Pegylated Erythropoietin interactions

Conditions

Conditions in which Pegylated Erythropoietin needs care, as documented in this source.

• Diseases requiring hemodialysis

  Major

  The increase in hematocrit and decrease in plasma volume associated with erythropoiesis-stimulating agents therapy may, theoretically, affect dialysis efficiency. Patients may require adjustments in their dialysis prescription after initiation of erythropoiesis stimulating agents. During hemodialysis, patients may require increased anticoagulation with heparin to prevent clotting.

  11 sources

  1. Stockenhuber F, Loibl U, Gottsauner-Wolf M, et al. "Pharmacokinetics and dose response after intravenous and subcutaneous administration of recombinant erythropoietin in patients on regular haemodialysis treatment or." Nephron 59 (1991): 399-402
  2. MacDougall IC, Neubert P, Coles GA, Roberts DE, Dharmasena AD, Williams JD "Pharmacokinetics of recombinant human erythropoietin in patients on continuous ambulatory peritoneal dialysis." Lancet 02/25/89 (1989): 425-7
  3. "Product Information. Epogen (epoetin alfa)." Amgen (2002):
  4. "Product Information. Procrit (epoetin alfa)." Ortho Biotech Inc (2002):
  5. Kindler J, Echardt KU, Ehmer B, et al. "Single-dose pharmacokinetics of recombinant human erythropoietin in patients with various degrees of renal failure." Nephrol Dial Transplant 4 (1989): 345-9
  6. Ateshkadi A, Johnson CA, Oxton LL, Hammond TG, Bohenek WS, Zimmerman SW "Pharmacokinetics of intraperitoneal, intravenous, and subcutaneous recombinant human erythropoietin in patients on continuous ambulatory peritoneal dialysis." Am J Kidney Dis 21 (1993): 635-42
  7. Boran M, Dalva I, Yazicioglu A, Cetin S "Subcutaneous versus intravenous recombinant human erythropoietin administration in hemodialysis patients." Nephron 63 (1993): 113-4
  8. Lago M, Perezgarcia R, Devinuesa MSG, Anaya F, Valderrabano F "Efficiency of once-weekly subcutaneous administration of recombinant human erythropoietin versus three times a week administration in hemodialysis patients." Nephron 72 (1996): 723-4

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  9. Swanepoel C, Jacobs P, Byrne MJ, Rayner B, Cassidy MJD, Meyer J "The effect of recombinant human erythropoietin on haematopoiesis in patients undergoing haemodialysis." S Afr Med J 86 (1996): 952-5
  10. "Product Information. Aranesp (darbepoetin alfa)." Amgen (2001):
  11. "Product Information. Mircera (epoetin beta-methoxy polyethylene glycol)." Vifor International Ltd c/o MCT (2007):

• Hypertension

  Major

  The use of erythropoiesis-stimulating agents is contraindicated in patients with uncontrolled hypertension. These agents may cause blood pressure to rise. Hypertensive encephalopathy and seizures have been observed in patients with chronic renal failure treated with these agents. Blood pressure should be adequately controlled prior to initiation of therapy, and monitored closely during treatment. Aggressive antihypertensive measures may be necessary, particularly early on in treatment when the hematocrit is increasing. It is recommended to reduce or withhold the use of these agents if blood pressure becomes difficult to control.

  9 sources

  1. Bennett WM "Side effects of erythropoietin therapy." Am J Kidney Dis 18 (1991): 84-6
  2. Eschbach JW, Abdulhadi MH, Browne JK, Delano BG, Downing MR, Egrie JC, Evans RW, Friedman EA, Graber SE, Haley NR, et al. "Recombinant human erythropoietin in anemic patients with end-stage renal disease. Results of a phase III multicenter clinical trial." Ann Intern Med 111 (1989): 992-1000
  3. Raine AE "Hypertension, blood viscosity, and cardiovascular morbidity in renal failure: implications of erythropoietin therapy." Lancet 1 (1988): 97-100
  4. Buckner FS, Eschbach JW, Haley NR, Davidson RC, Adamson JW "Hypertension following erythropoietin therapy in anemic hemodialysis patients." Am J Hypertens 3 (1990): 947-55
  5. "Product Information. Epogen (epoetin alfa)." Amgen (2002):
  6. "Product Information. Procrit (epoetin alfa)." Ortho Biotech Inc (2002):
  7. Singbartl G "Adverse events of erythropoietin in long-term and in acute short-term treatment." Clin Investig 72 (1994): s36-43
  8. "Product Information. Aranesp (darbepoetin alfa)." Amgen (2001):

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  9. "Product Information. Mircera (epoetin beta-methoxy polyethylene glycol)." Vifor International Ltd c/o MCT (2007):

• Seizures

  Major

  The use of erythropoiesis stimulating agents increases the risk of seizures in patients with chronic renal failure. Seizure development may be related to the rate of rise in hematocrit, which is also associated with blood pressure elevations. It is recommended to monitor patients closely for the development of premonitory neurologic symptoms during the first several months after the administration of these agents. Patients with epilepsy or predisposed to seizures should be monitored closely for blood pressure changes and neurologic symptoms during therapy with these agents.

  8 sources

  1. Bennett WM "Side effects of erythropoietin therapy." Am J Kidney Dis 18 (1991): 84-6
  2. Temple RM, Eadington DW, Swainson CP, Winney R "Seizure related to erythropoietin treatment in patients undergoing dialysis." BMJ 300 (1990): 46
  3. "Product Information. Epogen (epoetin alfa)." Amgen (2002):
  4. "Product Information. Procrit (epoetin alfa)." Ortho Biotech Inc (2002):
  5. Beccari M "Seizures in dialysis patients treated with recombinant erythropoietin - review of the literature and guidelines for prevention." Int J Artif Organs 17 (1994): 5-13
  6. Singbartl G "Adverse events of erythropoietin in long-term and in acute short-term treatment." Clin Investig 72 (1994): s36-43
  7. "Product Information. Aranesp (darbepoetin alfa)." Amgen (2001):
  8. "Product Information. Mircera (epoetin beta-methoxy polyethylene glycol)." Vifor International Ltd c/o MCT (2007):

• Thromboembolism

  Major

  The use of erythropoiesis-stimulating agents may be associated with an increased risk of thrombotic events and mortality. During clinical trials, an increased risk was observed in: 1) patients with chronic renal failure (CRF) and ischemic heart disease or congestive heart failure targeted to a maintenance hematocrit of 42%, and 2) in patients without CRF undergoing coronary artery bypass surgery. Although a causal relationship has not been established, therapy with these agents should be administered cautiously in patients with preexisting cardiovascular disease and/or a history of thrombotic events.

  10 sources

  1. Bennett WM "Side effects of erythropoietin therapy." Am J Kidney Dis 18 (1991): 84-6
  2. Raine AE "Hypertension, blood viscosity, and cardiovascular morbidity in renal failure: implications of erythropoietin therapy." Lancet 1 (1988): 97-100
  3. Wirtz JJ, van Esser JW, Hamulyak K, Leunissen KM, van Hooff JP "The effects of recombinant human erythropoietin on hemostasis and fibrinolysis in hemodialysis patients." Clin Nephrol 38 (1992): 277-82
  4. Flaharty KK, Grimm AM, Vlasses PH "Epoetin: human recombinant erythropoietin." Clin Pharm 8 (1989): 769-82
  5. "Product Information. Epogen (epoetin alfa)." Amgen (2002):
  6. "Product Information. Procrit (epoetin alfa)." Ortho Biotech Inc (2002):
  7. Lutz B, Tillman K, Santos M, Morvant C, Webb S "Life threatening venous thrombosis associated with high dose epoetin alfa therapy for HIV-related anemia." Int Conf AIDS 9 (1993): 463
  8. Singbartl G "Adverse events of erythropoietin in long-term and in acute short-term treatment." Clin Investig 72 (1994): s36-43

  Show all 10 sourcesShow fewer sources

  9. "Product Information. Aranesp (darbepoetin alfa)." Amgen (2001):
  10. "Product Information. Mircera (epoetin beta-methoxy polyethylene glycol)." Vifor International Ltd c/o MCT (2007):

• Porphyrias

  Moderate

  The use of epoetin alfa has rarely been associated with exacerbation of porphyria in patients with chronic renal failure. In healthy volunteers, however, epoetin alfa has not been shown to cause increased urinary excretion of porphyrin metabolites. Nevertheless, therapy with epoetin alfa should be administered cautiously in patients with porphyria.

  3 sources

  1. "Product Information. Epogen (epoetin alfa)." Amgen (2002):
  2. "Product Information. Procrit (epoetin alfa)." Ortho Biotech Inc (2002):
  3. Singbartl G "Adverse events of erythropoietin in long-term and in acute short-term treatment." Clin Investig 72 (1994): s36-43