Indications And Dose
EPREX ® PRE-FILLED SYRINGES Symptomatic anaemia associated with chronic renal failure in patients on haemodialysis ▶BY INTRAVENOUS INJECTION, OR BY SUBCUTANEOUS INJECTION ▶Adult: Initially 50 units/kg 3 times a week, adjusted in steps of 25 units/kg 3 times a week, dose adjusted according to response at intervals of at least 4 weeks; maintenance 75–300 units/kg once weekly, intravenous route preferred, intravenous injection to be given over 1–5 minutes, subcutaneous injection, maximum 1 mL per injection site, maintenance dose can be given as a single dose or in divided doses, reduce dose by approximately 25% if rise in haemoglobin concentration exceeds 2 g/100 mL over 4 weeks or if haemoglobin concentration exceeds 12 g/100 mL; if haemoglobin concentration continues to rise, despite dose reduction, suspend treatment until haemoglobin concentration decreases and then restart at a dose approximately 25% lower than the previous dose Symptomatic anaemia associated with chronic renal failure in adults on peritoneal dialysis ▶BY INTRAVENOUS INJECTION, OR BY SUBCUTANEOUS INJECTION ▶Adult: Initially 50 units/kg twice weekly; maintenance 25–50 units/kg twice weekly, intravenous route preferred, intravenous injection to be given over 1–5 minutes, subcutaneous injection, maximum 1 mL per injection site, reduce dose by approximately 25% if rise in haemoglobin concentration exceeds 2 g/100 mL over 4 weeks or if haemoglobin concentration exceeds 12 g/100 mL; if haemoglobin concentration continues to rise, despite dose reduction, suspend treatment until haemoglobin concentration decreases and then restart at a dose approximately 25% lower than the previous dose Severe symptomatic anaemia of renal origin in adults with renal insufficiency not yet on dialysis ▶BY INTRAVENOUS INJECTION, OR BY SUBCUTANEOUS INJECTION ▶Adult: Initially 50 units/kg 3 times a week, increased in steps of 25 units/kg 3 times a week, adjusted according to response, dose to be increased at intervals of at least 4 weeks; maintenance 17–33 units/kg 3 times a week (max. per dose 200 units/kg 3 times a week), intravenous route preferred, intravenous injection to be given over 1–5 minutes, subcutaneous injection, maximum 1 mL per injection site, reduce dose by approximately 25% if rise in haemoglobin concentration exceeds 2 g/100 mL over 4 weeks or if haemoglobin concentration exceeds 12 g/100 mL; if haemoglobin concentration continues to rise, despite dose reduction, suspend treatment until haemoglobin concentration decreases and then restart at a dose approximately 25% lower than the previous dose Symptomatic anaemia in adults receiving cancer chemotherapy ▶BY SUBCUTANEOUS INJECTION ▶Adult: Initially 150 units/kg 3 times a week, alternatively initially 450 units/kg once weekly, increased to 300 units/kg 3 times a week, increased if appropriate rise in haemoglobin (or reticulocyte count) not achieved after 4 weeks; discontinue if inadequate response after 4 weeks at higher dose, subcutaneous injection maximum 1 mL per injection site, reduce dose by approximately 25–50% if rise in haemoglobin concentration exceeds 2 g/100 mL over 4 weeks or if haemoglobin concentration exceeds 12 g/100 mL; if haemoglobin concentration continues to rise, despite dose reduction, suspend treatment until haemoglobin concentration decreases and then restart at a dose approximately 25% lower than the previous dose. Discontinue approximately 4 weeks after ending chemotherapy To increase yield of autologous blood (to avoid homologous blood) in predonation programme in moderate anaemia either when large volume of blood required or when sufficient blood cannot be saved for elective major surgery ▶BY INTRAVENOUS INJECTION ▶Adult: 600 units/kg twice weekly for 3 weeks before surgery, consult product literature for details and advice on ensuring high iron stores, intravenous Blood and nutrition injection to be given over 1–5 minutes Moderate anaemia (haemoglobin concentration 10–13 g/100 mL) before elective orthopaedic surgery in adults with expected moderate blood loss to reduce exposure to allogeneic blood transfusion or if autologous transfusion unavailable ▶BY SUBCUTANEOUS INJECTION ▶Adult: 600 units/kg once weekly for 3 weeks before surgery and on day of surgery, alternatively 300 units/kg daily for 15 days starting 10 days before surgery, consult product literature for details, subcutaneous injection maximum 1 mL per injection site
PDF page 1095