From the Guidelines
Retacrit dosing should start at 150 U/kg subcutaneously three times a week, with dose adjustments based on hemoglobin levels, aiming for the lowest dose that maintains hemoglobin within the target range to reduce cardiovascular risks, as recommended by the American Society of Hematology/American Society of Clinical Oncology clinical practice guideline update 1.
Initial Dosing
The initial dose of Retacrit can be administered subcutaneously at 150 U/kg three times a week, or alternatively, 2.25 μg/kg subcutaneously weekly, as outlined in the guideline update 1.
Dose Adjustments
Dose adjustments should be made based on hemoglobin levels, with the goal of achieving and maintaining the lowest hemoglobin level sufficient to avoid the need for red blood cell transfusions. If there is no reduction in transfusion requirements or increase in hemoglobin after 4 weeks of therapy, the dose can be increased to 300 U/kg three times a week, as suggested by the guideline update 1.
Monitoring and Maintenance
Hemoglobin levels should be monitored regularly, and dose adjustments made in 25% increments or decrements based on hemoglobin response, to minimize the risk of thromboembolic events, which is a concern in patients receiving erythropoiesis-stimulating agents, as noted in the guideline update 1.
Special Considerations
It is essential to consider the individual patient's baseline risk of thromboembolic events and to exercise caution when using Retacrit in patients with increased risk, such as those with multiple myeloma being treated with thalidomide or lenalidomide and doxorubicin or corticosteroids, as highlighted in the guideline update 1.
Key Points
- Initial dose: 150 U/kg subcutaneously three times a week
- Dose adjustments: based on hemoglobin levels, aiming for the lowest dose that maintains hemoglobin within the target range
- Monitoring: regular hemoglobin level checks, with dose adjustments made in 25% increments or decrements
- Special considerations: caution in patients with increased risk of thromboembolic events, such as those with multiple myeloma receiving certain therapies.
From the FDA Drug Label
Double-check that the correct amount of PROCRIT is in the syringe. Remove the prepared syringe and needle from the vial of PROCRIT and hold it in the hand that you will use to inject the medicine. Inject the prescribed dose subcutaneously as directed by your doctor, nurse or pharmacist.
The dosing of retacrit (epoetin alfa) should be as prescribed by a doctor, nurse, or pharmacist. The dose may vary depending on the patient's condition and the route of administration (subcutaneous or intravenous).
- Subcutaneous Route: The prescribed dose should be injected subcutaneously.
- Intravenous Route: The prescribed dose should be injected into a vein through a special access port. The exact dose is not specified in the provided text, but it is mentioned that the dose may be 40,000 Units, 300 Units/kg, 100 Units/kg, 150 Units/kg, or 600 Units/kg, depending on the specific study or patient population 2.
From the Research
Dosing of Retacrit (Epoetin Alfa)
- The dosing of Retacrit, also known as epoetin alfa, can vary depending on the patient's condition and response to treatment 3, 4, 5.
- A study published in 2004 found that administering epoetin alfa 10,000 U subcutaneously once weekly for 16 weeks was effective in increasing hemoglobin levels in patients with chronic kidney disease (CKD) 3.
- Another study published in 2007 found that the most common initial dosing intervals for epoetin alfa were once weekly, and the dominant dosing intervals were every 2 weeks 4.
- A study published in 2006 found that targeting a hemoglobin level of 13.5 g/dL with epoetin alfa was associated with increased risk and no incremental improvement in quality of life compared to targeting a level of 11.3 g/dL 5.
- A network meta-analysis published in 2023 found that epoetin alfa may be superior to placebo in preventing blood transfusions, but the comparative effects of different erythropoiesis-stimulating agents (ESAs) on blood transfusions and death were uncertain 6.
Administration and Dosage
- Epoetin alfa can be administered subcutaneously or intravenously 3, 4, 5.
- The dosage of epoetin alfa can vary depending on the patient's weight, hemoglobin level, and response to treatment 3, 4, 5.
- A typical starting dose of epoetin alfa is 10,000 U subcutaneously once weekly, with titration to 20,000 U once weekly at week 5 if necessary 3.