Darbepoetin Alfa

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

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)
1. Use the lowest effective dose
Iron Supplementation if needed
1. Check for Iron Deficiency before administration

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
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
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

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

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