Aprodust

Indications

Daprodustat is a tablet used to treat anaemia (low red blood cells or haemoglobin) caused by long-term (chronic) kidney disease in adults. In most countries it is used for adults who have been on dialysis for some time.

How It Works

Healthy kidneys make a hormone called erythropoietin that tells the bone marrow to make red blood cells. In kidney disease this signal is weak. Daprodustat blocks enzymes called HIF prolyl hydroxylases, which tricks the body into acting as if oxygen were low. The body then makes more of its own erythropoietin and uses iron better, so haemoglobin rises.

Dosage and Administration

Take by mouth once a day, at about the same time, with or without food, exactly as prescribed by the kidney specialist. The starting dose depends on the current haemoglobin and on any earlier anaemia treatment, and the dose is adjusted every few weeks based on blood tests. Do not change the dose on your own. If a dose is missed, take it the same day if remembered; do not take two doses the next day.

Interactions

• Gemfibrozil (a cholesterol medicine) greatly raises Daprodustat levels and must not be taken with it.
• Clopidogrel and some other medicines that slow the enzyme CYP2C8 raise its levels; the dose may need lowering.
• Rifampicin can lower its levels and make it work less well.
• Tell the doctor about all medicines, including iron and other anaemia treatments.

Contraindications

• Allergy to Daprodustat or any ingredient of the tablet
• Taking Gemfibrozil
• High blood pressure that is not controlled

Side Effects

Common side effects include high blood pressure, stomach pain, dizziness and allergic skin reactions. Like other medicines that raise haemoglobin, it can increase the risk of heart attack, stroke, blood clots and clotting of the dialysis access, especially if haemoglobin rises too high or too quickly.

Get urgent medical help if there is:

• Chest pain or tightness, or sudden shortness of breath
• Weakness or numbness on one side, trouble speaking or a drooping face
• Pain, swelling or warmth in one leg
• The dialysis access stops working or feels hard
• Black stools or vomiting blood
• Swelling of the face or throat, or difficulty breathing

Pregnancy and Lactation

There is not enough information on use in pregnancy, so it should be used only if the doctor decides the benefit is greater than the risk. Breastfeeding is not recommended during treatment and for about a week after the last dose.

Precautions and Warnings

• Haemoglobin is checked regularly; the aim is to reduce the need for blood transfusions, not to bring haemoglobin to normal levels.
• Blood pressure should be controlled before starting and checked during treatment.
• Iron levels are checked and iron given if needed.
• Moderate liver disease may need a lower dose; it is not used in severe liver disease.
• Tell the doctor about any history of heart attack, stroke, clots, stomach ulcers or cancer.
• It is not for anaemia from other causes.

Overdose

Taking too much may raise haemoglobin too high, increasing the risk of clots and high blood pressure. Contact a doctor or hospital promptly.

Therapeutic Class

Antianaemic medicine, hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PH inhibitor).

Storage

Store below 30°C in a dry place, away from light, in the original pack and out of the reach of children.