Epokrin - drug group glycoproteins.
Pharmacological action Epokrina
Epokrin is a recombinant erythropoietin, whose action is aimed at stimulation of erythropoiesis.
It is able to activate mitosis and maturation of erythrocytes from progenitor cells. Recombinant epoetin alfa type is synthesized in mammalian cells that contain a gene capable of encoding a human erythropoietin.
Composition epoetin mammals as well as its immunologic and biological properties similar to those of human erythropoietin.
With the introduction of epoetin alfa in the human body is an increase in hematocrit and hemoglobin, improves blood circulation and heart function.
The maximum efficiency of the drug is observed in those types of anemia that is caused by chronic renal failure.
In rare cases, prolonged use of epoetin in the treatment of anemia able to lead to the formation of neutralizing antibodies to the human erythropoietin, while sometimes develops partial red cell aplasia.
According to the instructions Epokrin, produced in the form of solution for injection, which may have different contents of active substance: 1000, 4000, 2000 or 10,000 IU. The solution is a colorless liquid, packed in ampoules, in which one pack contains 10 pieces.
Epokrin recommended in the following cases:
- for anemia in patients with chronic renal insufficiency in form (including hemodialysis);
- as for the prevention and treatment of anemia arising after prolonged anti-tumor therapy;
- for the prophylaxis and treatment of anemia, which was the cause of zidovudine in patients infected with HIV;
- as prevention and treatment of anemia in patients diagnosed with multiple myeloma, non-Hodgkin lymphoma with the degree of malignancy of which is determined as "low", rheumatoid arthritis and chronic lymphocytic leukemia;
- for the prophylaxis and in the treatment of anemia in preterm infants born weighing less than 1500 g;
- in order to reduce the volume of transfused blood in acute blood loss and surgical interventions.
Epokrin has a number of contraindications, recommended Epokrin instruction to become acquainted with them before taking the medication. Epokrin should not be applied in the following cases:
- when partial red cell aplasia if previously conducted therapy with erythropoietin;
- with uncontrolled hypertension;
- if you can not conduct an adequate anticoagulant treatment;
- a period within one month after myocardial infarction;
- unstable angina;
- at increased risk of thromboembolism and deep vein thrombosis;
- when porphyria;
- in case of hypersensitivity to any component of Epokrina.
Precautions Epokrin appoint the following groups of patients:
- patients with various malignancies;
- patients with thrombosis (including history);
- patients with sickle cell anemia;
- patients with epilepsy;
- patients with chronic liver disease;
- patients with moderate anemia without iron deficiency.
Instructions for use Epokrina
Epokrin the treatment of anemia in patients with CRF administered subcutaneously or intravenously.
Changing the method of administration requires dose adjustment only if necessary (it should be noted that to achieve the same therapeutic effect when s / to require 20-30% less drug than with a / c). The optimum content of hemoglobin (HB) in blood of patients with anemia in chronic renal failure: adults - from 100 to 120 g / l in children - from 95 to 110 g / l.
Treatment Epokrin divided into two stages:
- correction step, wherein the initial dose Epokrina in s / to be 30 IU / kg thrice a week (at / in - 50 IU / kg at the same frequency). Stage lasts as long as you reach the optimal level of concentration HB. Monitoring should be carried out weekly. In this situation possible: a) increasing the hematocrit of 0, 5 to 1% in the week - dose not change; b) increasing hematocrit less than 0, 5% per week - to increase the dose of 1, 5 p .; c) the growth rate of more than 1% over the same period - to reduce the dose of 1, 5 p .; d) hematocrit is not changed or reduced - need analysis of the causes of resistance;
- maintenance therapy phase. Hematocrit be retained 30-35% of this dose Epokrina applied in step correction reduces to 1, 5 times. After that, a maintenance dose Epokrina selected taking into account the dynamics of the individual hemoglobin and hematocrit. Stabilization of hematological parameters allows you to assign administration Epokrina for once in 1-2 weeks.
Initial and final dosage Epokrina determined in accordance with the disease, the condition and age of the patient:
- before treatment and prevention Epokrin anemia in patients with solid tumors determine the level of endogenous erythropoietin. If it is less than 200 IU / ml, the initial dose at / in the introduction should be 150 IU / kg (if s / c infusion - 100 IU / kg). Allowed to increase the dose to 300 IU / kg (maximum) when there is no answer;
- in the treatment and as prophylaxis of anemia associated with the use of AZT in HIV-positive patients recommended / introduction Epokrina in an amount of 100-150 IU / kg only in the case of zidovudine dose not exceeding 4, 2 g of a week and the level of endogenous erythropoietin does not exceed the level of 500 IU / ml;
- prevention and treatment of anemia in patients with rheumatoid arthritis carried Epokrin n / k in a dosage of 50-75 IU / kg thrice a week. Then, in the case of increasing the content of HB less than 10 g / L, the dose can be increased to 150-200 IU / kg (maximum), frequency remain the same;
- prevention and treatment of anemia in children born with low birth weight: the dosage is 200 IU / kg three times a week. Start with the 6th day of life and until a normal hematocrit and hemoglobin, but no longer than 6 weeks;
- prevention of anemia in acute blood loss and operations carried out in / or s / c administration Epokrina in an amount of 100 to 150 IU / kg. When normalizing hemolytic indicators therapy overturned.
Side effects Epokrina
Carefully read the instructions in the Epokrin, since the use of the drug is able to cause adverse reactions, including:
- drowsiness, dizziness, headache, arthralgia, myalgia;
- worsening hypertension, hypertensive crisis;
- hyperkalemia, hyperphosphatemia, reduction of serum ferritin;
- redness, burning, soreness at the injection site;
- itching, hives, eczema;
- thrombocytosis, aggravation of porphyria, disordered breathing and blood pressure.
Store Epokrin necessary at 2 to 8 ° C for greater than 2 years.