Polypeptide Hormones Recombinant Human Erythropoietin Injection EPO 5000iu

EPO application :

Treatment of anemia in chronic renal failure:

Erythropoietin is administered to maintain hemoglobin concentration between 11 to 12 g/dl and hematocrit of 33 -36 % in adults.

Starting dose:

• Adult: usually 50 to 100 IU/kg three times in a week (TIW) by IV or Subcutaneous route

• Pediatric: 50 IU/kg TIW by IV or Subcutaneous route

Dose adjustment: Dose should be increased if hematocrit doses not increase by 5 to 6 points after 8 weeks therapy, and hematocrit is below suggested target range. Dose should be reduced when hematocrit approaches 36% or hematocrit increases >4 points in any 2-week period.

Maintenance dose: Maintenance dose must be individualized for each patient. In patients undergoing dialysis, the median maintenance dose is 75 IU/kg TIW, with a range from 12.5 to 525 IU/kg TIW as directed by the physician. In CRF patients not on dialysis, maintenance dose is 75 to 150 IU/kg/week.

Treatment of Anemia in Cancer Patients on Chemotherapy:

Starting dose:

• Adult: 150 IU/kg TIW by Subcutaneous route or 40,000 IU Subcutaneous route weekly

• Pediatric: 25 to 300 IU/kg 3 to 7 times per week by Subcutaneous or IV route

Dose adjustment: If the response is not satisfactory, the dose should be increased to 300 IU/kg TIW. If the hematocrit exceeds 40%, the dose should be withheld until the hematocrit falls to 36%. The dose should be reduced to 25% when treatment is resumed and titrated to maintain the desired hematocrit.
 

Surgery Patients:

The recommended dose is 300 IU/kg/day subcutaneously for 10 days before surgery, on the day of surgery, and for 4 days after surgery. An alternate dose schedule is 600 IU/kg subcutaneously in once weekly dose (21, 14, and 7 days before surgery) plus a fourth dose on the day of surgery.
 

Zidovudine-treated HIV-infected Patients:

Starting dose:

• Adult: 100 IU/kg as an IV or Subcutaneous injection TIW for 8 weeks

• Pediatric: 50 to 400 IU/kg 2 to 3 times per week by Subcutaneous or IV route

Dose adjustment: If the response is not satisfactory, the dose should be increased by 50-100 IU/kg TIW. Response should be evaluated every 4 to 8 weeks thereafter and the dose adjusted accordingly by 50 to 100 IU/kg increments TIW.

Maintenance dose: The dose is titrated to maintain the hematocrit between 33-36%.

EPO Dosage:

EPO is generally used for treatment of anaemia resulting from chronic kidney failure, inflammatory bowel disease, and myelodysplasia. It is generally injected subcutaneously or intra venous.

For performance enhancing purpose recommended dosage is 15-50 U /Kg of body weight.

This comes out to be 1000 -4000 IU per injection every 3-4 days.

The dosage should be started 7-10 days before the event so that the peak activity is reached around the event.

The dose of Epo (expressed in International Units or IU) depends on your disease condition, the way the injection is given (under the skin or into a vein) and your body weight. Your doctor will work out the right dose for you.

Anaemia caused by chronic renal failure

The injections are given under the skin or into a vein. Patients on haemodialysis will usually receive the injection at the end of dialysis via an arterio-venous fistula. Patients who do not have to undergo dialysis are usally given the injections under the skin. Your doctor will carry out blood tests regularly and adjust the dosage or suspend the treatment if necessary. The haemoglobin values in your blood should not exceed a value of 12 g/dl (7.45 mmol/l).

Treatment with Epo is divided into two stages:

      a) Correcting the anaemia The initial dose for injections under the skin is 20 IU per kg of bodyweight, given 3 times per week. If necessary, your doctor will increase your dose at monthly intervals.

The initial dose for injections into veins is 40 IU per kg of bodyweight, given 3 times per week. If necessary, your doctor will increase your dose at monthly intervals.

      b) Maintaining sufficient red blood cell levels Once an adequate number of red blood cells has been reached, the maintenance dose required to keep the number constant will be determined by your doctor.

In the case of injections under the skin, the weekly dose can be given either as 1 injection per week or as 3 divided injections per week.

In the case of injections into veins, your dosage may be switched to 2 injections weekly.

If the frequency of administration is changed, dose adjustments may be necessary.

Treatment with Eporatio is normally a long-term therapy.

The maximum dose should not exceed 700 IU per kg of bodyweight per week.

Anaemia in cancer patients

Injections are given under the skin. The injection will be given once-weekly. The initial dose is 20,000 IU. Your doctor will carry out blood tests regularly and adjust the dosage or suspend the treatment if necessary. The haemoglobin values in your blood should not exceed a value of 12 g/dl (7.45 mmol/l). You will usually receive Eporatio until 1 month after the end of chemotherapy.

The maximum dose should not exceed 60,000 IU.