Darbepoetin alfa is a drug used to treat anemia in chronic kidney failure patients. It was approved by the Food and Drug Administration (FDA) in September 2001. The drug is effective for patients with dialysis and non-dialysis. It increases the red blood cell count by increasing the erythropoietin turnover rate.
How Does Darbepoetin Alfa Work?
Individuals with a low red blood cell count may suffer from anemia. This is quite common in people with chronic kidney failure, as the red cells are produced in the bone marrow. Darbepoetin alfa is generally injected into the bone marrow to induce the production of red blood cells. It is a type of erythropoiesis-stimulating agent. Defective bone marrow may produce damaged red blood cells, resulting in various forms of anemia. Anemia is also prone to occur in patients receiving cancer treatment through chemotherapy or radiotherapy. The drug is useful for patients receiving dialysis. Dialysis is a medical treatment that aids in removing excess fluid from the blood when the kidney is incapable of functioning appropriately. A dialyzer is used to eliminate waste from the body.
Uses:
Darbepoetin alfa is useful in treating low blood cell count or anemia caused by dialysis, chemotherapy, and other medications. It is an erythropoiesis stimulator that increases the production of red blood cells in the bone marrow. The drug is used in patients with chronic kidney diseases and cancer patients, as it helps reduce the need for blood transfusions in patients who may need surgery. The drug is effective only in specific types of anemia with low blood counts due to low levels of erythropoietin.
Dosage:
The dose may vary for each patient depending on the severity of the condition. The different types of dosage are listed below.
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The dose starts from 0.45 to 0.75 microgram per kilogram of body weight for patients with anemia due to chronic kidney failure. The drug is injected into the vein or under the skin once a week or every two weeks, depending on the dosage the doctor recommends.
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For patients with anemia due to chemotherapy, the starting dose is 2.25 micrograms per kilogram body weight, which is administered once a week, or 500 micrograms, which is injected for three weeks.
Warnings:
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Darbepoetin alfa should be used cautiously in patients with cardiovascular disease as it may increase the risk of cardiovascular events.
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In case of previous allergic reactions to the drug, informing the doctor before proceeding with further treatment is safer.
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No appropriate studies have been proven to indicate the drug's efficacy in pediatric patients.
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In elderly patients with pre-existing medical conditions, the drug has to be carefully administered and monitored to prevent adverse reactions.
For Patients
What Is Anemia With Chronic Kidney Failure?
Anemia generally occurs when an individual has a lower blood count or hemoglobin level. It is a common complication of chronic kidney failure. Hemoglobin is essential to carry oxygen throughout the body. In patients with anemia, sufficient oxygen is not delivered to the cells, resulting in symptoms like weakness, fatigue, and shortness of breath. In chronic kidney disease (CKD), there is improper functioning of the hormone erythropoietin. This hormone stimulates red blood cell production in the bone marrow. The red blood cell count also decreases when sufficient hormone is not produced in the bone marrow.
Learn More About Darbepoetin Alfa
Darbepoetin alfa is used to treat anemia in patients with chronic kidney failure. It increases the erythropoietin rate, which helps produce more red blood cells, thereby compensating for the anemia. Anemia is a common condition caused by a low blood count. It could be due to various reasons. The drug specifically treats anemia due to chronic kidney failure and patients on dialysis.
When and How Often to Take Darbepoetin Alfa?
The dosage and frequency of drug intake depend on the patient’s condition and recovery from the treatment. Following a proper dosing schedule helps to improve the condition. The drug is administered intravenously by the healthcare provider once a week or every two weeks for patients with chronic kidney disease. The dosage may vary according to the patient's weight and hemoglobin levels.
The drug is given once a week or every three weeks for patients undergoing chemotherapy. It is important to avoid missing any appointments as it could affect the prognosis of the condition and delay the recovery.
How Effective Is Darbepoetin Alfa?
The drug effectively treats anemia and stimulates red blood cell production. It helps improve the symptoms of anemia, like shortness of breath and fatigue.
Things to Inform the Doctor Before They Prescribe Darbepoetin Alfa:
Before going to the doctor, it is better to carry the prescription for current drugs. This helps the doctor prescribe the medications accordingly after analyzing the drug interactions and pre-existing medical conditions.
Look Out for Side Effects:
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Pus accumulation.
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Chest pain.
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Chills.
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Dizziness.
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Fever.
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Rapid breathing.
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Vomiting.
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Weight gain.
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Sunken eyes.
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Thirst.
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Swelling of face and ankles.
Dietary Alterations:
No specific dietary alterations are required unless suggested by the doctor. A healthy diet and minimal exercise can help lead a healthy lifestyle. Patients with other medical conditions can discuss their diet with the dietician before the drug administration.
What Should Be Done When a Dose Is Missed?
Missing any drug dose may interfere with the treatment outcomes, so it is always better to take the dose promptly. In case of a missed dose, reschedule the appointment for the nearest date available and get the dose administered.
What Should Be Done to Treat Darbepoetin Alfa Overdose?
An overdose may lead to serious complications and result in side effects like nausea, vomiting, and diarrhea. In some cases, allergic reactions may also be observed, which have to be treated carefully.
How to Store Darbepoetin Alfa?
The drug has to be refrigerated in vials or pre-filled syringes between two-degree celsius and eight-degree celsius. Avoid refrigerating the drug directly, as it may make it ineffective. Protect the drug from sunlight. Do not shake the drug vigorously; gently rotate the vial and mix the solution. Avoid using if the drug's color changes, and do not use it beyond the expiration date.
How to Handle Darbepoetin Alfa?
Before drug administration, wash hands carefully. Use a new needle and syringe for every injection to prevent contamination and infection. Use cotton to clean the injection site with spirit and administer the drug carefully. Pinch the skin, create a fold, and insert the needle at forty-five degrees. After using the syringe, safely dispose of the needle.
How to Dispose of Darbepoetin Alfa?
Do not flush the drug down the toilet or down the drain, as it could contaminate the water sources and harm the environment. Contacting the waste management system can help figure out the disposal without causing any biohazards.
Avoid Self-Medication:
Self-medication can cause serious consequences; hence, it is better to follow the instructions given by the doctor when administering the medication.
Tips to Stay On Track:
Set a reminder when the appointment is scheduled; this prevents missing the dose and helps with a speedy recovery.
For Doctors
Indication:
The drug is indicated in patients with anemia due to chronic kidney failure. It helps to improve the erythropoietin production, thereby increasing the number of red blood cells and hemoglobin. Hemoglobin is essential for carrying oxygen and maintaining the oxygen content in the body.
Mechanism of Action:
The drugs belong to a class of medications called erythropoiesis-stimulating agents. It is a synthetic form of the hormone that is produced in the kidneys and stimulates the production of red blood cells in the bone marrow. Red blood cell production is complex, as various steps and factors are involved. The drug binds to and activates the erythropoietin receptor on the red blood cell and promotes the proliferation and differentiation of mature red blood cells.
Pharmacodynamics:
Ingredients:
Each solution contains 2.5 milligrams of albumin and 2.23 milligrams of sodium phosphate monobasic hydrate. In addition, it also has 0.53 milligrams of sodium dibasic anhydrous and 8.18 mg of sodium chloride.
Absorption:
The drug is quickly absorbed into the bloodstream when administered intravenously and subcutaneously. The half-life of the drug is 70 hours in patients who do not undergo dialysis and 46 hours in patients undergoing dialysis. The steady state of the drug is achieved within four weeks.
Toxicity:
It is rare to achieve a toxic dose of Darbepoetin alfa. Toxicity may cause effects like fever and joint pain. These effects may resolve on their own. Serious side effects like heart attacks, strokes, and seizures are likely to occur in patients with existing heart diseases.
Warning and Precaution:
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Individuals with anemia are frequently tired and sick, but after the drug administration for about six weeks, the individuals start to feel better. But the drawback of the treatment is that Darbepoetin alfa can only correct the anemia. It does not have any effects on the existing kidney diseases or cancer.
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During drug administration, monitoring the blood regularly for any allergic reactions and blood pressure is important.
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The drug can potentially cause an allergic reaction called anaphylaxis, which can be life-threatening and require serious medical attention.
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There are higher chances of blood clots, especially in patients who use higher doses, which may increase the risk of heart disease.
Administration of the Drug:
The drug is administered intravenously by the health care professional. Any allergic reactions to the drug have to be quickly reported. The patient is monitored carefully during and after drug administration. The drug can also be administered subcutaneously, according to the doctor’s suggestion after examining the severity of the disease.
Contraindications:
Contraindications for Darbepoetin alfa are listed below:
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Hypersensitivity.
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High blood pressure.
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Pregnancy or breastfeeding.
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Uncontrolled bleeding.
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History of blood clots.
Clinical Studies for Darbepoetin Alfa:
Various clinical studies have proved that Darbepoetin alfa increases hemoglobin levels and decreases blood transfusion needs. Also, the drug reduces the need for blood transfusions for patients undergoing cancer therapy.
Drug Interactions:
The drug can interact with other medications and affect their effectiveness or increase their side effects. It is important to examine the patient thoroughly and evaluate the drug history to check if drug interactions are possible. Some of the possible drug interactions are mentioned below.
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Iron supplements increase the production of red blood cells and may decrease the drug's effectiveness.
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Non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen can increase the risk of bleeding when administered with Darbepoetin alfa.
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Anticoagulants like Warfarin may also increase the risk of bleeding when administered with other drugs.
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Chemotherapy or cancer treatment may increase the risk of blood clots and other complications.
It is important to adjust the dosage and frequency of administration according to the individual’s needs. Monitoring the administered dose is crucial to prevent any adverse effects.
Other Specifications
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Darbepoetin Alfa in Pregnant Women: Drug administration to pregnant women has to be done only after properly analyzing the need for the treatment. In most cases, it is likely to be avoided if it interferes with the growth and development of the child (fetus).
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Darbepoetin Alfa in Lactating Women: The administration of the drug is contraindicated in nursing mothers, as it could pass to the child through the milk and cause growth defects.
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Darbepoetin Alfa in Pediatric Patients: The drug is contraindicated in pediatric patients, as it may cause serious side effects and hamper the child's growth. When administering the drug, a proper medical and family history has to be evaluated to measure the benefits and outweigh the risks of the treatment.
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Darbepoetin Alfa in Geriatric Patients: For elderly individuals, more precaution is needed to prevent any drug interaction from causing side effects. Also, while administering the drug, the patient has to be constantly monitored.
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Darbepoetin Alfa in Renal Impairment Patients: The drug is safe to use in renal-impaired patients, and although it may not help to improve kidney diseases, it is efficient in producing red blood cells.
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Darbepoetin Alfa in Hepatic Impairment Patients: The exact effect of the drug on hepatic-impaired patients is yet to be known. However, there have not been any reported side effects so far.
