Nanokine injection solution 2000iu/ml Nanogen treat anemia

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Specifications Recomminant Human Erythropoietin Alfa

Ingredient

Thành phần cho 1ml

Composition information	Content
Recomminant Human Erythropoietin Alfa	2000iu

Uses

Indications

Nanokine injection solution 2000iu/ml are indicated in the following cases:

Anemia in patients with chronic renal impairment, including patients with or not dialysis. Low.

pharmacokinetics

No data.

Before taking Nanokine injection solution 2000iu/ml Nanogen treat anemia

How to use

Sugar: Inject subcutaneous or intravenously.

should only use intravenously for patients with chronic kidney disease.

Dosage

Erythropoietin treatment effect depends on the dose, but the dose is higher than 300 units/kg, 3 times a week does not give better results. The maximum dose of erythropoietin has not been determined. Using more iron or L - Carnitin increases response to erythropoietin, so the drug can be reduced to stimulate red blood cells.

Anemia in patients with chronic renal failure:

Intravenous injection: The initial dose is commonly used 50 - 100 IU /kg, three times a week. Erythropoi-Etin dose is required when Hematocrit reaches 30% to 36% or when every two weeks, Hematocrit increases over 4%.

If after 8 weeks of treatment, hematocrit does not increase by 5% to 6% and is still lower than the level of need, it is necessary to increase the dose. Hematocrit must not increase higher than 36%. Need to calculate the dose for each patient, maintenance dose from 12.5 to 525 IU/kg, three times a week.

Hematocrit increases depending on the dose, but if the dose is higher than 300 IU/kg, 3 times a week, nor does it give better results. Dosage to treat anemia in patients with end -stage renal disease is from 3 IU/kg/dose to 500 IU/kg/dose, three times a week, starting with low doses and gradually increasing hiccups depending on hematology. The dose may increase twice the previous dose and 1 to 2 weeks apart.

subcutaneous injection: Erythropoietin is often used in the initial dose of 50 - 100 IU/kg, three times a week. Erythropoietin should be reduced when hematocrit reaches 30% to 36% or up 4% within 2 weeks.

Need to increase the dose if after 8 weeks of treatment, Hema-Tocrit does not increase by 5% to 6% and is still lower than the need to reach. Hematocrit increases depending on the dose but the dose is higher than 300 IU/kg, three times a week does not give better results. The dose should be calculated for each case, every month should not change the dose exceeding 1 time, unless clinically indicated. It is possible to reduce the maintenance dose per week to 23% to 52% when subcutaneously injecting the skin rather than intravenous injection (because the drug is absorbed from the subcutaneous line). The subcutaneous dose to maintain hemoglobin concentration is at 9.4% to 10g/decor is from 2800 to 6720 IU per week, compared to 8350 to 20300 IU per week when intravenously.

erythropoietin can be injected subcutaneously or intravenously, should use intravenous lines in patients with feces. The subcutaneous injection takes more days to reach the concentration of hemoglobin that needs to be compared to intravenous injection.

Can be injected erythropoietin into the muscle (Delta muscle) with a dose of 4000 to 8000 IU, once a week, Hemato-CRIT can increase to 30% to 33%. Intramuscular pain less than subcutaneous injection.

Dosage recommended in children: The initial dose is 150 IU/kg in the skin, three times a week; If hematocrite increases to 35%, reduces the dose of 25 IU/kg/dose and stops medication if hematocrit reaches 40%. This usage is safe and effective for children with kidney failure at the end of the abdominal division.

Adjust the dose during the fertilizer:

Dialycemia: Erythropoietin is used 12 hours after dialysis.

Peritoneal jurisdiction: The effective way is to take one, two or three times a week. After using 2000 to 8000 IU, once a week for 2 to 10 months, the average hematocrit increases from 20% to 30%. Or you can use a dose of 60 to 120 IU/kg, subcutaneously, twice a week. The next dose must then be based on Hemoglobin response. The dose needed to maintain hemoglobin concentration is from 11 to 11.5 g/Decilids is from 12.5 to 50 IU/kg, 3 times/week.

Erythropoietin's bioavailability is used by subcutaneous injection (22%) 7 times higher than the peritoneal injection (3%); 3 to 4 days after subcutaneous injection, the drug is still in serum.

Anemia due to cancer chemotherapy:

Need to start at a dose of 150 IU/kg under the skin, 3 times/week. If after 8 weeks, the results are not good, the dose can be increased to 300 IU/kg. Higher doses do not increase the effectiveness. During treatment, if hematocrit is 40% higher, it is necessary to suspend the use of erythropoietin until hematocrit drops to 36% lower, then it is necessary to reduce 25% of the dose and adjust.

Reducing blood transfusion needs in patients with surgery:

erythropoietin is indicated to treat anemia patient (hemoglobin from 10 to 13 g/decilite) preparing selective surgery (not heart or blood vessels) to reduce the need for genetic blood transfusion, or patients with high risk of blood loss need to be transferred blood first, during and after surgery. The recommended dose is 300 IU/kg/day, subcutaneously 10 days before surgery, during the surgery day and 4 days after surgery. Another way is to injection under the skin 600 IU/kg, once a week (before surgery 21, 14, and 7 days) add the fourth dose on the surgery day. Need to supplement iron.

erythropoietin subcutaneous or vein (300 IU/kg/day until the appropriate response, then 150 IU/kg, a day) for 3 to 10 days, combined with folat, cyanocobalamin, oral or iron enhancement can cause hemoglo-bin or hematocrit to increase every day to 5% or more.

Anemia in patients treated with zidovudin:

The initial dose is recommended to treat anemia for HIV -infected patients treated with zidovudine is 100 IU/kg intravenously or under the skin, 3 times/week for 8 weeks. If after 8 weeks, the results are not good, it may increase from 50 to 100 IU per kg, 3 times/day.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double doses to compensate for missed dose.

Side Effects

When using Nanokine, you may experience unwanted effects (ADR) such as:

relatively light and often dependent side effects. Intravenous injection or causing side effects than subcutaneous injections.

Common (ADR> 1/100):

Systemic: headache, edema, chills and bone pain (symptoms like fake flu) mainly in the first intravenous injection. body.

Slow red blood cell property (Prca) after many months to many years of Erythropoi-Etin treatment has been recorded at a very rare rate ( Need to monitor hematocrit regularly and adjust the dose according to the concentration of hemoglobin.

To avoid increasing blood clotting, after being injected into a vein, an additional 10 ml of isothermal salt solution and heparin dose during dialysis prevent thrombosis.

When hypertension is dangerous, anti -hypertension therapy has no results. It is possible to perform veins when hemoglobin (HB) concentration increases excessively.

Notify the physician the unwanted effects when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Nanokine drugs contraindicated in the following cases:

uncontrolled high blood pressure. (See more cautious sections and special warnings when using unwanted drugs and effects).

Be cautious when using

need to be very careful when taking the drug for patients in the following cases:

Do not use drugs for babies and young children under 3 years old, because the drug has excipients Benzyl alcohol.

Patients with myocardial ischemia.

Patients begin to hypertension, or go with headache, should treat high blood pressure. In the case of an increased control, patients need to be carefully monitored until the blood pressure is appropriately controlled.

Patients with muscle tone increase without controlling cramps, with a history of epilepsy.

Patients with platelets.

There are blood diseases including sickle cell anemia, medullary dysplasia syndrome, and bloody condition.

Patients with cerebral hemorrhage.

Use erythropoietin for athletes who are considered to use stimulants, without the physician's supervision and do not monitor dehydration while competing requires toughness, it is likely to occur seriously about changes in blood, fatigue.

Effects of erythropoietin are slow or decreased due to many causes such as iron deficiency, bacterial infection, inflammation or cancer, blood disease (thalas-semi anemia, anti-therapy anemia, bone marrow dysplasia), folic acid deficiency or vitamin B12 deficiency, hemolysis, aluminum poisoning.

Soldness of red blood cells (PRCA) related to the use of erythropoietin has been recorded at a very rare rate. Prca occurs mainly in patients with chronic kidney disease using erythropoietin injections under the skin. This syndrome is described by the phenomenon of sudden loss of effectiveness of the drug, severe anemia, hemoglobin reduction (1-2g/dl or 0.62-1.25 mmol/l per month), low number of mesh red blood cells ( Need to closely monitor patient response during treatment. If the effect is reduced or lost suddenly, anemia is more serious, it is necessary to assess other causes that may cause non -response to drugs such as iron deficiency, folat, vitamin B12; Aluminum poisoning, bacterial or inflammation, blood loss and hemorrhage. If the red blood cell suspect (PRCA) is suspected and does not detect other causes, it is necessary to stop using erythropoietin, strictly considering antibodies of erythropoietin and bone marrow. Other Erythropoietin should not be switched because antibodies are likely to react cross -reactions between erythropoietin. Other causes should be eliminated and applied appropriate management measures.

In patients with chronic renal impairment, the treatment of anemia increases the appetite in patients, and the amount of potassium is eaten. If there is an increase in potassium in patients who are being separated, the diet and the diet must be adjusted. Increasing urea and cretinin premature jurisdiction can occur in several patients due to the increase in the amount of protein intake, in this case the regime needs to be adjusted. Hemorrhage patients must be carefully monitored with increased blood clotting, if there is increased blood clotting, increased hepa-rin.

The effect of the drug on the ability to drive and operate machinery

The drug does not affect the ability to drive and operate machinery.

Use drugs for women during pregnancy and lactation

Pregnant women:

There is no test to use Erythropoietin Alfa during pregnancy, only medication during pregnancy if the benefit of taking the drug is higher than possible.

breastfeeding women:

There is no evidence that Erythropoietin Alfa excreted through human milk. Should be cautious when used in breastfeeding women.

Interactive drug

Use enzyme inhibitors simultaneously with erythropoietin may increase the risk of hyperkalemia, especially in patients with renal function.

There are no important clinical interactions between Erythropoietin ALFA and other drugs. However, the effectiveness of erythropoietin alfa increases when used simultaneously with sulfate iron when symptoms of iron deficiency.

Storage

Store at 2-8 ° C, not to freeze, avoid light.

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