Generic
Pegylated Erythropoietin
2 brands available in the market
At a glance
Pegylated Erythropoietin is an erythropoietin receptor activator used for the treatment of anemia associated with chronic kidney disease (CKD) in adult patients on dialysis and patients not on dialysis.
Description
Pegylated erythropoietin is an erythropoietin receptor activator with greater in vivo activity and increased half-life compared to erythropoietin. It differs from erythropoietin through the integration of an amide bond between the N-terminal amino group or the ε-amino group of any lysine present in erythropoietin and PEG.
Indications
- Anemia associated with chronic kidney disease (dialysis patients)
- Anemia associated with chronic kidney disease (non-dialysis patients)
Therapeutic class
Drugs for Haemolytic Hypoplastic & Renal Anemia
Pharmacological class
Erythropoietin Receptor Activator
Pharmacology
Pegylated erythropoietin is an erythropoietin receptor activator that stimulates erythropoiesis in the bone marrow. It provides extended half-life and greater in vivo activity through amide bond conjugation.
Mechanism of action
Stimulates red blood cell production by activating erythropoietin receptors in the bone marrow.
Dosage
Adult Dose (SC/IV):
- Initial dose (CKD dialysis and non-dialysis): 0.6 mcg/kg once every two weeks
- Once hemoglobin stabilized: May be given once monthly (double the dose)
- Initiate when Hb <10 g/dL; reduce/interrupt if Hb approaches/exceeds 11 g/dL
- Rapid Hb rise (>1 g/dL in 2 weeks): Reduce dose by 25%
- Inadequate response (Hb increase <1 g/dL after 4 weeks): Increase dose by 25%
Administration
- Administered by healthcare professional as IV or SC injection
- Do not self-administer
- Do not shake
Missed dose
If you miss a dose, consult your doctor.
Side effects
Side Effects:
- Increased mortality, myocardial infarction, stroke, and thromboembolism
- Increased mortality and/or tumor progression in patients with cancer
- Hypertension
- Seizures
- Pure red cell aplasia
- Serious allergic reactions
Precautions & warnings
- Targeting Hb >11 g/dL increases rate of serious adverse cardiovascular reactions
- Caution in patients with coexistent cardiovascular disease, stroke, seizures, etc.
- Control hypertension prior to and during treatment
- Monitor for changes in seizure frequency or premonitory symptoms
- If severe anemia and low reticulocyte count develop, withhold and evaluate for neutralizing antibodies
Contraindications
- Uncontrolled hypertension
- History of pure red cell aplasia
- Hypersensitivity to the product
Drug interactions
- Iron status evaluation: Supplementary iron therapy recommended for ferritin <100 mcg/L or transferrin saturation <20%
Food interactions
It is not known whether it is safe to consume alcohol with Pegylated Erythropoietin; consult your doctor.
Use in pregnancy
Use in Pregnancy: Pregnancy Category C; unknown if excreted in human milk; caution required.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Unknown if excreted in human milk; caution required as many drugs are excreted in human milk.
Pediatric use
Safety and effectiveness not established in pediatric patients.
Geriatric use
Caution required in elderly patients; dose adjustment may be needed.
Renal / hepatic impairment
Renal Impairment: Indicated for CKD patients; dose titration required.
Hepatic Impairment: Limited information on use in liver disease; consult your doctor.
Overdose effects
Overdose can elevate hemoglobin levels above desired level; managed with discontinuation/reduction of dosage and/or phlebotomy. Severe hypertension has been observed.
Storage conditions
Store at 2-8°C in the refrigerator; protect from light; do not shake syringe; keep out of reach of children.
Chemical structure
Pegylated Erythropoietin