Darbepoetin Alfa(dar bah poe e’ tin)
Aranesp
PREGNANCY CATEGORY C
Drug Classes
Erythropoiesis-stimulating hormone
Therapeutic Actions
An erythropoietin-like glycoprotein hormone produced by recombinant DNA technology; stimulates RBC production in the bone marrow in the same manner as naturally occurring erythropoietin, a hormone released into the bloodstream in response to renal hypoxia.
Indications
Treatment of anemia associated with chronic renal failure, including during dialysis
Treatment of chemotherapy-induced anemia in patients with nonmyeloid malignancies
Unlabeled use: Anemia associated with malignancy
Contraindications and Cautions
Contraindicated with uncontrolled hypertension or hypersensitivity to any component of the drug.
Use cautiously with hypertension, pregnancy, lactation.
Available Forms
Polysorbate solution for injection—25, 40, 60, 100, 200, 300, 500 mcg/mL; 25 mcg/0.42 mL, 40 mcg/0.4 mL; 60 mcg/0.3 mL; 100 mcg/0.5 mL; 150 mcg/0.3 or 0.75 mL; 200 mcg/0.4 mL; 300 mcg/0.6 mL
Dosages
Adults
Chronic renal disease
Starting dose: 0.45 mcg/kg IV or subcutaneously once per wk or 0.75 mcg IV or subcutaneously once every 2 wk. Dosage may be adjusted no more frequently than once per mo. Target Hgb level is 11 g/dL. Adjust dosage by 25% at a time to achieve that level. Avoid rapid increase in Hgb.
Switching from epoetin alfa:
Epoetin Alfa Dose in Units/wk
Darbepoetin Alfa Dose in mcg/wk (adult)
Darbepoetin Alfa Dose in mcg/wk (pediatric)
1,500–2,499
6.25
6.25
2,500–4,999
12.5
10
5,000–10,999
25
20
11,000–17,999
40
40
18,000–33,999
60
60
34,000–89,999
100
100
90,000 or more
200
200
Patients who were receiving epoetin two to three times per week should receive darbepoetin once per wk. Patients who were receiving epoetin once per wk should receive darbepoetin once every 2 wk.
Chemotherapy-induced anemia: 2.25 mcg/kg subcutaneously once per wk; adjust to maintain acceptable Hgb levels. Or 500 mcg by subcutaneous injection once every 3 wk; adjust dosage to maintain Hgb level at 11 g/dL.
Anemia of chronic renal failure: Start with single subcutaneous injection every 2 wk. Dosage should start slowly and be increased based on Hgb levels; check Hgb levels weekly until stable, then monthly.
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