: Anemia associated with chronic renal failure, cancer chemotherapy and chronic disease.
There is robust evidence for benefit in patients receiving anticancer therapy; apart from increasing hemoglobin (Hb), it also reduces fatigue, increases energy, and quality of life.
The FDA has issued guidelines regarding its use:
- Epoetin products should be used only for their approved indications
- They should not be used in cancer patients not on chemotherapy
- The dose recommendations should be strictly adhered to
- Cancer patients on chemotherapy should receive the lowest possible dose to relieve the symptoms of anemia
- The target Hb should not be more than 12g/dl
- If the Hb rises above 12g/dl or more than 1g/dl in any 2-week period, the next dose should be withheld.
: 10,000 units three times weekly increasing to 20,000 units three times weekly. Alternatively 40,000 units may be given weekly increasing to up to 60,000 units. It takes 4-8 weeks for the Hb to increase by 1-2 g/dl.
: Thrombotic episodes, flu-like symptoms.
Yennurajalingam S, Bruera E. Fatigue and Asthenia. Hanks G, Cherny NI, Christakis NA, Fallon M, Kaasa S, Portenoy RK (Ed). Oxford Textbook of Palliative Medicine. Oxford University Press, Fourth Edition, 2010, pp. 916-927.