Pegylated Erythropoietin

Indications

Anemia Cancer

Pegylated Erythropoietin is used to treat anemia linked to chronic kidney disease (CKD) in adult patients who are on dialysis, and also in those who are not on dialysis. It is not indicated for anemia caused by cancer chemotherapy. It should also not be used as a substitute for RBC transfusions in patients who need their anemia corrected immediately.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Pegylated erythropoietin is an erythropoietin receptor activator. Compared with erythropoietin, it is more active in vivo and stays in the body longer, because its half-life is increased.

The difference comes from an amide bond. This bond forms between the N-terminal amino group, or the ε-amino group of any lysine present in erythropoietin (mainly Lys52 and Lys45), and the Pegylated Erythropoietin (PEG).

Pregnancy & Breastfeeding

Pegylated Erythropoietin is Pregnancy Category C. It is not known whether the medicine passes into human breast milk. Many drugs do pass into milk, so take care when giving it to a nursing woman.

Evaluation of iron stores

Extra iron therapy is recommended for all patients whose serum ferritin is below 100 mcg/L or whose transferrin saturation is below 20%. Red blood cells need to be made effectively, so check iron status in every patient both before and during treatment.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: Start Pegylated Erythropoietin when the hemoglobin level is less than 10 g/dL. If the hemoglobin gets close to 11 g/dL or goes above it, reduce the dose or stop it for a while. If the hemoglobin rises quickly (for example, by more than 1 g/dL in any 2 week period), cut the dose by 25% or more, as needed, to slow the response. Some patients don't respond well. If the hemoglobin has not gone up by more than 1 g/dL after 4 weeks of treatment, increase the dose by 25%. If there is still no adequate response over a 12 week escalation period, raising the dose further is unlikely to help and may increase risks. For patients with CKD on dialysis, the recommended starting dose in adults who are not currently treated with an ESA is 0.6 mcg/kg body weight. It is given as a single IV or SC injection once every two weeks. Once the hemoglobin has stabilised, the injection can be given once monthly, using a dose twice that of the every two-week dose, and then adjusted as necessary. For patients with CKD not on dialysis, the starting dose is the same. Adults who are not currently treated with an ESA receive 0.6 mcg/kg body weight as a single IV or SC injection once every two weeks. After the hemoglobin has stabilised, it can be given once monthly at twice the every two-week dose, and adjusted as necessary. Conversion from another ESA to Pegylated Erythropoietin: patients whose hemoglobin has been stabilised on an ESA can take it once every two weeks or once monthly.