Aprodust 2 Tablet 1 Strip

✔️ How Aprodust 2 Works

Daprodustat works by inhibiting HIF prolyl hydroxylase enzymes, which normally break down HIF under standard oxygen conditions. Inhibition of these enzymes stabilizes HIF-1α and HIF-2α transcription factors, increasing the expression of genes involved in erythropoiesis, including erythropoietin production.

Following administration, endogenous erythropoietin levels rise in a dose-dependent manner within approximately 6–8 hours. Repeated dosing leads to increased reticulocyte production within 7–15 days, followed by enhanced red blood cell formation. Stable hemoglobin levels are generally achieved within several weeks.

✔️ Dosage & Administration

Adult Dose

Adults Not Previously Receiving ESA Therapy

• Hemoglobin <9 g/dL: 4 mg once daily
• Hemoglobin 9–10 g/dL: 2 mg once daily
• Hemoglobin >10 g/dL: 1 mg once daily

Switching from ESA Therapy

4 mg once daily

• Epoetin alfa IV ≤2,000 units/week
• Darbepoetin alfa 20–30 mcg/4 weeks
• Methoxy PEG-epoetin beta 30–40 mcg/month

6 mg once daily

• Epoetin alfa IV >2,000 to <10,000 units/week
• Darbepoetin alfa >30–150 mcg/4 weeks
• Methoxy PEG-epoetin beta >40–180 mcg/month

8 mg once daily

• Higher ESA equivalent doses as clinically indicated

12 mg once daily

• Epoetin alfa IV ≥20,000 units/week
• Darbepoetin alfa >300 mcg/4 weeks
• Methoxy PEG-epoetin beta >360 mcg/month

Maximum Dose

• 24 mg orally once daily

Pediatric Use

Not recommended for children

Exposure to Daprodustat remains generally similar in patients with normal or impaired renal function. Hemodialysis and peritoneal dialysis do not significantly affect drug exposure.

However, metabolite exposure may be increased in patients with advanced CKD, especially on non-dialysis days.

✔️ Drug Interactions

CYP2C8 Inhibitors

Strong CYP2C8 inhibitors such as gemfibrozil significantly increase Daprodustat exposure and are contraindicated.

CYP2C8 Inducers

Agents like rifampin may decrease Daprodustat levels and reduce therapeutic effectiveness.

✔️ Aprodust is contraindicated in:

• Patients taking strong CYP2C8 inhibitors such as gemfibrozil
• Patients with uncontrolled hypertension

✔️ Pregnancy & Lactation

Use during pregnancy is not recommended. Animal studies have demonstrated adverse fetal effects.

✔️ Not indicated for:

• Replacement of red blood cell transfusions in patients requiring rapid correction of anemia
• Treatment of CKD-related anemia in patients who are not receiving dialysis