Indications
Pegylated Erythropoietin (methoxy polyethylene glycol-epoetin beta) is used to treat anaemia (a low red blood cell count) caused by chronic kidney disease, in people on dialysis and in people not yet on dialysis.
How It Works
Healthy kidneys make a hormone called erythropoietin, which tells the bone marrow to make red blood cells. Damaged kidneys make too little of it. This medicine acts like natural erythropoietin and stimulates the bone marrow to produce more red blood cells. A polyethylene glycol chain is attached to the molecule, which makes it last much longer in the body, so it can be given less often than older forms.
Dosage and Administration
It is given as an injection under the skin or into a vein by a doctor or nurse, or by a trained patient at home. It is usually given once every 2 weeks or once a month. The dose is worked out by the doctor from your body weight and haemoglobin level and is adjusted according to regular blood tests. Use exactly as prescribed. Iron supplements are often needed during treatment.
Interactions
No major drug interactions are known. Iron deficiency, infection or inflammation can reduce how well it works. Tell your doctor about all medicines you take, including blood pressure medicines, as the dose of these may need adjusting.
Contraindications
- Allergy to the medicine or any ingredient
- Uncontrolled high blood pressure
- Pure red cell aplasia (a rare condition where the bone marrow stops making red cells) after any erythropoietin treatment
Side Effects
The most common side effect is high blood pressure. Others include headache, injection site reactions, clotting of the dialysis access (fistula or graft), rash and flu-like symptoms. If the haemoglobin rises too high or too fast, the risk of blood clots, stroke and heart problems increases. Rarely, fits or pure red cell aplasia can occur.
Get urgent medical help if you have a sudden severe headache, confusion, fits, chest pain, sudden weakness or numbness of one side of the body, trouble speaking, painful swelling of a leg, or signs of a severe allergic reaction such as swelling of the face or difficulty breathing.
Pregnancy and Lactation
There is limited experience in pregnancy and breastfeeding. It should be used only if the doctor decides the benefit outweighs any risk.
Precautions and Warnings
Blood pressure must be controlled before and during treatment. Haemoglobin is checked regularly so that it stays in the target range; too high a level is harmful. Use with care in people with epilepsy, cancer, liver disease or a history of stroke or blood clots. Tell the doctor if you suddenly feel very tired or breathless, as this may mean the medicine has stopped working.
Overdose
Too much can raise haemoglobin too high, increasing the risk of clots and high blood pressure. The doctor may pause treatment and, if needed, remove blood (venesection).
Therapeutic Class
Erythropoiesis-stimulating agent (anti-anaemia preparation)
Storage
Store in a refrigerator at 2 to 8°C, do not freeze. Keep in the original carton to protect from light and out of the reach of children. Follow pack directions for any short period at room temperature.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.