Brand : RPO
Ingredients : Erythropoietin
Strength : 10000IU
Manufactured : RPG life sciences
Package :1ml injection in a 1 prefilled syringe
Most necessary Dosing Information for RPO:
1. Administer Evaluation of Iron Stores and Nutritional Factors
2. Monitoring of Response to Therapy in Anemia
3. Formulation Based Selection In pregnant women, lactating women, neonates, and infants use only single-dose vials (the benzyl alcohol-free formulation)
Patients with Chronic Kidney Disease :
For all patients with CKD:
When starting or adjusting therapy, monitor haemoglobin levels at least weekly until stable, then monitor at least monthly.
• Avoid rises of the dose more frequently than once every 4 weeks. Reduces in dose can occur more frequently. Avoid frequent dose adjustments.
• If the haemoglobin increases rapidly, decrease the dose of RPO by 25% or more as required to reduce fast responses.
For adult patients with CKD on dialysis:
Start RPO therapy when the haemoglobin level is less than 10 g/dL. If the haemoglobin level approaches or exceeds 11 g/dL, decrease the dose of RPO.
The usual starting dose for adult patients is 50 to 100 Units/kg 3 times weekly IV or SC. The intravenous route is prescribed for patients on haemodialysis.
For paediatric patients with CKD: Start RPO therapy only when the haemoglobin level is less than 10 g/dL.If the haemoglobin level approaches or exceeds 12 g/dL, reduce or interrupt the dose of RPO.
The usual starting dose for paediatric patients (ages 1 month or older) is 50 Units/kg 3 times weekly intravenously or subcutaneously.
Zidovudine-treated Patients with HIV-infection: The prescribed initial dose in adults is 100 Units/kg as an IV or SC injection 3 times per week. Discontinue RPO if an increase in haemoglobin is not achieved at a dose of 300 Units/kg for 8 weeks.
Patients on Cancer Chemotherapy :
Start RPO in patients on cancer chemotherapy only if the haemoglobin is less than 10 g/dL, and if there is a minimum of two additional months of planned chemotherapy. Use the less dose of RPO needed to avoid RBC transfusions.
Usually Starting Dose: For Adults administer the dose of 150 Units/kg subcutaneously 3 times per week until completion of a chemotherapy course or 40,000 Units subcutaneously weekly until completion of a chemotherapy course.
Paediatric Patients (5 to 18 years): 600 Units/kg intravenously weekly until completion of a chemotherapy course.
Surgery Patients :
The prescribed RPO injections are:300 Units/kg per day subcutaneously (SC) for 15 days total: given daily for 10 days before surgery, on the day of surgery, and for 4 days after surgery. And 600 Units/kg subcutaneously (SC) in 4 doses given the patients 21, 14, and 7 days before surgery and on the day of surgery.
RPO 10000IU overdose can cause by above the desired level of haemoglobin levels, which must be controlled with discontinuation or reduction of RPO 10000IU dosage with phlebotomy.
• Patients go through surgery are at high risk for DVT; concomitant DVT prophylaxis is strongly recommended
• In Zidovudine-treated patients may have response only when zidovudine dosage <4200 mg/wk. and endogenous epoetin <500 U/mL
• In Dialysis patients having IV administration recommended to decrease red-cell aplasia risk; rises anticoagulation with heparin may be needed to prohibit clotting of extracorporeal circuit during haemodialysis
• Avoid increase dose more frequently than once monthly.
• Patients Contains albumin; may carry extremely specific risk for transmission or viral diseases or Creutzfeldt-Jakob disease.
• In Cases of PRCA and of severe Anemia, with or without other cytopenia’s that appears following the growth of neutralizing antibodies to erythropoietin resulted in patients treated with epoetin alfa
• High incidence of death, myocardial infarction (MI), stroke, and thromboembolism: while Using ESAs to aim haemoglobin level of >11 g/dL rises risk of severe adverse cardiovascular reactions
• Special caution usage in hypertension, iron deficiency, folate or B12 deficiency, congestive heart failure (CHF), coronary artery disease (CAD), seizure disorder, sickle-cell disease, haemolytic Anemia, porphyria, hematologic disorders
• Cancer patients will Increased tumor development rate when dosed to achieve haemoglobin level of >12 mg/ld.
• In Chronic renal failure patients at starting of treatment, transferrin saturation should be ≥20% and ferritin ≥100 ng/mL
The injection RPO 10000IU has some serious side effects like
Increase mortality, Myocardial infarction, stroke and thromboembolism
Increased mortality/ risk of tumor progression or recurrence in patients.
Serious allergic reactions
Severe cutaneous reaction.