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Erythropoietin information from DrugsUpdate  

See Available Brands of Erythropoietin in India

P - Caution when used during pregnancy
L - Caution when used during lactation

Erythropoietin, or EPO, is a glycoprotein hormone that controls erythropoiesis, or red blood cell production. It is a cytokine for erythrocyte (red blood cell) precursors in the bone marrow.

Also called hematopoietin or hemopoietin, it is produced by the peritubular capillary endothelial cells in the kidney, and is the hormone that regulates red blood cell production. It also has other known biological functions. For example, erythropoietin plays an important role in the brain's response to neuronal injury. EPO is also involved in the wound healing process.

When exogenous EPO is used as a performance-enhancing drug, it is classified as an erythropoiesis-stimulating agent (ESA). Exogenous EPO can often be detected in blood, due to slight difference from the endogenous protein, for example in features of posttranslational modification.

Pharmacodynamics

Pharmacokinetics

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.

Erythropoietin Indications / Erythropoietin Uses

Information Not Available

Erythropoietin Adverse Reactions / Erythropoietin Side Effects

Hypertension, myalgia, arthralgia, flu-like syndrome, rashes and urticaria.

Potentially Fatal: Hypertensive crisis with encephalopathy-like symptoms e.g. headache, confusion, generalised seizures. Thrombosis. -

Precautions

Information Not Available

Special Precautions

Chronic renal failure, ischaemic heart diseases, hypertension, pregnancy, seizures, liver dysfunction, lactation.

Other Drug Interactions

Haematinics enhance efficiency. Increased dose of heparin in patients undergoing dialysis.

Other Interactions

Information Not Available

Dosage

Intravenous
Increase yield of autologous blood
Adult: As epoetin alfa or zeta: 600 U/kg over 2 minutes twice wkly for 3 wk before surgery; in conjunction with iron, folate and B12 supplementation.

Subcutaneous
Anemia related to non-myeloid malignant disease chemotherapy
Adult: As epoetin alfa or zeta: Initially, 150 U/kg 3 times wkly. Dose may be increased at 4-8 wk intervals to 300 U/kg 3 times wkly. Stop treatment if response is still inadequate after 4 weeks of treatment using this higher dose.

Parenteral
Anemia of chronic renal failure
Adult: As epoetin alfa: Initially, 50 U/kg SC/IV 3 times wkly for predialysis and haemodialysis patients and 50 U/kg twice wkly for peritoneal dialysis patients, may increase according to response in steps of 25 U/kg 3 times wkly at 4 wkly intervals.
Child: As epoetin alfa: Initially, 50 U/kg 3 times wkly. May increase dose at 4 wkly intervals in increments of 25 U/kg 3 times wkly until a target haemoglobin concentration of 9.5-11 g/100 mL is reached. Usual maintenance dose: <10 kg: 225-450 U/kg/wk; 10-30 kg: 180-450 U/kg/wk and >30 kg: 90-300 U/kg/wk.

Parenteral
Anaemia in zidovudine-treated HIV-infected patients
Adult: As epoetin alfa: Initially, 100 U/kg SC/IV thrice wkly for 8 wk; increase every 4-8 wk by 50-100 U/kg according to response. Max: 300 U/kg thrice weekly.

Food(before/after)

Information Not Available

List of Contraindications

Erythropoietin and Pregnancy

Caution when used during 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.

Erythropoietin and Lactation

Caution when used during lactation

Erythropoietin and Children

Information Not Available

Erythropoietin and Geriatic

Information Not Available

Erythropoietin and Other Contraindications

Uncontrolled hypertension, hypersensitivity to mammalian cell products and human albumin.

Storage

Intravenous
Refrigerate at 2-8°C. Do not freeze.

Parenteral
Refrigerate at 2-8°C. Do not freeze.

Subcutaneous
Refrigerate at 2-8°C. Do not freeze.

Lab interference

Intravenous
Refrigerate at 2-8°C. Do not freeze.

Parenteral
Refrigerate at 2-8°C. Do not freeze.

Subcutaneous
Refrigerate at 2-8°C. Do not freeze.

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