II. Indications
- See Erythropoietin
- Anemia of Chronic Renal Failure
- Anemia of Myelosuppressive Cancer Chemotherapy (not intended for cure)
III. Contraindications
- See Erythropoietin
IV. Mechanism
- See Erythropoietin
- Darbepoetin Alfa is a recombinant synthetic agent chemically similar to endogenous Erythropoietin
- Darbopoetin Alfa has 2 additional Carbohydrate chains that extend its Half-Life 3 fold over Erythropoietin
V. Medications
- Darbepoetin Single dose vials (ranging from 25 to 500 mcg/ml)
- Also available in various single dose prefilled syringes and autoinjectors
- Do not shake solution and avoid exposing to light
VI. Precautions
- Not a substitute for Blood Products in acute severe, symptomatic Anemia
- Avoid Hemoglobin targets above 11 g/dl (higher risk of cardiovascular and thrombotic events)
- Use the lowest effective dose
-
Iron Supplementation if needed
- Check for Iron Deficiency before administration
VII. Dosing: Adults
-
Anemia of Chronic Renal Failure and Dialysis
- Darbepoetin 0.45 mcg/kg IV or SQ each week OR
- Darbepoetin 0.75 mcg/kg SQ every 2 weeks
- Indicated for Hemoglobin <10 g/dl
- Discontinue if Hemoglobin >= 11 g/dl
-
Anemia of Chronic Renal Failure and NO Dialysis
- Darbepoetin 0.45 mcg/kg IV or SQ every 4 weeks
- Discontinue if Hemoglobin >= 10 g/dl
-
Anemia of Myelosuppressive Cancer Chemotherapy (not intended for cure)
- See dailymed reference below for conversions to Erythropoietin
- Administer lowest dose to avoid transfusion
- Darbepoetin 2.25 mcg/kg SQ every week OR
- Darbepoetin 500 mcg SQ every 3 weeks
VIII. Dosing: Children
-
Anemia of Chronic Renal Failure
- Dialysis: 0.45 mcg/kg IV or SQ each week OR
- No Dialysis: 0.75 mcg/kg SQ every 2 weeks
- Indicated for Hemoglobin <10 g/dl
- Discontinue if Hemoglobin >= 12 g/dl
IX. Adverse Effects
- See Erythropoietin
- Common (>10%)
- Hypertension
- Hypotension during infusion
- Dyspnea
- Peripheral Edema
- Cough
- Less common (1 to 10%)
- Abdominal Pain
- Edema
- Cardiovascular or thromboembolic events (esp. Hemoglobin >11 g/dl)
X. Safety
- Pregnancy Category C
- Unknown safety in Lactation
XI. Resources
- Darbepoetin Alfa (DailyMed)