Precautions
Epogen injections can be given subQ in the outer upper arms, front of thighs, or abdomen. If you are injecting in the abdomen, just be sure to not be too close to the umbilicus. If you're giving Lovenox also, you could still give Epogen in the abdo, just not in the same site. Letina is correct. it can be given as same as how an insulin ...
How do you administer Epogen by IV push?
EPOGEN ® is contraindicated in patients with: . Uncontrolled hypertension; Pure red cell aplasia (PRCA) that begins after treatment with EPOGEN ® or other erythropoietin protein drugs; Serious allergic reactions to EPOGEN ®; EPOGEN ® from multidose vials contains benzyl alcohol and is contraindicated in neonates, infants, pregnant women, and lactating women.
What is the main contraindication to Epogen therapy?
Epogen is used to treat anemia caused by chemotherapy or chronic kidney disease, anemia caused by taking zidovudine to treat HIV (human immunodeficiency virus), or anemia due to other reasons. Epogen is also used to reduce the need for red blood cell transfusions in people having certain types of surgery.
What conditions does Epogen vial treat?
- rash
- hives
- itching
- skin blisters or peeling skin
- swelling of the face, throat, tongue, lips, or eyes
- wheezing
- difficulty breathing or swallowing
- seizures
How to inject Epogen?
How do you administer epoetin?
Adults—Dose is based on body weight and must be determined by your doctor. The starting dose is 50 to 100 units per kilogram (kg) injected into a vein or under the skin three times a week. Your doctor may adjust the dose as needed. Children—Use and dose must be determined by your doctor.
Is Epogen given IV?
If the hemoglobin level approaches or exceeds 11 g/dL, reduce or interrupt the dose of Epogen. The recommended starting dose for adult patients is 50 to 100 Units/kg 3 times weekly intravenously or subcutaneously. The intravenous route is recommended for patients on hemodialysis.
How is erythropoietin injection given?
You have erythropoietin as an injection under the skin (subcutaneously). It is usually given into the thigh or tummy. A nurse can teach you, or a person caring for you, how to inject it. If you or a carer cannot give the injections, a district or practice nurse may do it for you.
How often is Epogen administered?
This medication is given as an injection under the skin or into a vein as directed by your doctor, usually 1 to 3 times a week. Patients getting this medication before surgery may have a special dosing schedule. Hemodialysis patients should receive this medication by injection into a vein.
Is epoetin given IV?
The initial clinical trials of epoetin were performed in patients undergoing hemodialysis, with the drug administered intravenously during hemodialysis.
What syringe is used for Epogen?
Use only the type of disposable syringe and needle that your healthcare provider has prescribed. Do not shake Epogen. Shaking could cause Epogen not to work. If you shake Epogen, the solution in the vial may look foamy and should not be used.
Why is EPO given subcutaneously?
Conclusions: In patients receiving hemodialysis, subcutaneous administration of epoetin can maintain the hematocrit in a desired target range, with an average weekly dose of epoetin that is lower than with intravenous administration.
How do you administer an EPO 4000 injection?
EPREX should be administered as a subcutaneous injection. EPREX should be administered as a subcutaneous injection. In paediatric patients with chronic renal failure where intravenous access is routinely available (haemodialysis patients) administration of EPREX by the intravenous route is preferable.
How do you take a hemoglobin injection?
HB-IV Injection is given by slow infusion (drip) into a vein by your doctor or nurse. Your doctor will decide the dose you need and how many injections you should have to improve your anemia. It will also help to eat a well-balanced diet that has enough iron.
What is the best time to inject epoetin?
Typically we give it when returning a dialysis patient, but most doctors say it is fine to inject EPO 20 to 25 minutes before dialysis patient termination by saying it is a protein.
How long does it take for an injection of Epogen take to work?
It takes time for your body to make new red blood cells and raise your hemoglobin (Hb) level. With EPOGEN® treatment, Hb levels usually increase in 2 to 6 weeks. Your doctor will test your blood regularly—at least weekly at the beginning of your treatment—to make sure EPOGEN® is working.
How do you administer a PROCRIT shot?
Subcutaneous Route: PROCRIT can be injected directly into a layer of fat under your skin. This is called a subcutaneous injection. When giving subcutaneous injections, follow your healthcare provider's instructions about changing the site for each injection. You may wish to write down the site where you have injected.
What is epogen used for?
Epogen is indicated for the treatment of anemia due to chronic kidney disease (CKD), including patients on dialysis and not on dialysis to decrease the need for red blood cell (RBC) transfusion.
How old is Epogen?
Epogen is indicated in pediatric patients, ages 1 month to 16 years of age, for the treatment of anemia associated with CKD requiring dialysis. Safety and effectiveness in pediatric patients less than 1 month old have not been established [see Clinical Studies ( 14.1 )].
How long does it take for Epogen to increase hemoglobin?
Epogen increases the reticulocyte count within 10 days of initiation, followed by increases in the RBC count, hemoglobin, and hematocrit, usually within 2 to 6 weeks. The rate of hemoglobin increase varies among patients and is dependent upon the dose of Epogen administered. For correction of anemia in hemodialysis patients, a greater biologic response is not observed at doses exceeding 300 Units/kg 3 times weekly.
What is the target level of erythropoiesis-stimulating agents?
In controlled trials, patients experienced greater risks for death, serious adverse cardiovascular reactions, and stroke when administered erythropoiesis-stimulating agents (ESAs) to target a hemoglobin level of greater than 11 g/dL. No trial has identified a hemoglobin target level, ESA dose, or dosing strategy that does not increase these risks. Individualize dosing and use the lowest dose of Epogen sufficient to reduce the need for RBC transfusions [see Warnings and Precautions ( 5.1 )]. Physicians and patients should weigh the possible benefits of decreasing transfusions against the increased risks of death and other serious cardiovascular adverse reactions [see Boxed Warning and Clinical Studies ( 14)].
How much does epoetin alfa weigh?
It has a molecular weight of approximately 30,400 daltons and is produced by mammalian cells into which the human erythropoietin gene has been introduced. The product contains the identical amino acid sequence of isolated natural erythropoietin.
Does Epogen require heparin?
Patients may require adjustments in their dialysis prescriptions after initiation of Epogen. Patients receiving Epogen may require increased anticoagulation with heparin to prevent clotting of the extracorporeal circuit during hemodialysis.
Does Epogen cause seizures?
Epogen increases the risk of seizures in patients with CKD. During the first several months following initiation of Epogen, monitor patients closely for premonitory neurologic symptoms. Advise patients to contact their healthcare practitioner for new-onset seizures, premonitory symptoms or change in seizure frequency.
What is PRCA in epogen?
Have been told by your healthcare provider that you have, or have ever had a type of anemia called Pure Red Cell Aplasia (PRCA) that starts after treatment with EPOGEN. ®.
Can you die from epogen?
, including people with cancer or chronic kidney disease: Serious heart problems, such as heart attack or heart failure, and stroke. You may die sooner if you are treated with EPOGEN. ®. to increase red blood cells (RBCs) to near the same level found in healthy people. Blood clots.
Does Epogen cause high blood pressure?
High blood pressure is a common side effect of EPOGEN. ®. in people with chronic kidney disease. Your blood pressure may go up or be difficult to control with blood pressure medication while taking EPOGEN.
Is it safe to take epogen with multiple doses?
Dangers of using EPOGEN. ®. from multiple-dose vials (which contain ben zyl alcohol) in newborns, infants, and pregnant or breastfeeding women. Benzyl alcohol has been shown to cause brain damage, other serious side effects, and death in newborn and premature babies.
What is Zidovudine used for?
This medication is used to treat anemia (low red blood cell count) in people with long-term serious kidney disease (chronic kidney failure ), people receiving zidovudine to treat HIV, and people receiving chemotherapy for some types of cancer ( cancer that does not involve the bone marrow or blood cells ).
Can epoetin alfa cause heart failure?
Discuss the risks and benefits of epoetin alfa with your doctor, as this medication may rarely cause very serious (possibly fatal) side effects, including blood clots, heart attack, stroke, or heart failure.
How long does it take for Epogen to increase hemoglobin?
Epogen increases the reticulocyte count within 10 days of initiation, followed by increases in the RBC count, hemoglobin, and hematocrit , usually within 2 to 6 weeks . The rate of hemoglobin increase varies among patients and is dependent upon the dose of Epogen administered. For correction of anemia in hemodialysis patients, a greater biologic response is not observed at doses exceeding 300 Units/kg 3 times weekly.
What is epoetin alfa?
Epoetin alfa is a 165- amino acid erythropoiesis-stimulating glycoprotein manufactured by recombinant DNA technology. It has a molecular weight of approximately 30,400 daltons and is produced by mammalian cells into which the human erythropoietin gene has been introduced. The product contains the identical amino acid sequence of isolated natural erythropoietin.
What is the target level of erythropoiesis-stimulating agents?
In controlled trials, patients experienced greater risks for death, serious adverse cardiovascular reactions, and stroke when administered erythropoiesis-stimulating agents (ESAs) to target a hemoglobin level of greater than 11 g/dL. No trial has identified a hemoglobin target level, ESA dose, or dosing strategy that does not increase these risks. Individualize dosing and use the lowest dose of Epogen sufficient to reduce the need for RBC transfusions [see WARNINGS AND PRECAUTIONS ]. Physicians and patients should weigh the possible benefits of decreasing transfusions against the increased risks of death and other serious cardiovascular adverse reactions [see BOXED WARNING and Clinical Studies ].
Does Epogen cause seizures?
Epogen increases the risk of seizures in patients with CKD. During the first several months following initiation of Epogen, monitor patients closely for premonitory neurologic symptoms. Advise patients to contact their healthcare practitioner for new-onset seizures, premonitory symptoms or change in seizure frequency.
Is Epogen contraindicated for dialysis?
Epogen is contraindicated in patients with uncontrolled hypertension. Following initiation and titration of Epogen, approximately 25% of patients on dialysis required initiation of or increases in antihypertensive therapy; hypertensive encephalopathy and seizures have been reported in patients with CKD receiving Epogen.
Is Epogen good for cancer patients?
Limitations Of Use. Epogen has not been shown to improve quality of life , fatigue, or patient well-being. Epogen is not indicated for use: In patients with cancer receiving hormonal agents, biologic products, or radiotherapy, unless also receiving concomitant myelosuppressive chemotherapy.
Can epogen cause anemia?
Anemia Due To Chemotherapy In Patients With Cancer. Epogen is indicated for the treatment of anemia in patients with non- myeloid malignancies where anemia is due to the effect of concomitant myelosuppressive chemotherapy, and upon initiation, there is a minimum of two additional months of planned chemotherapy.
What is epogen procrit?
Epogen, Procrit, Retacrit. Reduction of need for red blood cell (RBC) transfusion in patients with chronic kidney disease (CKD) on dialysis and not on dialysis .
Is erythropoietin in human milk?
However, endogenous erythropoietin is present in human milk.
What is the purpose of epogen?
EPOGEN® is indicated to elevate or maintain the red blood cell level (as manifested by the hematocrit or hemoglobin determinations) and to decrease the need for transfusions in these patients. EPOGEN® is not indicated for the treatment of anemia in HIV-infected patients due to other factors such as iron or folate deficiencies, hemolysis, or gastrointestinal bleeding, which should be managed appropriately. EPOGEN® use has not been demonstrated in controlled clinical trials to improve symptoms of anemia, quality of life, fatigue, or patient well-being.
What are the symptoms of overdosage of epogen?
The expected manifestations of EPOGEN® overdosage include signs and symptoms associated with an excessive and/or rapid increase in hemoglobin concentration, including any of the cardiovascular events described in WARNINGS and listed in ADVERSE REACTIONS. Patients receiving an overdosage of EPOGEN® should be monitored closely for cardiovascular events and hematologic abnormalities. Polycythemia should be managed acutely with phlebotomy, as clinically indicated. Following resolution of the effects due to EPOGEN® overdosage, reintroduction of EPOGEN® therapy should be accompanied by close monitoring for evidence of rapid increases in hemoglobin concentration (>1 gm/dL per 14 days). In patients with an excessive hematopoietic response, reduce the EPOGEN® dose in accordance with the recommendations described in DOSAGE AND
How long did the placebo study last?
In double-blind, placebo-controlled studies of 3 months duration involving approximately 300 zidovudine-treated HIV-infected patients, adverse events with an incidence of ≥ 10% in either patients treated with EPOGEN® or placebo-treated patients were:
What is the endogenous serum erythropoietin level?
Available evidence suggests that patients receiving zidovudine with endogenous serum erythropoietin levels > 500 mUnits/mL are unlikely to respond to therapy with
How long does erythropoietin stay in plasma?
In adult and pediatric patients with CRF, the elimination half-life of plasma erythropoietin after intravenously administered EPOGEN® ranges from 4 to 13 hours.13-15 The half-life is approximately 20% longer in CRF patients than that in healthy subjects. After SC administration, peak plasma levels are achieved within 5 to 24 hours. The half-life is similar between adult patients with serum creatinine level greater than 3 and not on dialysis and those maintained on dialysis. The pharmacokinetic data indicate no apparent difference in EPOGEN® half-life among adult patients above or below 65 years of age.
How does endogenous erythropoietin work?
Endogenous production of erythropoietin is normally regulated by the level of tissue oxygenation. Hypoxia and anemia generally increase the production of erythropoietin, which in turn stimulates erythropoiesis.2 In normal subjects, plasma erythropoietin levels range from 0.01 to 0.03 Units/mL and increase up to 100- to 1000-fold during hypoxia or anemia.2 In contrast, in patients with chronic renal failure (CRF), production of erythropoietin is impaired, and this erythropoietin deficiency is the primary cause of their anemia.3,4
Where is erythropoietin produced?
Erythropoietin is a glycoprotein which stimulates red blood cell production. It is produced in the kidney and stimulates the division and differentiation of committed erythroid progenitors in the bone marrow. EPOGEN® (Epoetin alfa), a 165 amino acid glycoprotein manufactured by recombinant DNA technology, has the same biological effects as endogenous erythropoietin.1 It has a molecular weight of 30,400 daltons and is produced by mammalian cells into which the human erythropoietin gene has been introduced. The product contains the identical amino acid sequence of isolated natural erythropoietin.
