Methoxy Polyethylene Glycol-Epoetin Beta

Adults: Methoxy Polyethylene Glycol-Epoetin Beta is given less often than other erythropoiesis stimulating agents (ESAs), because it stays in the body longer (its elimination half-life is longer). Treatment must be started under the supervision of a healthcare professional. Treatment of anemic patients with chronic kidney disease: the solution can be given subcutaneously (s.c.) or intravenously (i.v.), depending on clinical preference. For a subcutaneous injection you can use the abdomen, arm or thigh. All three sites are equally suitable. Hemoglobin should be checked every two weeks until it is stable, and then periodically. Patients not currently treated with an Erythropoiesis Stimulating Agent: for patients not on dialysis, the aim is to raise hemoglobin to greater than 11 g/dl (6.83 mmol/L). The recommended starting dose is 1.2 microgram/kg body weight once every month as a single subcutaneous injection. Another option is a starting dose of 0.6 microgram/kg body weight once every two weeks as a single IV or SC injection. For patients on dialysis, with the same aim of greater than 11 g/dl (6.83 mmol/L), the recommended starting dose is 0.6 microgram/kg body weight once every two weeks as a single IV or SC injection. The dose may be increased by approximately 25 to 50% of the previous dose if hemoglobin rises by less than 1.0 g/dl (0.621mmol/l) over a month. Further increases of approximately 25 to 50% can be made at monthly intervals until the individual target hemoglobin level is reached. If hemoglobin rises by more than 2 g/dl (1.24 mmol/l) in one month, the dose is to be reduced by approximately 25 to 50%. If hemoglobin goes above 13 g/dl (8.07 mmol/l), therapy is to be interrupted until the level falls below 13 g/dl, and then restarted at approximately 50% of the dose given before. In regions where the upper limit of hemoglobin has been set at 12 g/dl, dose adjustments of 25% should be considered. After a dose interruption, hemoglobin is expected to fall by approximately 0.35 g/dl per week. Patients treated once every two weeks whose hemoglobin is above 11 g/dl (6.83 mmol/l) may be given Methoxy Polyethylene Glycol-Epoetin Beta once monthly, using a dose equal to twice the previous once every two weeks dose. Doses should not be adjusted more often than once a month. Patients currently treated with an Erythropoiesis Stimulating Agent: patients on an ESA can be switched to this medicine once a month or, if wanted, once every two weeks, as a single i.v. or s.c. injection. The starting dose depends on the weekly dose of darbepoetin alfa or epoetin the patient was receiving at the time of the switch, as set out in Tables 1 and 2 below. The first injection should be given at the next scheduled dose of the darbepoetin alfa or epoetin the patient was using before.