Eprex Pre-filled Syringe 4000IU 0 ml

Description

Overview 

One of the essential protein-based hormones released by kidneys is erythropoietin which causes the production of red blood cells from our spine. RBCs are perhaps the single most important blood cells without which human life can not exist, as these are involved in supplying oxygen all across the body. A lack of this particular protein associated with diseased states directly affects RBCs, causing anemia and thus it must be taken from exogenous sources. 

How Does Eprex Pre-filled Syringe 4000IU 0 ml Work

“Erythropoietin” is a natural hormone normally released from the kidney in response to low cell oxygen levels. Eprex Pre-filled Syringe 4000IU 0 ml is chemically composed of epoetin alfa, similar to the natural hormone, obtained by DNA technology. It works on erythroid progenitor cells and causes the bone marrow to synthesize and release mature RBCs, making up for the deficiency. 

Dosing and Indications

Eprex Pre-filled Syringe 4000IU 0 ml can be used to treat:

• Anemia because of kidney disease 
• Anemia in patients on dialysis 
• Anemia in patients undergoing chemotherapy for tumors like lymphoma, myeloma 
• Moderate anemia in patients scheduled to have a surgery 
• Moderate anemia in patients who donate their blood to be used at the tie of their surgery 

Adult Dose

Chronic Kidney Disease without Dialysis

50 to 100 IU per kg of body weight, given as an IV injection 3 times a week

Dose adjustment: Increase by 25 IU per kg, 3 times a week every 4 weeks

Maintenance Dose: 17 to 33 IU per kg per week in 3 divided doses

Chronic Kidney Disease on Dialysis

Hemodialysis

50 to 100 IU per kg of body weight, given as a subcutaneous (SC) injection or an IV injection 3 times a week

Dose adjustment: Increase by 25 IU per kg, 3 times a week every 4 weeks

Maintenance Dose: 75 to 300  IU per kg per week in 3 divided doses

Peritoneal Dialysis

50 to 100 IU per kg of body weight, given as a subcutaneous (SC) injection or an IV injection 3 times a week

Dose adjustment: Increase by 25 IU per kg, 2 times a week every 4 weeks

Maintenance Dose: 25 to 50  IU per kg per week in 2 divided doses

Anemia Associated with Chemotherapy

Starting Dose: 150 units/kg either IV or SC thrice a week 

OR,

40,000 units SC once weekly until termination of chemotherapy 

Target Hb: 10 to 12 gm/dL

Dose Adjustment

Reduction or increase is indicated by evaluating Hb levels every 4 weeks

Child Dose

Not indicated in children less than 1 month old due to safety concerns

Chronic Kidney Disease on Dialysis

Hemodialysis

50 units/kg via IV injection 3 times weekly initially,

Maintenance Dose:

10 kg: 75 to 150 IU per kg

10 – 30 kg: 60 to 150 IU  per kg

More than 30 kg: 30 to 100  IU  per kg

Target Hb: 9.5 to 11 gm/dL

Elderly Dose

Regarding the dosage for the elderly, caution should be advised. Follow your doctor’s prescription. 

How To Use Eprex Pre-filled Syringe 4000IU 0 ml

Eprex Pre-filled Syringe 4000IU 0 ml is available as an injectable solution, to be given under the skin subcutaneously or as an intravenous injection, which is decided by your doctor. It is administered in a healthcare facility by a professional. Eprex Pre-filled Syringe 4000IU 0 ml comes packed in a glass vial or prefilled injections to be used under aseptic conditions. Liquid from vials is withdrawn in a syringe under sterile conditions and injected. Prefilled syringes need not be prepared as such, follow the instructions given in the manual. At-home injection technique can also be taught, considering the patient or his helper understands the technique well enough.  

Side Effects

Inform your healthcare supervisor immediately, if you experience any of the following symptoms:

• Pain or bruising at the injection site 
• Allergic reaction 
• Upset stomach 
• Vomiting/ Diarrhea 
• Stuffy nose
• Sore throat 
• Cough  
• Formation of blood clots (embolism/ DVT)
• Muscle or joint pain 
• Swelling of the limbs 
• Skin rash/itching 

Contraindications

Please tell your doctor if you have a history of any of the following before using Eprex Pre-filled Syringe 4000IU 0 ml:

• Hypersensitivity to Eprex Pre-filled Syringe 4000IU 0 ml
• Pure Red Cell Aplasia 
• Cancers originating from bone marrow
• Uncontrolled high blood pressure 
• Unable to receive transfusion with your blood 
• Recent history of stroke/ arterial or venous disorder  
• Scheduled for major surgery and inability to take blood thinners
• Antithrombotic prophylaxis can not be taken 
• Known hypersensitivity to albumin 

Precautions

Please tell your doctor about any of the following conditions before using Eprex Pre-filled Syringe 4000IU 0 ml:

• Eprex Pre-filled Syringe 4000IU 0 ml must be used with caution if you have a history of drug-related allergies
• Before starting Eprex Pre-filled Syringe 4000IU 0 ml, rule out the possibility of Pure Red Cell Aplasia and other causes of anemia 
• Regular monitoring of RBC count is required before, during, and after the treatment, so as not to exceed the count
• Extra caution is advised if you have high blood pressure, your doctor will stop the treatment if BP is unmanageable 
• During the first 8 weeks, regularly monitor platelets and thrombocytosis
• Eprex Pre-filled Syringe 4000IU 0 ml is not indicated in pregnancy. It will only be prescribed if considered necessary
• In case of a history of heart disease or seizures, inform your doctor
• Electrolytes must be checked periodically, there is a risk of developing Hyperkalemia
• If the patient is using Eprex Pre-filled Syringe 4000IU 0 ml on his own, the at-home injection technique can be taught to him or a healthcare provider
• In dialysis patients, extra attention must be given to “Shunt thrombosis”
• There is an increased risk of blood clots, your doctor may decide to give you blood thinners 

Interactions With Other Medications

Always provide correct information to the doctor about all the drugs that you are currently taking. Following drugs may interact with Eprex Pre-filled Syringe 4000IU 0 ml, a few of which are: 

• Immunosuppressants like Cyclosporine

FAQ’s

# 1. How To Store Eprex Pre-filled Syringe 4000IU 0 ml?

Eprex Pre-filled Syringe 4000IU 0 ml is to be kept away from the reach of children and pets, in a cool dry, and dark place at 2 to 8°C in a refrigerator, away from direct sunlight and humidity. Do not freeze this medicine. 

#2. Can I take Eprex Pre-filled Syringe 4000IU 0 ml during my pregnancy?

Eprex Pre-filled Syringe 4000IU 0 ml is not prescribed during pregnancy due to safety concerns. Careful consideration must be given to the seriousness of adverse effects it can cause if it is used to treat pregnant females.  

#3. Can  Eprex Pre-filled Syringe 4000IU 0 ml raise my blood pressure?

Yes,  Eprex Pre-filled Syringe 4000IU 0 ml has been associated with hypertension. Regular monitoring of B.P is advised at home while using this medicine. In case of unmanageable blood pressure, your doctor will have to stop the treatment. 

#4. How long will I have to take Eprex Pre-filled Syringe 4000IU 0 ml?

This depends on the status of your deficiency and kidney function. Eprex Pre-filled Syringe 4000IU 0 ml is started by your doctor after checking your RBCs, usually at 10 g/dL or less. A maintenance dose is used to keep the level at 11 – 12 g/dL. 

#5. What is the ideal time to get an Epoprotein shot for patients on dialysis?

Your doctor will determine the right time and amount. Usually, it can be given after the procedure ends, alternatively, it is safely given 20 to 25 minutes before ending the dialysis since it is a protein in nature. 

#6. When will I start feeling better after taking Eprex Pre-filled Syringe 4000IU 0 ml?

Generally, it takes about 1 to 2 months before you can start feeling improvement in your overall health. It may take even longer if your deficiency is severe or not responding to Eprex Pre-filled Syringe 4000IU 0 ml. 

#7. Do I have to take iron supplements with Eprex Pre-filled Syringe 4000IU 0 ml?

Eprex Pre-filled Syringe 4000IU 0 ml performs better when taken with iron since both are a prerequisite for producing RBCs. your doctor will determine the dose of iron you should take.