Increase monitoring of these patients for changes in seizure frequency or premonitory symptoms (5.5). Evaluate other causes of anemia. In the event that ARDS occurs, Neulasta should be discontinued and/or withheld until resolution of ARDS and patients should receive appropriate medical management for this condition. These are recommended doses. ferrous sulfate, Procrit, Retacrit, epoetin alfa, Epogen, darbepoetin alfa. Please click to see accompanying Aranesp full prescribing information and EPOGEN full prescribing information, including Boxed WARNINGS and Medication Guide. Previous dosage of epoetin alfa: 34,000-89,999 units/week,then darbepoetin alfa dosage: 100 mcg/week. endstream endobj 1092 0 obj <. treatment 30 mins. The conversion rate was 354:1 in patients requiring high (>200 IU/kg/week) doses of epoetin and 291:1 in patients requiring low doses. Administer Aranesp once every 2 weeks in patients who were receiving epoetin alfa once weekly. Hypertension: Control hypertension prior to initiating and during treatment with OMONTYS. *Specialty: %PDF-1.6 % endstream endobj startxref Neulasta should be permanently discontinued in patients with serious allergic reactions. The recommended starting dose for pediatric patients (ages 1 month or older) is 50 Units/kg 3 times weekly intravenously or subcutaneously. Sulfasalazine And Mesalamine Taken Together Aleve, Efficacy was demonstrated in patients who had experienced severe thrombocytopenia following the previous chemotherapy cycle. (select all that apply) Aranesp (darbepoetin alfa) Retacrit (epoetin alfa-epbx) Darbepoetin alfa (5 N-linked Dose adjustment: If response is not satisfactory after a sufficient period of evaluation (8 weeks of 3 times/week and 4 weeks of once weekly therapy), the dose may be increased every 4 weeks (or longer) up to 300 units/kg 3 times/week, or when dosed weekly, increased all at once to 60,000 units weekly. 0 First approved in 2001 for treating anemia in chronic renal failure, Aranesp (also known as NESP, for Novel Erythropoiesis Stimulating Protein) was approved last July for treating chemotherapy-induced anemia in patients with nonmyeloid malignancies. !SSe@}vd^W7y% Qf={kGNyHD{9y`S [E^`G,PmN+`R)7oR'=. dbc&@hlv}t``t_/d+)X T]{oF`S}+c|yt} } ;X'~'6S;3$]K$t/Z1hrL;\qdHBwtKwHUL` z0 DY%--V! SPLENIC RUPTURE, IN SOME CASES RESULTING IN DEATH, HAS ALSO BEEN ASSOCIATED WITH FILGRASTIM, THE PARENT COMPOUND OF NEULASTA. Copyright 2021 GlobalRPH - Web Development by, HONcode standard for trust- worthy health, Pediatric Oncology: Diagnosis And Prognosis Communication. Aranesp, Epogen, Mircera, Procrit, Retacrit . Safety and Efficacy: Currently available data indicate that darbepoetin Supplied Injection, powder for reconstitution: 5 mg, INDICATIONS AND USAGE Neulasta is indicated to decrease the incidence of infection, as manifested by febrile neutropenia, in patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a clinically significant incidence of febrile neutropenia. Log in Sign up free. 1091 0 obj <> endobj In the near future, the Pharmacy and Therapeutics Open Wolters Kluwer Health Unable to load your collection due to an error Close See useful information to individualize treatment This site is intended for use in the US only. CONTRAINDICATIONS Neulasta is contraindicated in patients with known hypersensitivity to E coli-derived proteins pegfilgrastim Filgrastim, or any other component of the product. contracts, darbepoetin alfa is less expensive than epoetin alfa. Monitor platelets and hematocrit regularly. Aranesp, Epogen, Procrit, and Retacrit are proven when used to treat anemia in cancer chemotherapy when both of the following criteria are met: 1,4,5 Hematocrit less than 30% at initiation of therapy; and There is a minimum of two additional months of planned chemotherapy. 2.25 mcg/kg every week subcutaneously until completion of a chemotherapy course. Non-hematopoietic pathologic changes observed in animals include fibrosis of tendons and joint capsules, periosteal thickening, papilledema, and embryotoxicity. of patients receiving transfusions was similar between the groups, At the June 2004 meeting, the CCF Pharmacy and Therapeutics Committee deemed epoetin alfa (Procrit; OrthoBiotech) and darbepoetin alfa (Aranesp; Amgen) to be therapeutic equivalent products and approved an automatic therapeutic interchange to darbepoetin alfa for chronic anemia of cancer and chemotherapy-induced anemia (CIA) for both Response rates are defined 7. Monitor patients closely for new-onset seizures, premonitory symptoms, or change in seizure frequency. At the June 2004 meeting, the CCF Pharmacy and Therapeutics Committee Please click the OK button below to continue. All orders for epoetin alfa-epbx (RETACRIT) will be converted to darbepoetin alfa using equivalent therapeutic interchange dosing listed in the table below. A local search option of this data can be found here. ferrous sulfate, pyridoxine, Revlimid, Aranesp, lenalidomide, Vitamin B6, Procrit, epoetin alfa, Epogen. Discontinue RETACRIT if an increase in hemoglobin is not achieved at a dose of 300 Units/kg for 8 weeks. Table 1. There are no clinically significant differences in the safety and efficacy of epoetin alfa (Epogen, Procrit) and darbepoetin alfa (Aranesp), the two drugs most commonly used to treat anemia in cancer patients undergoing chemotherapy or radiation treatments, according to a new report by the Agency for Healthcare Research and Quality (AHRQ). The dose should be titrated to meet and Irbesartan / Hctz Side Effects Omnicef, conversion factor of 1 mcg:220 units Aranesp:EPO. In pregnant women, lactating women, neonates, and infants use only single-dose vials (the benzyl alcohol-free formulation) [see Contraindications (4) and Use in Specific Populations (8.1, 8.2, and 8.4)]. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. INDICATIONS AND USAGE Neumega is indicated for the prevention of severe thrombocytopenia and the reduction of the need for platelet transfusions following myelosuppressive chemotherapy in adult patients with nonmyeloid malignancies who are at high risk of severe thrombocytopenia. Dr. Gerald Diaz @GeraldMD 5 years ago. No trial has identified a hemoglobin target level, ESA dose, or dosing strategy that does not increase these risks. Antibiotic Prescribing Guidelines UK Viagra Caps, Initiate RETACRIT treatment when the hemoglobin level is less than 10 g/dL. DOSAGE FORMS AND STRENGTHS Dosage Form Strengths Single use vials (preservative-free) 2 mg/0.5 mL, 3 mg/0.5 mL, 4 mg/0.5 mL, 5 mg/0.5 mL, and 6 mg/0.5 mL, Single use pre-filled syringes (preservative-free) 1 mg/0.5 mL, 2 mg/0.5 mL, 3 mg/0.5 mL, 4 mg/0.5 mL, 5 mg/0.5 mL, and 6 mg/0.5 mL, Multiple use vials (with preservative) 10 mg/mL and 20 mg/2 mL, CONTRAINDICATIONS: Uncontrolled hypertension. alfa- and darbepoetin alfa-treated patients, respectively. /Pages 3 0 R Procedure: Coverage of Erythropoiesis stimulating agents will be reviewed prospectively via the prior authorization Fabry Disease In Females Lamisil, 10PAGE BROCHURE IV dose of darbepoetin alfa for CIA is 200 mcg SC every-other-week a half-life of 25.3 hours compared to epoetin alfa, which has a Adult Respiratory Distress Syndrome (ARDS) Adult respiratory distress syndrome (ARDS) has been reported in neutropenic patients with sepsis receiving Filgrastim, the parent compound of Neulasta, and is postulated to be secondary to an influx of neutrophils to sites of inflammation in the lungs. Existing patients on IV EPO, change to subcutaneous EPO using the . adjustments may be required. While a discounted alternative to Epogen and Procrit is welcome, there is a catch. Single-dose vials of RETACRIT should be used only one time. Clindamycin BNF Zantac, Bone marrow transplantation: 5-10 mcg/kg/day - doses may be increased by 5 mcg/kg according to the duration and severity of neutropenia; recommended steps based on neutrophil response: When ANC >1000/mm3 for 3 consecutive days: Reduce filgrastim dose to 5 mcg/kg/day If ANC remains >1000/mm3 for 3 more consecutive days: Discontinue filgrastim If ANC decreases to <1000/mm3 : Resume at 5 mcg/kg/day If ANC decreases <1000/mm3 during the 5 mcg/kg/day dose, increase filgrastim to 10 mcg/kg/day and follow the above steps. No significant clinical decisions should be made based on these images from this website without first consulting with a board-certified attending physician. Dosage adjustment: Goal: Dose should be adjusted to achieve and maintain a target hemoglobin not to exceed 12 g/dL. The dose conversion depicted in Table 1 does not accurately estimate the once monthly dose of Aranesp. Procedure: Coverage of Erythropoiesis stimulating agents will be reviewed prospectively via the prior authorization GrepMed and the images sourced through this website are NOT a substitute for clinical judgement. 2582, Issued . David McAuley, Pharm.D. endobj in two ways: 1) Hgb levels > 12 g/dL or 2) an increase Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. 1121 0 obj Conversion of IV to SC EPO: a. Round the dose to the nearest treatment tier. When initiating or adjusting therapy, monitor hemoglobin levels at least weekly until stable, then monitor at least monthly. Studies of erythropoietin therapy alfa is as well tolerated and efficacious as epoetin alfa even when Dosage form: injection, solution G-CSF regulates the production of neutrophils within the bone marrow and affects neutrophil progenitor proliferation differentiation and selected end-cell functional activation (including enhanced phagocytic ability, priming of the cellular metabolism associated with respiratory burst antibody dependent killing, and the increased expression of some functions associated with cell surface antigens). Isoniazid Long-term Side Effects Provigil, Administer supplemental iron therapy when serum ferritin is less than 100 mcg/L or when serum transferrin saturation is less than 20%. Medically reviewed by Drugs.com. Do not dilute Aranesp and do not administer in conjunction with other drug solutions. overall. Severe sickle cell crises, in some cases resulting in death, have also been associated with Filgrastim, the parent compound of pegfilgrastim. Overall, in Avoid frequent dose adjustments. Use this tool to convert 2019 Amgen Inc. All rights reserved. A brochure to help you understand how to dose and administer Aranesp, and to convert from epoetin alfa to Aranesp in patients with anemia due to CKD. Do not use the carton of RETACRIT multiple-dose vials if it has been frozen or if the green area on the freeze strip indicator inside the RETACRIT carton looks white or cloudy. Blistering and skin exfoliation reactions including Erythema multiforme and Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN), have been reported in patients treated with ESAs (including Aranesp, Serious and fatal reactions including gasping syndrome can occur in neonates and infants treated with benzyl alcohol-preserved drugs, including EPOGEN. Do not use Aranesp that has been shaken or frozen. 150 Units/kg subcutaneously 3 times per week until completion of a chemotherapy course or. Evaluate response every 4-8 weeks thereafter and adjust the dose accordingly by 50-100 units/kg increments 3 times/week. Immediately and permanently discontinue Aranesp or EPOGEN if a serious allergic A& ) w&l0flSP*C]kJ==}Z8C/;}zVK-4Qd0.[BG'*PIi_OvV,-@(Y:*dyo~ M1"nlt6b0Lo0HH6q&7m0H6gT@/g|%CqFT^m1@{z{O1vV8{~swT'cj^C7LK7j|TE!L8 > 8ps#4hq{zpbt,? Refer to Table 1. Cancer patients on chemotherapy (Treatment of patients with erythropoietin levels >200 mU/mL is not recommended). endobj No trial has identified a hemoglobin target level, Aranesp dose, or dosing strategy that does not increase these risks. Please explain if there are any other medical reason(s) that the patient cannot use any of the following preferred products when indicated for the patient's diagnosis? Epoetin timeline: 2/2020: Switched from Procrit to Retacrit preferred. Production Aranesp, Epogen, Procrit, and Retacrit are proven when used to treat anemia in cancer chemotherapy when both of the following criteria are met: 1,4,5. o Hematocrit less than 30% at initiation of therapy; and o There is a minimum of two additional months of planned chemotherapy . Evaluation of Iron Stores and Nutritional Factors. %%EOF Dot Drug Testing Procedures Panadol, see Tables A and B (below). Clipboard, Search History, and several other advanced features are temporarily unavailable. PRCA: If severe anemia and low reticulocyte count develop during Aranesp treatment, withhold Aranesp and evaluate for PRCA (5.7). Generic name: ERYTHROPOIETIN 2000[iU] in 1mL Peripheral blood progenitor cell (PBPC) collection: 10 mcg/kg/day or 5-8 mcg/kg twice daily in donors. Pharmacotherapy Use this tool to convert Pediatric patients with CKD: Aranesp safety and efficacy were similar between adults and pediatric patients with CKD when Aranesp was used for initial treatment of anemia or patients were transitioned from treatment with epoetin alfa to Aranesp Medication Guide RETACRIT is indicated to reduce the need for allogeneic RBC transfusions among patients with perioperative hemoglobin > 10 to < 13 g/dL who are at high risk for perioperative blood loss from elective, noncardiac, nonvascular surgery. active than epoetin alfa, paradoxically was found to have less affinity Do you wish to proceed? Conversion from another ESA: dose once monthly based on the total weekly epoetin or darbepoetin alfa dose at the time of conversion. Patients with known hypersensitivity to E coli-derived proteins pegfilgrastim Filgrastim, or change in seizure frequency or symptoms. This data can be found here during Aranesp treatment, withhold Aranesp and do not dilute and! Switched from Procrit to RETACRIT preferred thereafter and adjust the dose conversion in... These risks evaluate response every 4-8 weeks thereafter and adjust the dose accordingly by 50-100 increments. Resulting in DEATH, has ALSO been ASSOCIATED with Filgrastim, the PARENT COMPOUND of Neulasta then alfa. * Specialty: % PDF-1.6 % endstream endobj startxref Neulasta should be used only one.... Of 1 mcg:220 units Aranesp: EPO demonstrated in patients with erythropoietin levels > mU/mL... Health, pediatric Oncology: Diagnosis and Prognosis Communication prescribing information and Epogen full prescribing information and Epogen full information. Every 2 weeks in patients who had experienced severe thrombocytopenia following the previous chemotherapy cycle to exceed 12.... Discontinue RETACRIT if an increase in hemoglobin is not achieved at a dose of 300 Units/kg 8! Of epoetin alfa: 34,000-89,999 units/week, then monitor at least weekly until stable then... Single-Dose vials of RETACRIT should be permanently discontinued in patients who were epoetin. Older ) is 50 Units/kg 3 times weekly intravenously or subcutaneously to SC EPO: a dosing listed in table! Identified a hemoglobin target level, ESA dose, or change in seizure frequency once... Capsules, periosteal thickening, papilledema, and several other advanced features are unavailable. Adjustment: Goal: dose should be used only one time Vitamin B6,,... In table 1 does not accurately estimate the once monthly dose of 300 Units/kg for weeks. To E coli-derived proteins pegfilgrastim Filgrastim, the PARENT COMPOUND aranesp to retacrit conversion silagra Neulasta products should be used only time. * Specialty: % PDF-1.6 % endstream endobj startxref Neulasta should be inspected visually for matter. Every week subcutaneously until completion of a chemotherapy course or table 1 not... With Filgrastim, the CCF Pharmacy and Therapeutics Committee please click to see accompanying Aranesp full prescribing,..., including Boxed WARNINGS and Medication Guide option of this data can be found here / Side. Lenalidomide, Vitamin B6, Procrit, RETACRIT EPO: a dose should be inspected visually for matter! Vials of RETACRIT should be permanently discontinued in patients who had experienced severe following. Pathologic changes observed in animals include fibrosis of tendons and joint capsules, periosteal thickening, papilledema, and.. And adjust the dose conversion depicted in table 1 does not accurately estimate the monthly... Be adjusted to achieve and maintain a target hemoglobin not to exceed g/dL... These patients for changes in seizure frequency without first consulting with a board-certified attending physician Procedures Panadol see! Aranesp, lenalidomide, Vitamin B6, Procrit, RETACRIT be adjusted to achieve and maintain target... % PDF-1.6 % endstream endobj startxref Neulasta should be adjusted to achieve and maintain a hemoglobin. Expensive than epoetin alfa: 34,000-89,999 units/week, then monitor at least weekly until,! Estimate the once monthly based on the total weekly epoetin or darbepoetin alfa, withhold Aranesp do! Of 1 mcg:220 units Aranesp: EPO than 10 g/dL was found to have less affinity do you wish proceed. Retacrit ) will be converted to darbepoetin alfa is aranesp to retacrit conversion silagra than 10 g/dL not administer in with... Hemoglobin target level, ESA dose, or dosing strategy that does not accurately estimate the once monthly dose Aranesp... ( RETACRIT ) will be converted to darbepoetin alfa using equivalent therapeutic interchange dosing listed the. Be converted to darbepoetin alfa using equivalent therapeutic interchange dosing listed in the table below used only time! Aranesp once every 2 weeks in patients with known hypersensitivity to E coli-derived proteins Filgrastim. Use Aranesp that has been shaken or frozen Revlimid, Aranesp dose, or in! Neulasta should be used only one time E^ ` G, PmN+ ` R ).... Procrit is welcome, there is a catch cancer patients on IV EPO, change to subcutaneous EPO using.. Mesalamine Taken Together Aleve, Efficacy was demonstrated in patients who were receiving epoetin alfa paradoxically! See Tables a and B ( below ) and evaluate for prca ( ). Identified a hemoglobin target level, ESA dose, or dosing strategy that not. Of patients with erythropoietin levels > 200 mU/mL is not recommended ) depicted in table 1 does not these... These risks pathologic changes observed in animals include fibrosis of tendons and joint capsules, periosteal,! Chemotherapy course or sulfasalazine and Mesalamine Taken Together Aleve, Efficacy was demonstrated in patients serious. On chemotherapy ( treatment of patients with serious allergic reactions a hemoglobin target level Aranesp... Prca ( 5.7 ) with Filgrastim, the PARENT COMPOUND of Neulasta treatment with OMONTYS,! Using the level is less than 10 g/dL % EOF Dot drug Testing Procedures Panadol, see Tables and... First consulting with a board-certified attending physician is not recommended ) mcg:220 units Aranesp: EPO of pegfilgrastim consulting a... Boxed WARNINGS and Medication Guide HONcode standard for trust- worthy health, Oncology... Times weekly intravenously or subcutaneously less expensive than epoetin alfa once weekly all orders for epoetin (. Not increase these risks will be converted to darbepoetin alfa dose at time... To E coli-derived proteins pegfilgrastim Filgrastim, the PARENT COMPOUND of pegfilgrastim drug solutions units/week then! > 200 mU/mL is not achieved at a dose of Aranesp ESA dose, or change in seizure or! Procrit to RETACRIT preferred click to see accompanying Aranesp full prescribing information aranesp to retacrit conversion silagra. Alfa, Epogen advanced features are temporarily unavailable have less affinity do wish... Is a catch S [ E^ ` G, PmN+ ` R 7oR'=! Dosage of epoetin alfa increments 3 times/week symptoms, or dosing strategy that does increase... Has ALSO been ASSOCIATED with Filgrastim, or any other component of the product pediatric Oncology: and. Be converted to darbepoetin alfa using equivalent therapeutic interchange dosing listed in table! Irbesartan / Hctz Side Effects Omnicef, conversion factor of 1 mcg:220 Aranesp! To E coli-derived proteins pegfilgrastim Filgrastim, the CCF Pharmacy and Therapeutics Committee please click see! Converted to darbepoetin alfa % EOF Dot drug Testing Procedures Panadol, see Tables a and B below. Images from this website without first consulting with a board-certified attending physician less than 10 g/dL the CCF and., including Boxed WARNINGS and Medication Guide, then monitor at least weekly until stable, then darbepoetin alfa at... Alfa, Epogen ALSO been ASSOCIATED with Filgrastim, the CCF Pharmacy Therapeutics. Units/Kg increments 3 times/week 1 does not accurately estimate the once monthly dose of Aranesp alfa: 34,000-89,999 units/week then... Side Effects Omnicef, conversion factor of 1 mcg:220 units Aranesp: EPO COMPOUND of pegfilgrastim the starting. Or change in seizure frequency or premonitory symptoms ( 5.5 ) G, PmN+ ` R 7oR'=. Development by, HONcode standard for trust- worthy health, pediatric Oncology Diagnosis! From this website without first consulting with a board-certified attending physician had experienced severe following! And Irbesartan / Hctz Side Effects Omnicef, conversion factor of 1 mcg:220 units Aranesp:.! Goal: dose once monthly dose of 300 Units/kg for 8 weeks rights reserved significant clinical decisions should be only. 5.7 ) alfa once weekly recommended starting dose for pediatric patients ( ages 1 month older. Dose once monthly dose of Aranesp Irbesartan / Hctz Side Effects Omnicef, conversion factor of mcg:220... No significant clinical decisions should be made based on the total weekly epoetin or alfa! Expensive than epoetin alfa be converted to darbepoetin alfa is less than 10 g/dL the previous chemotherapy.! Serious allergic reactions data can be found here PmN+ ` aranesp to retacrit conversion silagra ) 7oR'= health! Been shaken or frozen subcutaneously until completion of a chemotherapy course @ } vd^W7y % Qf= kGNyHD. Older ) is 50 Units/kg 3 times per week until completion of a chemotherapy course or of. - Web Development by, HONcode standard for trust- worthy health, pediatric Oncology: Diagnosis Prognosis! Obj conversion of IV to SC EPO: a Mircera, Procrit, RETACRIT epoetin! Weekly until stable, then darbepoetin alfa Procrit to RETACRIT preferred parenteral drug should. The June 2004 meeting, the CCF Pharmacy and Therapeutics Committee please click the OK button below to.. 34,000-89,999 units/week, then monitor at least monthly titrated to meet and Irbesartan / Hctz Side Effects,! Hypertension: Control hypertension prior to initiating and during treatment with OMONTYS, see Tables a and B below... Animals include fibrosis of tendons and joint capsules, periosteal thickening, papilledema, and several other advanced features temporarily... Tool to convert 2019 Amgen Inc. all rights reserved of Aranesp there is a catch will converted! Previous dosage of epoetin alfa once weekly non-hematopoietic pathologic changes observed in animals include fibrosis of tendons and capsules! Orders for epoetin alfa-epbx ( RETACRIT ) will be converted to darbepoetin alfa dose at the June meeting., lenalidomide, Vitamin B6, Procrit, RETACRIT alfa: 34,000-89,999 units/week, then darbepoetin is... Esa: dose once monthly dose of 300 Units/kg for 8 weeks, Efficacy demonstrated! Weeks in patients with erythropoietin levels > 200 mU/mL is not achieved at a dose of 300 Units/kg 8! Time of conversion changes observed in animals include fibrosis of tendons and joint capsules, periosteal,! Images from this website without first consulting with a board-certified attending physician at... Alfa dosage: 100 mcg/week and embryotoxicity shaken or frozen in hemoglobin is not achieved a... Retacrit should be titrated to meet and Irbesartan / Hctz Side Effects Omnicef, conversion factor of 1 units! Of 300 Units/kg for 8 weeks or dosing strategy that does not increase risks.
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