bone marrow. It is used for the treatment of anemia of chronic renal failure, anemia in zidovudine-treated HIV-infected patients, and anemia related to non-myeloid malignant disease chemotherapy.

For patients receiving hemodialysis, IV route is recommended because IV route may be less immunogenic. For SC route, inject in abdomen, arm or thigh.

• Anaemia of Chronic Renal Failure: Treatment of anemia in CKD patients.
• Anaemia in Zidovudine-treated HIV-infected Patients: Prevention and treatment of anemia in HIV patients.
• Anemia Related to Non-Myeloid Malignant Disease Chemotherapy: Treatment of anemia in cancer patients receiving chemotherapy.
• To Reduce the Need for Allogenic Blood Transfusion: Reduce transfusion requirements before surgery.
• Anaemia of Prematurity: Treatment of anemia in premature infants.

Erythropoiesis-Stimulating Agents (ESA)

Erythropoietin (Recombinant)

Epoetin beta stimulates RBC production in the bone marrows which transmits O2 throughout the body.

Epoetin beta stimulates RBC production in the bone marrows which transmits O2 throughout the body.

Adult Dose (Chronic Renal Failure):

• On dialysis (not on ESA therapy): 0.6 mcg/kg IV/SC q2week initially; initiate when Hb <10 g/dL.
• Currently receiving other ESA (epoetin <8000 units/week): 120 mcg/month or 60 mcg/q2week IV/SC
• Epoetin 8000-16000 units/week: 200 mcg/month or 100 mcg/q2week IV/SC
• Epoetin >16000 units/week: 360 mcg/month or 180 mcg/q2week IV/SC

Child Dose: Safety and efficacy not established.

Administration:

• IV route recommended for patients receiving hemodialysis (less immunogenic).
• SC route: inject in abdomen, arm or thigh.
• Do not increase dose more frequently than q4weeks; decreases in dose can occur more frequently.

If you miss a dose of Epoetin beta, please consult your doctor.

Common Side Effects (>10%):

• Hypertension (13%)
• Diarrhea (11%)
• Nasopharyngitis (11%)

Occasional Side Effects (1-10%):

• Headache (9%)
• Upper respiratory tract infection (9%)
• Cough (6%)
• Hypotension (5%)
• Urinary tract infection (5%)
• Arteriovenous fistula thrombosis (5%)

Rare Side Effects: Coronary artery disease, septic shock, serious cardiovascular and thromboembolic events, seizures, PRCA, Stevens-Johnson syndrome, toxic epidermal necrolysis.

Precautions:

• Caution in hypertension, history of seizure, thrombocytosis, chronic hepatic impairment, ischaemic vascular disease, malignant tumours, epilepsy; recent MI or CVA.
• Iron deficiency, infection, inflammatory disorders, haemolysis and aluminium intoxication may decrease response.
• Regularly monitor platelet counts and serum-potassium concentrations.
• Control haematocrit levels.
• Poorly-controlled hypertension: Monitor BP, Hb and electrolytes.
• Anemia (eg, megaloblastic or folic acid): Give Fe supplements when needed.
• Thrombocytosis: monitor platelet count for 1st 8 weeks.

Contraindications:

• Uncontrolled hypertension
• Neonates: injections containing benzyl alcohol

Drug Interactions: Antagonises the hypotensive effects of ACE inhibitors and angiotensin-II receptor antagonists and increases risk of hyperkalaemia.

Food Interactions: It is not known whether it is safe to consume alcohol with Epoetin beta. Consult your doctor.

Use in Pregnancy: Adequate studies not available. Should be used only if the potential benefit justifies the potential risk to the fetus.

Use in Lactation: Not known if excreted in breast milk; use caution.

Pediatric Use: Safety and efficacy in pediatric patients have not been established.

Geriatric Use: No specific dosage adjustment is necessary for elderly patients.

Renal Impairment: Safe to use in patients with kidney disease. No dose adjustment needed.

Hepatic Impairment: Use with caution in patients with liver disease.

Overdose: Overdose may cause hypertension, polycythemia, seizures, thrombosis. In case of overdose, seek immediate medical attention.

Storage: Store at 2-8°C. Do not freeze. Protect from light.

Epoetin beta