Eprex

What is it?

A preparation of synthesized, recombinant human erythropoietin, a glycoprotein hormone, produced by some kidney cells and released into the blood when there is a lack of oxygen reaching the tissues. This increases the rate of production of red blood cells (erythropoiesis) which transport oxygen. Eprex is produced in pre-filled syringes for injection with an autoinjector device and contains epoetin alfa in a phosphate buffered solution, available in strengths of 1,000 or 2,000iu per 0.5ml, 3,000iu per 0.3ml, 4,000iu per 0.4ml, 5,000iu per 0.5ml, 6,000iu per 0.6ml, 7,000iu per 0.7ml, 8,000iu per 0.8ml, 9,000iu per 0.9ml and 10,000iu per ml.

Medical Uses

Anaemia which accompanies chronic renal failure in both dialysis and non-dialysis patients; anaemia in adults receiving chemotherapy for certain malignant conditions, major, planned orthopaedic surgery

Dosage

Adults, haemodialysis patients, (following dialysis), 50iu per kg of body weight 3 times each week at first by intravenous injection; increase 3 times each week by 25iu per kg of body weight, if needed, every month. Usual maintenance dose is in order of 75 to 300iu per kg of body weight each week. Patients receiving peritoneal dialysis, 50iu per kg of body weight by intravenous injection twice each week, increasing twice each week by 25iu per kg of body weight, if needed, every month. Usual maintenance dose is in the order of 25 to 50iu per kg of body weight twice each week in two equal doses. Non-dialysis patients, 50iu per kg of body weight three times each week at first, by intravenous injection. Dose increased if necessary by 25iu per kg of body weight 3 times each week every month until desired haemoglobin level is reached. Usual maintenance dose is in the order of 17 to 33iu per kg of body weight 3 times each week. Chemotherapy and orthopaedic surgery, dosages according to specialist and manufacturer's specifications. Children, haemodialysis, 50iu per kg of bodyweight 3 times each week after dialysis, in first instance. Dose is then increased if necessary by 25iu per kg of body weight 3 times each week every month until desired haemoglobin level is reached. Usual maintenance dose is in the order of 75 to 1501u per kg of body weight for children weighing less than 10kg; 60 to 150iu per kg, for those weighing 10 to 30kg; 30 to 1001u per kg, for those weighing more than 30kg. All doses are given 3 times each week. Also, EPREX VIAL, containing 40,000iu per ml of epoetin alfa in a phosphate buffered solution. Used for. to increase yield of (autologous) blood in adults with anaemia in predonation programme; adults with moderate anaemia undergoing major orthopaedic surgery who are at high risk of complications from transfusions - risk of thromboembolic episodes must be weighed against benefits.

Dosage

According to manufacturer'sspecifications and specialist advice. Special cure: pregnancy, liver failure, hypertension, ischaemic vascular disease, history of epilepsy. Haemoglobin levels, blood pressure, electrolyte levels and blood count require consistent monitoring. Iron supplements may be needed and treatment for any other causes of anaemia.

Avoid Use

High blood pressure which is not under control, severe heart and circulatory disease in patients undergoing planned orthopaedic surgery and not in autologous blood donation programme, patients not able to be given preventative antithrombotic drugs.

Possible Drug and Food Interactions

Cyclosporin.

Known Side Effects

Headache, rise in blood pressure, feverish, flu-like symptoms, skin reactions, seizures, fluid retention, thrombosis. In extremely rare cases, pure red blood cell aplasia (complete absence of cells) has occurred - treatment must be stopped immediately.

Manufacturer

Janssen-Cilag.