Daprotab is used for the treatment of anemia due to chronic kidney disease (CKD) in adults who have been receiving dialysis for at least four months.
Daprotab is not recommended for:
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Daprodustat is a hypoxia-inducible factor, prolyl hydroxylase inhibitor (HIF-PHI). It regulates HIF levels, a key transcription factor for genes involved in erythropoiesis. By reversibly inhibiting HIF-PH, Daprodustat:
✅ Increases plasma erythropoietin (EPO) levels.
✅ Regulates iron transport proteins.
✅ Reduces hepcidin (an iron-regulating protein elevated in CKD).
✅ Improves iron bioavailability and promotes red blood cell production.
⚠ Serious Risks:
🚫 Not recommended during pregnancy—may cause fetal harm.
🚼 Breastfeeding should be avoided until one week after the final dose.
⚠ Increased Risk of:
✔ Death, myocardial infarction, stroke, venous thromboembolism, & vascular access thrombosis.
✔ Hospitalization due to heart failure.
✔ Hypertension.
✔ Gastrointestinal erosion.
✔ Malignancy risk in CKD patients not on dialysis.
✔ Children: Safety and efficacy not established.
✔ Elderly: Dose adjustments not necessary unless contraindicated.
⚠ Symptoms:
⚠ No specific antidote available. Hemodialysis is not effective due to high protein binding.
✔ Anemia & Iron Stores
✔ Liver Function Tests
✅ Individualized dosing—Use the lowest effective dose to minimize red blood cell transfusion dependency.
✅ Do not exceed hemoglobin levels of 11 g/dL.
✅ Can be taken with or without food.
✅ Swallow whole—do not cut, crush, or chew.
✅ Dosing is independent of dialysis timing.
🚨 Missed Dose: Take as soon as possible, unless it is the same day as the next dose. Do not double the dose.
✔ Not on ESA Therapy:
✔ On ESA Therapy:
✔ Monitor hemoglobin every 2 weeks for the first month, then every 4 weeks.
✔ Adjust doses only every 4 weeks, increasing or decreasing one level at a time.
✔ Reduce the dose if:
✔ Moderate Hepatic Impairment (Child-Pugh B): Reduce dose by half, except for those already on 1 mg.
✔ Severe Hepatic Impairment (Child-Pugh C): Not recommended.
✔ Patients on Moderate CYP2C8 Inhibitors (e.g., Clopidogrel): Reduce dose by half, except if already on 1 mg.
❌ Strong CYP2C8 Inhibitors (e.g., gemfibrozil) → Contraindicated due to increased drug exposure.
⚠ CYP2C8 Inducers (e.g., rifampin) → May reduce efficacy.
✔ Store below 30°C, in a cool, dry place.
✔ Keep away from light.
✔ Keep out of reach of children.
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