pronounced as (dar be poe' e tin)
- Why is this medication prescribed?
- How should this medicine be used?
- Other uses for this medicine
- What special precautions should I follow?
- What special dietary instructions should I follow?
- What should I do if I forget a dose?
- What side effects can this medication cause?
- What should I know about storage and disposal of this medication?
- In case of emergency/overdose
- What other information should I know?
- Brand names
IMPORTANT WARNING:
All patients:
Using darbepoetin alfa injection increases the risk that blood clots will form in or move to the legs, lungs, or brain. Tell your doctor if you have or have ever had heart disease and if you have ever had a stroke. Call your doctor immediately or get emergency medical help if you experience any of the following symptoms: pain, tenderness, redness, warmth, and/or swelling in the legs; coolness or paleness in an arm or leg; shortness of breath; cough that won't go away or that brings up blood; chest pain; sudden trouble speaking or understanding speech; sudden confusion; sudden weakness or numbness of an arm or leg (especially on one side of the body) or of the face; sudden trouble walking, dizziness, or loss of balance or coordination; or fainting. If you are being treated with hemodialysis (treatment to remove waste from the blood when the kidneys are not working), a blood clot may form in your vascular access (place where the hemodialysis tubing connects to your body). Tell your doctor if your vascular access stops working as usual.
Your doctor will adjust your dose of darbepoetin alfa injection so that your hemoglobin level (amount of a protein found in red blood cells) is just high enough that you do not need a red blood cell transfusion (transfer of one person's red blood cells to another person's body to treat severe anemia). If you receive enough darbepoetin alfa to increase your hemoglobin to a normal or near normal level, there is a greater risk that you will have a stroke or develop serious or life-threatening heart problems including heart attack, and heart failure. Call your doctor immediately or get emergency medical help if you experience any of the following symptoms: chest pain, squeezing pressure, or tightness; shortness of breath; nausea, lightheadedness, sweating, and other early signs of heart attack; discomfort or pain in the arms, shoulder, neck, jaw, or back; or swelling of the hands, feet, or ankles.
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to darbepoetin alfa injection. Your doctor may decrease your dose or tell you to stop using darbepoetin alfa injection for a period of time if the tests show that you are at high risk of experiencing serious side effects. Follow your doctor's directions carefully.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with darbepoetin alfa and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.
Talk to your doctor about the risks of using darbepoetin alfa injection.
Cancer patients:
In clinical studies, people with certain cancers who received darbepoetin alfa injection died sooner or experienced tumor growth, a return of their cancer, or cancer that spread sooner than people who did not receive the medication. If you have cancer, you should receive the lowest possible dose of darbepoetin alfa injection. You should only receive darbepoetin alfa injection to treat anemia caused by chemotherapy if your chemotherapy is expected to continue for at least 2 months after you begin treatment with darbepoetin alfa injection and if there is not a high chance that your cancer will be cured. Treatment with darbepoetin alfa injection should be stopped when your course of chemotherapy ends.
A program called the ESA APPRISE Oncology Program has been set up to decrease the risks of using darbepoetin alfa injection to treat anemia caused by chemotherapy. Your doctor will need to complete training and enroll in this program before you can receive darbepoetin alfa injection. As part of the program, you will receive written information about the risks of using darbepoetin alfa injection and you will need to sign a form before you receive the medication to show that your doctor has discussed the risks of darbepoetin alfa injection with you. Your doctor will give you more information about the program and will answer any questions you have about the program and your treatment with darbepoetin alfa injection.
Why is this medication prescribed?
Darbepoetin alfa injection is used to treat anemia (a lower than normal number of red blood cells) in people with chronic kidney failure (condition in which the kidneys slowly and permanently stop working over a period of time). Darbepoetin alfa injection is also used to treat anemia caused by chemotherapy in people with certain types of cancer. Darbepoetin alfa cannot be used in place of a red blood cell transfusion to treat severe anemia and has not been shown to improve tiredness or poor well-being that may be caused by anemia. Darbepoetin alfa is in a class of medications called erythropoiesis-stimulating agents (ESAs). It works by causing the bone marrow (soft tissue inside the bones where blood is made) to make more red blood cells.
How should this medicine be used?
Darbepoetin alfa injection comes as a solution (liquid) to inject subcutaneously (just under the skin) or intravenously (into a vein). It is usually injected once every 1 to 4 weeks. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use darbepoetin alfa injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Your doctor will start you on a low dose of darbepoetin alfa injection and adjust your dose depending on your lab results and on how you are feeling. Your doctor may also tell you to stop using darbepoetin alfa injection for a time. Follow these instructions carefully.
Darbepoetin alfa injection will help to control your anemia only as long as you continue to use it. It may take 2-6 weeks or longer before you feel the full benefit of darbepoetin alfa injection. Continue to use darbepoetin alfa injection even if you feel well. Do not stop using darbepoetin alfa injection without talking to your doctor.
Darbepoetin alfa injections may be given by a doctor or nurse, or your doctor may decide that you can inject darbepoetin alfa yourself, or that you may have a friend or relative give the injections. You and the person who will be giving the injections should read the manufacturer's information for the patient that comes with darbepoetin alfa injection before you use it for the first time at home. Ask your doctor to show you or the person who will be injecting the medication how to inject it.
Darbepoetin alfa injection comes in prefilled syringes and in vials to be used with disposable syringes. If you are using vials of darbepoetin alfa injection, your doctor or pharmacist will tell you what type of syringe you should use. Do not use any other type of syringe because you may not get the right amount of medication.
Do not shake darbepoetin alfa injection. If you shake darbepoetin alfa injection it may look foamy and should not be used.
Always inject darbepoetin alfa injection in its own syringe. Do not dilute it with any liquid and do not mix it with any other medications.
You can inject darbepoetin alfa injection anywhere on the outer area of your upper arms, your stomach except for the 2-inch (5-centimeter) area around your navel (belly button), the front of your middle thighs, and the upper outer areas of your buttocks. Choose a new spot each time you inject darbepoetin alfa. Do not inject darbepoetin alfa into a spot that is tender, red, bruised, or hard, or that has scars or stretch marks.
If you are being treated with dialysis (treatment to remove waste from the blood when the kidneys are not working), your doctor may tell you to inject the medication into your venous access port (place where dialysis tubing is connected to your body). Ask your doctor if you have any questions about how to inject your medication.
Always look at darbepoetin alfa injection solution before injecting it. Be sure that the prefilled syringe or vial is labeled with the correct name and strength of medication and an expiration date that has not passed. If you are using a vial, check to be sure that it has a colored cap, and if you are using a prefilled syringe, check that the needle is covered with the grey cover and that the yellow plastic sleeve has not been pulled over the needle. Also check that the solution is clear and colorless and does not contain lumps, flakes, or particles. If there are any problems with your medication, call your pharmacist and do not inject it.
Do not use prefilled syringes, disposable syringes, or vials of darbepoetin alfa injection more than once. Dispose of used syringes in a puncture-resistant container. Ask your doctor or pharmacist how to dispose of the puncture-resistant container.
Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before using darbepoetin alfa injection,
- tell your doctor and pharmacist if you are allergic to darbepoetin alfa, epoetin alfa (Epogen, Procrit), any other medications, or any of the ingredients in darbepoetin alfa injection. Ask your pharmacist or check the Medication Guide for a list of the ingredients. If you will be using the prefilled syringes, tell your doctor if you or the person who will be injecting the medication is allergic to latex.
- tell your doctor if you have or have had high blood pressure, and if you have ever had pure red cell aplasia (PRCA; a type of severe anemia that may develop after treatment with an ESA such as darbepoetin alfa injection or epoetin alfa injection). Your doctor may tell you not to use darbepoetin alfa injection.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had seizures. If you are using darbepoetin alfa injection to treat anemia caused by chronic kidney disease, tell your doctor if you have or have ever had cancer.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using darbepoetin alfa injection, call your doctor.
- before having surgery, including dental surgery, tell your doctor or dentist that you are being treated with darbepoetin alfa injection. It is especially important to tell your doctor that you are using darbepoetin alfa injection if you are having coronary artery bypass graft (CABG) surgery or surgery to treat a bone problem. Your doctor may prescribe an anticoagulant ('blood thinner') to prevent clots from forming during surgery.
What special dietary instructions should I follow?
Your doctor may prescribe a special diet to help control your blood pressure and to help increase your iron levels so that darbepoetin alfa injection can work as well as possible. Follow these directions carefully and ask your doctor or dietician if you have any questions.
What should I do if I forget a dose?
Call your doctor to ask what to do if you miss a dose of darbepoetin alfa injection. Do not use a double dose to make up for a missed one.
What side effects can this medication cause?
Darbepoetin alfa injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- cough
- stomach pain
- redness, swelling, bruising, itching, or a lump at the spot where you injected darbepoetin alfa
Some side effects can be serious. If you experience any of the following symptoms, or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment:
- rash
- itching
- difficulty breathing or swallowing
- wheezing
- hoarseness
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- fast pulse
- excessive tiredness
- lack of energy
- dizziness
- fainting
- pale skin
Darbepoetin alfa injection may cause other side effects. Call your doctor if you have any unusual problems or you do not feel well while using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
What should I know about storage and disposal of this medication?
Keep this medication in the carton it came in, tightly closed, and out of reach of children. Once a vial or prefilled syringe has been taken out of its carton, keep it covered to protect it from room light until the dose is given. Store darbepoetin alfa injection in the refrigerator, but do not freeze it. Discard any medication that has been frozen.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org
In case of emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
What other information should I know?
Keep all appointments with your doctor. Your doctor will monitor your blood pressure often during your treatment with darbepoetin alfa injection.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are using darbepoetin alfa injection.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Brand names
- Aranesp®
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FAQs
What is Darbepoetin alfa injection used for? ›
Darbepoetin may be used for patients on kidney dialysis or for those not on dialysis. Anemia can also occur in people who are receiving chemotherapy to treat cancer. Darbepoetin alfa is used to treat severe anemia in these patients. This medicine is available only with your doctor's prescription.
When should you not take darbepoetin? ›haemoglobin concentrations higher than 12 g/100 mL should be avoided.
How long does it take for darbepoetin to work? ›When darbepoetin alfa begins to work, usually in about 6 weeks, most people start to feel better. Some people are able to be more active. But darbepoetin alfa only corrects anemia. It has no effect on kidney disease, cancer, or any other medical problem that needs regular medical attention.
When should you not give Aranesp injection? ›Do not use Aranesp: - if you are allergic to darbepoetin alfa or any of the other ingredients of this medicine listed in section 6. - if you have been diagnosed with high blood pressure which is not being controlled with other medicines prescribed by your doctor.
How often can you give darbepoetin? ›Darbepoetin alfa injection comes as a solution (liquid) to inject subcutaneously (just under the skin) or intravenously (into a vein). It is usually injected once every 1 to 4 weeks.
What are the risks of darbepoetin? ›Darbepoetin alfa can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use darbepoetin alfa.
What are the side effects of darbepoetin alfa? ›- Shortness of breath.
- Cough.
- Low blood pressure during dialysis.
- Abdominal pain.
- Edema (swelling) of the arms or legs.
Do Medicare prescription drug plans cover Aranesp? No. In general, Medicare prescription drug plans (Part D) do not cover this drug. Be sure to contact your specific plan to verify coverage information.
How long does Aranesp shot last? ›Aranesp® may be given as a subcutaneous (under the skin) injection or rarely into a vein (intravenous). It is typically administered every two weeks, allowing patients to visit their doctor less frequently and avoid unnecessary injections.
Which is the best fruit for blood? ›Fruits: Raisins, prunes, dried figs, apricots, apples, grapes and watermelons not only get the red blood cells flowing but also improve the blood count. Citrus fruits like oranges, amla or Indian gooseberry, lime and grapefruit help to attract iron. They play a very important role in increasing blood count.
What level of hemoglobin is dangerously low? ›
A severe low hemoglobin level for men is 13.5 gm/dL or lower. For women, a severe low hemoglobin level is 12 gm/dL.
How much does darbepoetin cost? ›The retail price of $961 is the lowest available at Capsule Pharmacy. No need for a GoodRx discount. Haven't found your pharmacy? Pay between $ 752 and $ 773 chevron_right at other pharmacies with this coupon.
Does Aranesp help kidney function? ›This medication is used to treat anemia (low red blood cell count) in people with long-term serious kidney disease (chronic kidney failure) and people receiving chemotherapy for some types of cancer (cancer that does not involve the bone marrow or blood cells).
How much does Aranesp cost without insurance? ›The standard out-of-pocket price of Aranesp (Albumin Free) without health insurance is $386.43 per 1, 4ML of 40MCG/0.4ML Solution Prefilled Syringe but you can save using a SingleCare Aranesp (Albumin Free) coupon to pay only $313.15 for 1, 4ml of 40mcg/0.4ml Syringe of generic Aranesp (Albumin Free).
Can Aranesp cause stroke? ›Aranesp increases the risk of death, myocardial infarction, stroke, venous thromboembolism, and thrombosis of vascular access and tumor progression or recurrence. Aranesp can also lead to an increase in adverse cardiovascular events, hypertension, seizures, and severe anemia.
What happens if you take too much Aranesp? ›Your body may make antibodies to Aranesp that can block or lessen your body's ability to make red blood cells and cause you to have severe anemia. Symptoms to watch for include: unusual tiredness, lack of energy, dizziness, or fainting.
What happens if Aranesp doesn't work? ›Sometimes Aranesp (darbepoetin alfa) doesn't work or stops working after a while. If your anemia doesn't respond to the medication, your provider will evaluate potential factors that might be the cause. One possible reason is having low iron levels, so it's important to take iron supplements if prescribed or directed.
What happens if you miss an Aranesp injection? ›o If you miss a dose of Aranesp, call your healthcare provider right away and ask what to do. o If you take more than the prescribed dose of Aranesp, call your healthcare provider right away. During treatment with Aranesp, continue to follow your healthcare provider's instructions for diet and medicines.
Who should not take Aranesp? ›Aranesp® has not been proven to improve quality of life, fatigue, or well-being, and should not be used if: You have cancer and will not be receiving chemotherapy for at least two months. You have a cancer with a high chance of being cured.
How much does Aranesp shot cost? ›The cost for Aranesp injectable solution (25 mcg/mL) is around $825 for a supply of 4 milliliters, depending on the pharmacy you visit. Quoted prices are for cash-paying customers and are not valid with insurance plans.
Why does darbepoetin have a longer half life? ›
Due to the additional sialic acid-containing carbohydrate, darbepoetin alfa has a slower serum clearance and, therefore, a longer half-life than rHuEPO. The longer serum half-life increases the in vivo biological activity and allows darb-epoetin alfa to be administered less frequently than rHuEPO.
Which is better darbepoetin or erythropoietin? ›Compared with endogenous erythropoietin and epoetin alfa (rHuEPO), darbepoetin alfa has the characteristics of a prolonged half-life in the blood and increased biological activity in vivo.
How often should Aranesp be given? ›Aranesp® is the only long-acting erythropoiesis-stimulating agent (ESA) approved for both once weekly (QW) and once every three weeks (Q3W) dosing.
Does Aranesp affect blood pressure? ›Your blood pressure may go up or be difficult to control with blood pressure medicine while taking Aranesp. This can happen even if you have never had high blood pressure before. Your healthcare provider should check your blood pressure often.
How long has Aranesp been around? ›Darbepoetin is marketed by Amgen under the trade name Aranesp. The medication was approved in September 2001, by the US Food and Drug Administration for treatment of anemia in patients with chronic kidney failure by intravenous or subcutaneous injection.
Is Aranesp covered by Medicare Part B? ›EPO and Aranesp are covered under the Part B benefit for the treatment of anemia associated with ESRD patients who are on dialysis.
What drugs increase hemoglobin levels? ›Epoetin alfa products are in a class of medications called erythropoiesis-stimulating agents (ESAs). They work by causing the bone marrow (soft tissue inside the bones where blood is made) to make more red blood cells.
What medication can increase hemoglobin? ›Epoetin injection is a man-made version of human erythropoietin (EPO). EPO is produced naturally in the body, mostly by the kidneys. It stimulates the bone marrow to produce red blood cells. If the body does not produce enough EPO, severe anemia can occur.
How long can Aranesp be out of the fridge? ›maximum single period of seven days at room temperature (up to 25°C). Once a syringe has been removed from the refrigerator and has reached room temperature (up to 25°C) it must either be used within 7 days or disposed of. Darbepoetin alfa must not be shaken.
What is a critical hemoglobin level? ›An Hb value less than 5.0 g/dL (50 g/L) can lead to heart failure and death. A value greater than 20 g/dL (200 g/L) can lead to obstruction of the capillaries as a result of hemoconcentration.
Does darbepoetin increase blood pressure? ›
Aranesp ® may cause other serious side effects, including:
High blood pressure is a common side effect of Aranesp ® in people with chronic kidney disease. Your blood pressure may go up or be difficult to control with blood pressure medication while taking Aranesp ®.
Epoetin alfa products are in a class of medications called erythropoiesis-stimulating agents (ESAs). They work by causing the bone marrow (soft tissue inside the bones where blood is made) to make more red blood cells.
How long can you survive with low hemoglobin? ›Individuals with a Hb level of 2.0 g/dL or less had on median 1.0 (interquartile range, 0.5-1.5) day from their lowest Hb to death while individuals with their lowest Hb ranging between 4.1 and 5.0 g/dL had on median 11 (interquartile range, 1-23) days from their lowest Hb to death.
How can I raise my hemoglobin level quickly? ›- red meat, such as beef, pork, and poultry.
- dark leafy greens, such as spinach and kale.
- dried fruit, like raisins and apricots.
- peas, beans, and other legumes.
- seafood.
- iron-fortified foods, such as breakfast cereals.
- seeds and nuts.
- organ meats.
But 7 to 8 g/dL is a safe level. Your doctor should use just enough blood to get to this level. Often, one unit of blood is enough. Some doctors believe that hospital patients who fall below 10 g/dL should get a blood transfusion.
What hemoglobin is life threatening? ›Hemoglobin less than 6.5 g/dL is life-threatening and can cause death.
Is 7 too low for hemoglobin? ›A low hemoglobin count is generally defined as less than 13.2 grams of hemoglobin per deciliter (132 grams per liter) of blood for men and less than 11.6 grams per deciliter (116 grams per liter) for women.
What vitamin should you take with epoetin alfa? ›You may need to eat foods that contain iron, folic acid, or vitamin B12 such as eggs, certain cereals, meats, and vegetables, or you may take an iron, folic acid, or vitamin B12 supplement while you are using this medicine.
What should I monitor when taking epoetin alfa? ›It is very important that your doctor check the blood of you or your child on a regular basis while you are using this medicine. You may also need to monitor your blood pressure at home. If you notice any changes to your recommended blood pressure, call your doctor right away. .
What are the negative side effects of erythropoietin? ›Blood clot risk
Cancer and some cancer treatments can increase the risk of a blood clot. Erythropoietin can also increase the risk of developing a blood clot. Symptoms of a blood clot include: throbbing pain, redness or swelling in a leg or arm.