II. Indications

  1. See Erythropoietin
  2. Anemia of Chronic Renal Failure
  3. Anemia of Myelosuppressive Cancer Chemotherapy (not intended for cure)

III. Contraindications

IV. Mechanism

  1. See Erythropoietin
  2. Darbepoetin Alfa is a recombinant synthetic agent chemically similar to endogenous Erythropoietin
  3. Darbopoetin Alfa has 2 additional Carbohydrate chains that extend its Half-Life 3 fold over Erythropoietin

V. Medications

  1. Darbepoetin Single dose vials (ranging from 25 to 500 mcg/ml)
  2. Also available in various single dose prefilled syringes and autoinjectors
  3. Do not shake solution and avoid exposing to light

VI. Precautions

  1. Not a substitute for Blood Products in acute severe, symptomatic Anemia
  2. Avoid Hemoglobin targets above 11 g/dl (higher risk of cardiovascular and thrombotic events)
    1. Use the lowest effective dose
  3. Iron Supplementation if needed
    1. Check for Iron Deficiency before administration

VII. Dosing: Adults

  1. Anemia of Chronic Renal Failure and Dialysis
    1. Darbepoetin 0.45 mcg/kg IV or SQ each week OR
    2. Darbepoetin 0.75 mcg/kg SQ every 2 weeks
    3. Indicated for Hemoglobin <10 g/dl
    4. Discontinue if Hemoglobin >= 11 g/dl
  2. Anemia of Chronic Renal Failure and NO Dialysis
    1. Darbepoetin 0.45 mcg/kg IV or SQ every 4 weeks
    2. Discontinue if Hemoglobin >= 10 g/dl
  3. Anemia of Myelosuppressive Cancer Chemotherapy (not intended for cure)
    1. See dailymed reference below for conversions to Erythropoietin
    2. Administer lowest dose to avoid transfusion
    3. Darbepoetin 2.25 mcg/kg SQ every week OR
    4. Darbepoetin 500 mcg SQ every 3 weeks

VIII. Dosing: Children

  1. Anemia of Chronic Renal Failure
    1. Dialysis: 0.45 mcg/kg IV or SQ each week OR
    2. No Dialysis: 0.75 mcg/kg SQ every 2 weeks
    3. Indicated for Hemoglobin <10 g/dl
    4. Discontinue if Hemoglobin >= 12 g/dl

IX. Adverse Effects

  1. See Erythropoietin
  2. Common (>10%)
    1. Hypertension
    2. Hypotension during infusion
    3. Dyspnea
    4. Peripheral Edema
    5. Cough
  3. Less common (1 to 10%)
    1. Abdominal Pain
    2. Edema
    3. Cardiovascular or thromboembolic events (esp. Hemoglobin >11 g/dl)

X. Safety

  1. Pregnancy Category C
  2. Unknown safety in Lactation

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Ontology: darbepoetin alfa (C0937950)

Definition (NCI) A recombinant analog of the endogenous cytokine erythropoietin, an erythropoiesis-stimulating protein. Due to the addition of two carbohydrate chains, darbepoetin alfa exhibits a three-fold greater half-life than does erythropoietin. Similar to erythropoietin, darbopoietin alfa binds to and activates epoetin receptors, thereby inducing the differentiation and maturation of erythrocyte progenitors, stimulating endothelial cell proliferation, and stimulating B-cell proliferation and immunoglobulin production. (NCI04)
Definition (NCI_NCI-GLOSS) A substance made in the laboratory that stimulates the bone marrow to produce red blood cells. It belongs to the family of drugs called antianemics.
Definition (PDQ) A recombinant analog of the endogenous cytokine erythropoietin, an erythropoiesis-stimulating protein. Due to the addition of two carbohydrate chains, darbepoetin alfa exhibits a three-fold greater half-life than does erythropoietin. Similar to erythropoietin, darbopoietin alfa binds to and activates epoetin receptors, thereby inducing the differentiation and maturation of erythrocyte progenitors, stimulating endothelial cell proliferation, and stimulating B-cell proliferation and immunoglobulin production. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=38676&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=38676&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1878" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116)
MSH C417052
SnomedCT 391638006, 385610007, 385608005
LNC LA18622-3
English Novel Erythropoiesis Stimulating Protein, darbepoetin alfa (medication), DARBEPOETIN ALFA, alfa darbepoetin, novel erythropoiesis stimulating protein, 30-l-Asparagine-32-l-threonine-87-l-valine-88-l-asparagine-90-l-threonineerythropoietin (human), darbepoietin alfa, Darbepoetin alfa (product), Darbepoetin alfa, Darbepoetin alfa #1 (substance), Darbepoetin alfa (substance), NESP, darbepoetin alfa, Darbepoetin Alfa
Spanish darbepoyetina alfa - 1, darbepoyetina alfa - 1 (sustancia), darbepoetina alfa (sustancia), darbepoyetina alfa (sustancia), darbepoetin alfa, darbepoetina alfa (producto), darbepoetina alfa, darbepoyetina alfa