Oroxat 20 Tablet 1 Strip

✔️ Side Effects

• Hypertension
• Vascular access thrombosis
• Diarrhea
• Peripheral edema
• Hyperkalemia
• Nausea

✔️ Pharmacology

Roxadustat is an orally active HIF-PH inhibitor. By blocking HIF-PH enzymes that normally degrade HIF proteins under normal oxygen levels, it boosts HIF activity. This leads to:

Elevated endogenous erythropoietin (EPO) production

Decreased hepcidin levels

Improved iron absorption and mobilization

Enhanced hemoglobin (Hb) levels
It induces a coordinated erythropoietic response while maintaining EPO levels within the physiological range, even in inflamed states or without IV iron.
Roxadustat has also been shown to reduce cholesterol levels, regardless of statin usage.

✔️ Dosage & Administration

Frequency: Three times weekly (non-consecutive days)

With or without food

For patients not previously on erythropoiesis-stimulating agents (ESAs):

Start with 50 mg three times weekly.

Weight-based dosing:

• <100 kg: 70 mg
• ≥100 kg: 100 mg

For patients switching from ESAs:

Start with 70 mg or 100 mg three times weekly depending on previous treatment and patient condition.

Dose Adjustment:

Modify doses based on hemoglobin response and tolerability using the sequence:
20 mg → 40 mg → 50 mg → 70 mg → 100 mg → 150 mg → 200 mg → 250 mg → 300 mg → 400 mg (400 mg reserved for dialysis-dependent CKD).

Maintain each dose level for at least 4 weeks.

If Hb rises >2.0 g/dL within 4 weeks, reduce the dose or temporarily stop.

✔️ Interactions

Avoid co-administration or adjust timing/dosing with:

• Phosphate binders/multivalent cation products (except lanthanum carbonate):
  ↓ Roxadustat absorption. Take Oroxat at least 1 hour later.

Gemfibrozil, Probenecid:
↑ Roxadustat exposure. Monitor Hb and adjust dose accordingly.

Statins (simvastatin, rosuvastatin, atorvastatin):
↑ Statin levels. Monitor and adjust dose as needed.

✔️ Missed Dose:

≥24 hours before next dose: Take immediately.

<24 hours before next dose: Skip missed dose. Do not double-dose.

• Pediatrics: Not recommended
• Severe hepatic impairment: Use is not advised

✔️ Use Oroxat cautiously in:

Patients with a history of thrombotic vascular events (TVEs), obesity, or prior TVEs

• Those with a history of seizures
• Patients with active infections or liver dysfunction
• Pregnant women – not recommended to initiate treatment

✔️ Pregnancy & Lactation

• Contraindicated in pregnant women
• Not to be used during breastfeeding