Anaemia in zidovudine-treated HIV-infected patients, Anaemia of chronic renal failure, Anaemia of prematurity, Anaemia related to non-myeloid malignant disease chemotherapy, To reduce the need for allogenic blood tranfusion
Drugs for Haemolytic Hypoplastic & Renal Anemia
Erythropoietin regulates erythropoiesis by stimulating the differentiation and proliferation of erythroid precursors, stimulating the release of reticulocytes into the circulation, and synthesis of cellular haemoglobin. Recombinant human erythropoietin is available as epoetin alfa and epoetin beta which are used in the management of anaemias associated with CRF, cancer chemotherapy and anti-AIDS drug zidovudine.
Increase yield of autologous blood As epoetin alfa or zeta: 600 IU/kg twice wkly for 3 wk before surgery.Anaemia of chronic renal failure As epoetin alfa:
Predialysis and haemodialysis: Initial: 50 IU/kg 3 times/wk;
Peritoneal dialysis: 50 IU/kg twice wkly.
Anaemia in zidovudine-treated HIV-infected patients As epoetin alfa: Initial: 100 IU/kg 3 times/wk for 8 wk. Max: 300 IU/kg 3 times/wk.Anaemia related to non-myeloid malignant disease chemotherapy As epoetin alfa or zeta: Initial: 150 IU/kg 3 times/wk, up to 300 IU/kg 3 times/wk.Anaemia of chronic renal failure:
Child: As epoetin alfa: Initially, 50 IU/kg 3 times wkly. May increase dose at 4 wkly intervals in increments of 25 IU/kg 3 times wkly until a target haemoglobin concentration of 9.5-11 g/100 mL is reached. Usual maintenance dose: 30 kg: 90-300 IU/kg/wk.
Haematinics enhance efficiency. Increased dose of heparin in patients undergoing dialysis.
Uncontrolled hypertension, hypersensitivity to mammalian cell products and human albumin.
Hypertension, myalgia, arthralgia, flu-like syndrome, rashes and urticaria. Potentially Fatal: Hypertensive crisis with encephalopathy-like symptoms e.g. headache, confusion, generalised seizures. Thrombosis.
Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
