Epoetin Beta
Mechanism :
Has same effects as endogenous erythropoietin. Binding of erythropoietin to the erythropoietin receptor leads to receptor dimerization, which facilitates activation of JAK-STAT signalling pathways within the cytosol. Activated STAT (signal transducers and activators of transcription) proteins are then translocated to the nucleus where they serve as transcription factors which regulate the activation of specific genes involved in cell division or differentiation.
Indication :
- Anemia in Premature patients
- Anemia in Chronic Renal Failure
- Anemia in Cancer patients.
Contraindications :
Hypersensitivity to epoetin alfa or albumin or mammalian cell-derived products
Cancer patients whose anemia is caused by factors other than chemotherapy.
Uncontrolled hypertension.
Pure red-cell aplasia that begins after treatment with any erythropoietin protein drugs.
Use of multidose vials containing benzyl alcohol in neonates, infants, or pregnant or nursing women, because of increased risk of serious adverse events and death; single-dose vials should be used instead and must not be admixed with bacteriostatic saline containing benzyl alcohol.
Dosing :
Prevention of anemia of prematurity:
Give SC. <34 weeks gestation and birth weight 750 gm-1.5 kg: 250 IU/kg 3 times a week for 6 weeks.
Renal anemia in dialysis patients:
SC:
20 lU/kg 3 times in a week.
IV injection, over 2 min:
40 lU/kg 3 times in a week. Increase dose till results obtained.
For both routes, max weekly dose is 720 lU/kg.
Maintenance SC/IV:
After Hb of 9.5-12 gm% is achieved, reduce dose by half and then adjust according to response at 1-2 week intervals.
Adverse Effect :
Dose dependent side effects include aggravation of hypertension, flu-like symptoms, rash and shunt thrombosis. Other effects are arthralgia, pruritus, rash, pyrexia, headache, cough, vomiting.
Interaction :
None known.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Not dialysed. Dose as in normal renal function |
| CAV/VVHD | Not dialysed. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are recommended.