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Eprex 4000 is a medicine that helps your bone marrow produce more red blood cells. It is used to treat a type of anemia caused by kidney disease.
1. What is Eprex 4000?
Eprex 4000 belongs to a group of drugs called erythropoiesis-stimulating agents mainly used to treat anemia (lack of hemoglobin in the blood) caused by chronic kidney disease and anemia caused by chemotherapy (cancer treatment). . Anemia is a decrease in the levels of hemoglobin and red blood cells (RBCs) in the blood. Patients with chronic kidney disease (CKD) develop anemia that slowly develops, which gets worse as the disease progresses. In addition, cancer treatment, including chemotherapy and radiation, causes anemia in cancer patients.
Eprex 4000 contains 'Erythropoietin alfa, recombinant human'. Eprex 4000 works by stimulating the bone marrow (the soft tissue in bones that makes red blood cells) to make more red blood cells. This Eprex 4000 is very similar to the natural substance in the body called erythropoietin (the hormone formed by the kidneys and makes RBC), which prevents anemia (lack of hemoglobin and RBC in the blood).
2. Uses of drugs
Eprex 4000 is indicated for the treatment of symptomatic anemia associated with chronic renal failure (CRF):
In adults and pediatric patients 1 to 18 years of age on hemodialysis and adult patients on dialysis peritoneal stool. In adults with renal failure not receiving dialysis for the treatment of severe anemia of renal origin with clinical symptoms in the patient. Eprex 4000 is indicated in adults receiving chemotherapy for solid tumours, malignant lymphomas or multiple myeloma, and at risk for transfusion as assessed by the patient's general condition (e.g. status). cardiovascular disease, anemia prior to initiation of chemotherapy) to treat anemia and reduce transfusion requirements.
Eprex 4000 is indicated in adults in a pre-treatment program to increase autologous blood production. Treatment should only be given to patients with moderate anemia (hemoglobin levels between 10 and 13 g/dL [6.2 to 8.1 mmol/L], without iron deficiency) if the procedures Blood savings are not available or sufficient when a major scheduled elective surgery requires large volumes of blood (4 or more units of blood for women or 5 or more units for men). Eprex 4000 is indicated for adults without iron deficiency prior to major elective orthopedic surgery at high risk of transfusion complications to reduce exposure to systemic blood transfusion. Use should be limited to patients with moderate anemia (eg, hemoglobin concentration range of 10 to 13 gdL) who do not have an autologous history program available and who expect moderate blood loss. 900 to 1,800 mL). Eprex 4000 is indicated for the treatment of symptomatic anemia (hemoglobin concentration 10g/dL) in adults with low or moderate risk primary myelodysplastic syndrome (MDS) with serum erythropoietin levels. short.
3. Dosage of the drug and how to use it
Eprex 4000 is available only as an injection, given subcutaneously (under the skin) or intravenously (into a vein). People who receive medication subcutaneously can often be taught to self-administer the medication. Make sure you understand exactly how it is injected, as directed by your doctor or nurse. People who need intravenous medication will need to be given medication by a doctor or nurse.
For children with chronic renal failure, the starting dose for anemia is 50 units (IU) per kg body weight, injected 3 times a week.
For adults with chronic renal failure, the starting dose for anemia is 50 to 100 units per kilogram of body weight, injected three times a week.
For HIV-infected anemic adults, the usual starting dose is 100 units per kg body weight, injected 3 times a week.
For people with anemia caused by chemotherapy, the starting dose is 150 units per kg body weight, injected subcutaneously 3 times a week. As an alternative, epoetin alfa can be injected subcutaneously once a week at a dose of 40,000 units.
Your doctor may need to adjust the dosage according to your body's response to the medicine. Adjustment usually involves blood tests and is not done more often than every 4 weeks. While you are being treated with epoetin alfa, your doctor may want you to take an iron supplement to help it work its best.
4. Side effects of drugs
Some side effects when patients take the drug if they see the following manifestations:
Coagulation of the vascular access site (for those on hemodialysis) Edema (swelling of the face, fingers, ankles, feet, or legs) Flu-like symptoms (eg, dizziness, drowsiness, fever, headache, muscle and joint pain) Increased headache Increased or decreased blood pressure, dizziness or feeling faint fainting Muscle aches Shortness of breath with mild exertion Stop taking the medicine and seek medical attention immediately if any of the following occur:
Chest tightness Convulsions Signs of an allergic reaction (the symptoms may include a rash or hives on the skin, trouble breathing, sweating, an irregular heartbeat or a drop in blood pressure) signs of a blood clot (pain or swelling in the legs, worsening shortness of breath, coughing up blood) signs of a serious skin reaction (such as skin rash; red skin; blistering of lips, eyes, or mouth; peeling skin; fever; or joint pain) signs of stroke (confusion, severe headache, sudden weakness, face, difficulty speaking or vision problems)
5. Precautionary measures
Before you start taking your medicine, be sure to tell your doctor about any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or for breastfeeding and any other important information about your health. These factors may affect how you should take this medicine.
5.1. Blood clots In clinical trials, it has been established that cancer patients and patients with chronic renal failure treated with epoetin alfa to increase hemoglobin beyond normal are at risk of blood clot formation. higher, in some cases fatal. Your doctor will closely monitor your hemoglobin level with blood tests during treatment with this medicine.
If you experience symptoms such as sharp pain and swelling in your legs, or difficulty breathing, contact your doctor immediately.
5.2. Epoetin alfa cancer is used to treat anemia caused by chemotherapy for non-myeloid cancer. It is not used to treat anemia caused by the cancer itself. If you have cancer and your hemoglobin is kept too high, your cancer may grow faster or you may have an increased risk of heart attack or stroke.
5.3. Cardiovascular disease This drug often affects blood pressure and may contribute to symptoms of heart disease. If you have high blood pressure, a heart condition such as heart failure, angina, or a previous heart attack, discuss with your doctor how this medicine may affect your medical condition. How your medication may affect the dose and effectiveness of this medication, and whether special monitoring is needed. If you are taking blood pressure medicine to control your blood pressure, it is important to continue taking it regularly while you are using epoetin alfa. Your doctor will monitor your hemoglobin (the protein in red blood cells that transport oxygen) until the right dose of epoetin alfa is determined.
5.4. Gout This medication may cause symptoms of gout. If you have gout or a history of gout, discuss with your doctor how this medication may affect your condition.
5.5. Kidney disease This medicine can be used by people with chronic kidney disease who are on dialysis and who are not on dialysis. The dose may be different for each type.
5.6. Medical conditions Be sure to tell your doctor if you have any of the following medical problems, as they may affect how well this medicine works:
Lack of folic acid, iron or vitamin B12 Residual aluminum excess in the blood Infection Inflammation Cancer Cancer Bone problems 5.7. If you have a history of porphyria (a metabolic disorder), discuss with your doctor how this medication may affect your medical condition, health How your medication may affect the dosage and effectiveness of this medication and whether any special monitoring is not needed.
5.8. Pure red cell aplasia Cases of pure red cell aplasia (PRCA) have been reported in individuals treated with epoetin alfa. PRCA is a condition in which a person's bone marrow stops producing red blood cells, leading to severe anemia. People who develop PRCA may experience a new or worsening feeling of fatigue or shortness of breath. If you are experiencing such symptoms, call your doctor as soon as possible. Do not stop your medication without contacting your doctor first.
5.9. Seizures This drug may contribute to increased seizures although the relationship between epoetin alfa and seizures is not clear. If you have seizures or a history of seizures, discuss with your doctor how this medication may affect your health, how your medical condition may affect the dose and effectiveness. of this drug and whether special monitoring is needed.
6. Drug interactions
Drug-Drug Interactions: the drug may interact with medicines used after a kidney transplant (cyclosporin), other medicines for cancer and anemia (lenalidomide), medicines used for kidney disease skin and cancer (thalidomide), anti-cancer drugs (pomalidomide).
Drug-disease interactions: The drug should not be used in patients with high blood pressure and joint disorders.
7. Some notes when taking medicine
Avoid making any changes to your diet without first talking to your doctor. Your doctor may conduct regular blood tests to check the levels of blood cells, hemoglobin, and electrolytes like potassium in your blood. Eat foods rich in iron, vitamin B12 and folic acid. Eat foods like leaves, green vegetables, fish, eggs and liver. Light to moderate exercise. The medicine may suddenly stop working well after a while because your body can make antibodies. Notify your doctor right away if anemia symptoms return (more fatigue, low energy, pale skin, trouble breathing).
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