PEG-Epo 75mcg/0.3ml IV/SC Injection

✔️ Uses of PEG-Epo 75mcg/0.3ml IV/SC Injection

• Anemia due to cancer chemotherapy
• Anemia due to chronic kidney disease

✔️ How does PEG-Epo 75mcg/0.3ml IV/SC Injection work?

PEG-Epo 75mcg/0.3ml IV/SC Injection is an erythropoiesis-stimulating agent (ESA) that helps the body produce more red blood cells (RBCs). It contains Pegylated Recombinant Human Erythropoietin, which mimics the natural protein erythropoietin produced by the body. This protein stimulates the bone marrow to generate RBCs.

By promoting RBC production, PEG-Epo helps to replace the lost red blood cells in patients suffering from anemia. It is also beneficial for individuals at risk of anemia due to conditions like chemotherapy, antiviral therapy, or bone marrow disorders. This treatment is crucial for managing anemia and its related symptoms in these patients.

✔️ Side Effects of PEG-Epo 75mcg/0.3ml IV/SC Injection

• Increased risk of death, myocardial infarction, stroke, and thromboembolism.
• Higher mortality and/or tumor progression in cancer patients.
• Hypertension.
• Seizures.
• Pure red cell aplasia.
• Serious allergic reactions.

✔️ Quick Suggestions:

• PEG-Epo 75mcg/0.3ml IV/SC Injection increases hemoglobin levels and improves physical functioning in patients with chronic kidney failure or undergoing chemotherapy.
• Before and during the treatment with PEG-Epo 75mcg/0.3ml IV/SC Injection, your iron level and blood pressure will be monitored regularly.
• PEG-Epo 75mcg/0.3ml IV/SC Injection is not indicated for the treatment of anemia in cancer patients due to other factors such as iron or folate deficiencies, hemolysis, or gastrointestinal bleeding.
• PEG-Epo 75mcg/0.3ml IV/SC Injection may also be given before certain operations where the chances of significant blood loss and blood transfusion are high. This is to reduce the need for blood transfusions during and after surgery.
• Inform your doctor if you have a history of seizures, strokes, or blood disorders.
• Avoid potentially hazardous activities such as driving or operating heavy machinery while taking Erypeg 100mcg Injection.

✔️ Indication of PEG-Epo 75mcg/0.3ml IV/SC Injection

PEG-Epo 75mcg/0.3ml IV/SC Injection is a medicine used in the treatment of anemia due to chronic kidney disease and cancer chemotherapy.

Patients with serum ferritin levels below 100 mcg/L or transferrin saturation below 20% should receive supplementary iron therapy to ensure effective red blood cell production. Iron status should be checked before and during treatment.

✔️ Pharmacology

Pegylated erythropoietin is an activator of erythropoietin receptors with enhanced activity and a longer half-life compared to regular erythropoietin. Its structure differs due to the integration of an amide bond between the N-terminal amino group or the ε-amino group of specific lysines, particularly Lys52 and Lys45, with polyethylene glycol (PEG).

✔️ Dosage of PEG-Epo 75mcg/0.3ml IV/SC Injection

• Start PEG-Epo treatment when hemoglobin levels fall below 10 g/dL. Reduce or pause the dose if hemoglobin approaches or exceeds 11 g/dL.
• If hemoglobin increases by more than 1 g/dL within any 2-week period, reduce the dose by 25% or more to avoid a rapid response.
• For patients not responding sufficiently, if hemoglobin hasn’t increased by more than 1 g/dL after 4 weeks, increase the dose by 25%.
• If there is inadequate response over a 12-week period, further dose increases are unlikely to help and may increase risks.

For patients with CKD on dialysis:

• The recommended starting dose for adults with CKD on dialysis is 0.6 mcg/kg body weight, administered as a single intravenous (IV) or subcutaneous (SC) injection once every two weeks.
• Once hemoglobin is stabilized, the dose can be given once a month at double the two-week dose, with further adjustments as needed.

For patients with CKD not on dialysis:

• The starting dose is the same as for dialysis patients (0.6 mcg/kg body weight every two weeks), with monthly dosing after hemoglobin stabilization.

Conversion from another ESA to PEG-Epo:

• After hemoglobin stabilization on another erythropoiesis-stimulating agent (ESA), PEG-Epo can be administered every two weeks or monthly.

Use only under the guidance of a registered physician.

✔️ Administration of PEG-Epo 75mcg/0.3ml IV/SC Injection

PEG-Epo 75mcg/0.3ml IV/SC Injection will be given to you only by a doctor or a nurse into the vein (intravenously) or under the skin (subcutaneously). It can also be self-administered by the patient if instructed by the doctor. Carefully follow the instructions given by your doctor in case of self-administration.

Your doctor will decide the correct dose and duration of therapy for you depending on your age, body weight, and disease condition.

✔️ Interaction

Before receiving  PEG-Epo 75mcg/0.3ml IV/SC Injection, inform your doctor if you are taking any of the following medicines:

• Cyclosporin: Used for immunosuppression in organ transplant patients, as it may interact with the way PEG-Epo 75mcg/0.3ml IV/SC Injection works.
• Iron Supplements: Used to manage iron deficiency anemia. It's important to monitor iron levels to ensure effective red blood cell production while using PEG-Epo.
• Other Blood Stimulants: Such as darbepoetin alfa, as using multiple erythropoiesis-stimulating agents may increase the risk of side effects.
• Interferons: Such as interferon alfa-2A, which is used to manage cancer, as they may interfere with the response to PEG-Epo.
• Ribavirin: Used for managing hepatitis C infections, as it can impact the effectiveness of PEG-Epo or exacerbate anemia.

✔️ Overdosage:

PEG-Epo will be administered to you only by a doctor or a nurse in a hospital so it is unlikely to receive an overdose. However, consult your doctor or nurse if you experience any unusual symptoms. Symptoms of overdose might include fits and high blood pressure

✔️ Pregnancy & Lactation

• Pregnancy Category C: It is not confirmed if PEG-Epo passes into human breast milk. Since many drugs are excreted in breast milk, caution is advised for nursing mothers.

✔️ Precautions & Warnings

• Targeting hemoglobin levels above 11 g/dL may increase the risk of serious cardiovascular events. Use with caution in patients with cardiovascular disease, stroke, or seizure disorders.
• Ensure blood pressure is controlled before and during treatment.
• Monitor patients for seizure activity or warning signs.
• If severe anemia with a low reticulocyte count develops, stop treatment and check for neutralizing antibodies to erythropoietin.
• An overdose of PEG-Epo can lead to excessive hemoglobin levels, managed by stopping or reducing the dose, or with phlebotomy. Severe hypertension has been reported after overdosing on erythropoiesis-stimulating agents (ESAs).

✔️ Storage:

Store between 2°C to 8°C in the refrigerator, away from light. Do not shake the syringe. Keep out of reach of children.