From the Guidelines
The recommended dose of Procrit (Epoetin alfa) for anemia due to chronic kidney disease is typically 50-100 units/kg three times weekly, with adjustments made to maintain hemoglobin between 10-12 g/dL. This dosing regimen is based on the guidelines for anemia of chronic kidney disease, which suggest that administration of Epoetin via the subcutaneous (SC) route appears to be more efficient than intravenous (IV) administration, with target hemoglobin (Hgb) and/or hematocrit (Hct) levels able to be maintained with a lower weekly Epoetin dose (15% to 50% lower) when the SC route is used 1.
- Key considerations for dosing include:
- Starting dose: 50-100 units/kg three times weekly
- Adjustments: made to maintain hemoglobin between 10-12 g/dL
- Administration route: subcutaneous (SC) route is more efficient than intravenous (IV) route
- Frequency: two to three times per week is more efficient than once weekly administration, but once weekly administration may be more convenient for some patients
- It is also important to note that there are insufficient data to make a recommendation for a specific site of administration of Epoetin, and therefore, it would seem prudent to rotate the site of injection with each administration 1.
- Regular monitoring of hemoglobin levels is essential to ensure that the dose is adjusted appropriately to maintain hemoglobin within the target range and minimize the risk of cardiovascular complications.
From the FDA Drug Label
For correction of anemia in hemodialysis patients, a greater biologic response is not observed at doses exceeding 300 Units/kg 3 times weekly.
The dose of Procrit (Epoetin alfa) is not to exceed 300 Units/kg 3 times weekly for correction of anemia in hemodialysis patients 2.
From the Research
Dose of Procrit (Epoetin alfa)
The dose of Procrit (Epoetin alfa) can vary depending on the individual patient and their response to treatment.
- The therapeutic range is very wide, without any toxic effects for clinical use up to 100,000 IU/week 3.
- The target hemoglobin concentration is reached in most patients with mild anemia after 2 months' treatment with 4,000-10,000 epoetin per week 3.
- The dose of epoetin alfa can be individualized, with some patients requiring as little as 1,000-30,000 IU per week to maintain a target hemoglobin concentration of 11-12 g/dL 3.
- Once-weekly administration of epoetin alfa is feasible in dialysis patients, but dose increases are often required when switching patients from traditional twice- or thrice-weekly schedules 4.
- A study found that once-weekly epoetin alfa therapy is safe and effective for treating anemia in patients with chronic kidney disease not on dialysis, with a dose of 10,000 U administered subcutaneously once weekly for 16 weeks 5.
Administration and Monitoring
- Epoetin alfa can be administered subcutaneously or intravenously, with the subcutaneous route having a half-life of approximately 24 hours 4.
- The dose of epoetin alfa should be titrated to achieve and maintain a target hemoglobin concentration, with monitoring of hemoglobin levels and reticulocyte count 3.
- Patients with a stable dose-response during conservative therapy may require less frequent monitoring (every 2-3 months) 3.