Aranesp

Aranesp (darbepoetin alfa) is a drug used to treat anemia, especially in patients with chronic kidney disease, whether or not on dialysis, and in cancer patients receiving chemotherapy. It may also be used to treat anemia in patients with HIV infection and in patients with cancer who are not receiving chemotherapy.

Darbepoetin alfa is a synthetic analogue of erythropoietin, which is a hormone that stimulates the production of red blood cells in the bone marrow. Aranesp works by increasing the number of red blood cells in the blood, which helps reduce anemia and improve the patient's overall condition.

The attending physician prescribes the dosage and frequency of taking Aranesp depending on the severity of the anemia, the individual characteristics of the patient and the characteristics of the disease. This drug is available only by prescription and should be used under the supervision of a physician.

Indicações Aranespa

• Anemia in Chronic Kidney Disease: In patients with chronic kidney failure, especially those on dialysis or not, Aranesp is used to treat anemia. It helps increase the number of red blood cells and improve their overall health.
• Anemia in Cancer: Cancer patients, especially those undergoing chemotherapy, may develop anemia. Aranesp is used to treat this anemia and increase red blood cell levels.
• Anemia in HIV infection: Some patients with HIV infection may develop anemia. Aranesp can be used to treat this anemia and increase red blood cell levels.

Forma de liberação

Injection solution: Usually supplied in glass ampoules or cartridges with syringes for injection under the skin or into a vein. The injection solution is ready to use and can be prescribed by a doctor for self-administration by the patient or for administration by medical personnel.

Farmacodinâmica

The pharmacodynamics of Aranesp (darbepoetin alfa) are related to its ability to stimulate the formation of red blood cells in the bone marrow. Darbepoetin alfa is a synthetic analogue of the endogenous glycoprotein erythropoietin. It works by activating erythropoietin receptors on preformed red blood cells in the bone marrow. This leads to stimulation of their proliferation, differentiation and maturation, which ultimately leads to an increase in the number of red blood cells in the blood.

The process of stimulating red blood cell production occurs approximately two weeks after starting treatment with darbepoetin alfa and may result in an increase in hemoglobin and hematocrit levels in the blood. This helps improve oxygen transport and reduce symptoms of anemia in patients with chronic kidney disease, cancer, or HIV infection.

The pharmacodynamic effects of Aranesp allow for the management of red blood cell levels and the improvement of the general condition of patients suffering from anemia and the reduction of their dependence on blood transfusions.

Farmacocinética

• Absorption: Because Aranesp is usually given into the body by injection under the skin or into a vein, it is rapidly and completely absorbed into the blood.
• Metabolism: Darbepoetin alfa is metabolized in body tissues where it is broken down into smaller fragments.
• Excretion: Darbepoetin alfa metabolites and residues are eliminated from the body primarily via the kidneys, where they may undergo further metabolism and/or be excreted in the urine.
• Half-life: The half-life of darbepoetin alfa may be relatively long, meaning that its effects may persist in the body for a long time.
• Blood concentration: Blood levels of darbepoetin alfa peak a few days after administration and then gradually decline over time.

Dosagem e administração

• Subcutaneous injections: Aranesp is usually given subcutaneously once a week or every two weeks. The injection site is usually the abdomen, upper thigh, or upper arm.
• Dosage: The dosage is determined by the physician based on the hemoglobin level and patient characteristics. The usual starting dose is 0.45 mcg/kg, but can be adjusted in the range of 0.75 to 1.5 mcg/kg depending on the response to treatment.
• Dose adjustment: The dose may be adjusted based on changes in hemoglobin levels. It is generally recommended to reduce or stop Aranesp if hemoglobin exceeds 12 g/dL.
• Following Instructions: It is important to follow your doctor's instructions and not change your dosage or schedule without your doctor's approval.
• Regular monitoring: Patients receiving Aranesp treatment may require regular monitoring of hemoglobin levels and other blood parameters to assess the effectiveness of treatment and to detect side effects.

Uso Aranespa durante a gravidez

• Treatment of anemia after kidney transplant:

  • In one case of successful treatment of severe anemia in a pregnant woman after kidney transplantation, darbepoetin alfa was used to correct the anemia. The drug was effective and safe for both mother and fetus (Goshorn & Youell, 2005).

• Chronic renal failure:

  • In another case, darbepoetin alfa was used to treat anemia in a pregnant woman with chronic renal failure and nephrotic syndrome. The drug was prescribed after her condition worsened while taking oral hematinotes. Treatment with darbepoetin alfa was successful (Ghosh & Ayers, 2007).

• Safety and effectiveness:

  • Darbepoetin alfa is well tolerated and effectively maintains hemoglobin levels with various dosing regimens, including weekly and biweekly doses. The drug has not been associated with antibody formation and has shown good results in the treatment of anemia in patients with chronic renal failure (Vanrenterghem et al., 2002).

Contra-indicações

• Hypersensitivity: People with known hypersensitivity or allergic reaction to darbepoetin alfa or any of the components of the drug should avoid its use.
• Untreated hypertension: Use of Aranesp may increase the risk of developing serious complications in untreated hypertension.
• Iron deficiency: Patients with iron deficiency or other disorders of iron metabolism may not respond adequately to treatment with Aranesp.
• Anemia not due to erythropoietin deficiency: The use of Aranesp is not recommended in patients with anemia not due to erythropoietin deficiency.
• Thromboembolic Events: Patients with anemia due to chronic kidney disease or cancer may have an increased risk of thromboembolic events when treated with Aranesp.
• Untreated kidney abnormalities: Aranesp may be dangerous to use in patients with untreated kidney abnormalities or who require a kidney transplant.

Efeitos colaterais Aranespa

• Hypertension: Some patients may develop high blood pressure while using Aranesp.
• Headache: Headache or migraine may occur in some patients during treatment.
• Feeling tired or weak: This can be one of the most common side effects.
• Arthralgia and muscle pain: Some patients may experience pain in the joints or muscles.
• Thrombosis and thromboembolic events: Some patients may have an increased risk of thrombosis or thromboembolic complications.
• Allergic reactions: Rarely, allergic reactions such as hives, itching, skin rash or anaphylaxis may occur.
• Seizures: Some patients may experience seizures or muscle spasms.
• Increased Ferritin Levels: Some patients may experience increased levels of ferritin in the blood.
• Heart failure: Some patients are at risk of developing heart failure or worsening the condition if they have predisposing factors.

Overdose

Signs of overdose may include increased blood pressure, dizziness, headache, weakness, rapid heartbeat, warmth or redness of the skin, chest pain, or seizures.

Interações com outras drogas

• Medicines that increase the risk of thrombosis: The use of Aranesp simultaneously with medicines that increase the risk of thrombosis (eg, estrogens, hormonal drugs, blood clotting factors) may increase the likelihood of thromboembolic complications.
• Drugs that increase bleeding: Concomitant use of Aranesp with drugs that increase bleeding (eg, acetylsalicylic acid, nexstatin, anticoagulants) may increase the risk of bleeding.
• Iron-containing preparations: The use of iron-containing preparations concomitantly with Aranesp may increase the effectiveness of treatment of anemia in patients with chronic kidney disease.
• Medicines that affect kidney function: Some medicines that affect kidney function may affect how well Aranesp works or how it is metabolized and eliminated from the body.
• Drugs that affect hematopoiesis: Medicines that also affect the process of red blood cell formation (eg, cytostatics, drugs for the treatment of cancer) may interact with Aranesp.

Condições de armazenamento

• Temperature: Store Aranesp in the refrigerator at a temperature of 2°C to 8°C. The medicine should not be frozen. Do not store Aranesp at temperatures above 25°C.
• Light: Avoid exposing the medicine to direct sunlight. Store it in a dark place, such as in a box or package.
• Packaging: Keep the product in its original package or container to protect it from moisture and other external factors.
• Preparation for use: Before use, Aranesp may be stored for a short time at room temperature (15°C to 25°C), but not more than 30 days.
• Expiry date: Follow the expiry date stated on the package. Do not use Aranesp after the expiry date.