Indications And Dose
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 according to response, adjusted in steps of 25 units/kg 3 times a week, dose to be adjusted at intervals of at least 4 weeks; maintenance 25–100 units/kg 3 times a week, intravenous injection to be given over 1–5 minutes, if given by subcutaneous injection, a maximum of 1 mL can be given per injection site, avoid increasing haemoglobin concentration at a rate exceeding 2 g/100 mL over 4 weeks 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 injection to be given over 1–5 minutes, if given by subcutaneous injection, a maximum of 1 mL can be given per injection site, avoid increasing haemoglobin concentration at a rate exceeding 2 g/100 mL over 4 weeks 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, adjusted according to response, adjusted in steps of 25 units/kg 3 times a week, 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 injection to be given over 1–5 minutes, if given by subcutaneous injection, a maximum of 1 mL can be given per injection site, avoid increasing haemoglobin concentration at a rate exceeding 2 g/100 mL over 4 weeks 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, only increase dose if appropriate rise in haemoglobin (or reticulocyte count) not achieved after 4 weeks; discontinue if inadequate response after 4 weeks at higher dose, 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, intravenous injection to be given over 1–5 minutes, consult product literature for details and advice on ensuring high iron stores 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 every week for 3 weeks before surgery and on day of surgery, alternatively 300 units/kg daily for 15 days starting 10 days before surgery, maximum 1 mL per injection site, consult product literature for details
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