What are Erythropoiesis-Stimulating Agent (ESA) injection samples?

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Last updated: April 12, 2025View editorial policy

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From the Guidelines

ESA injection samples should be stored according to manufacturer guidelines, typically refrigerated at 2-8°C (36-46°F) and protected from light, as recommended by the most recent guidelines 1. When handling ESA injection samples, it is crucial to follow proper storage and handling procedures to maintain their potency and safety.

  • Storage: Refrigerate at 2-8°C (36-46°F) and protect from light.
  • Handling: Allow the medication to reach room temperature for about 15-30 minutes before administration to reduce injection discomfort.
  • Inspection: Always inspect samples for discoloration or particulate matter before use and discard if present. The primary goal of using ESAs is to reduce the need for transfusions by increasing hemoglobin levels, as demonstrated in several studies 1.
  • ESAs have been shown to decrease transfusion requirements in patients with cancer undergoing chemotherapy.
  • The use of ESAs should be guided by clinical judgment, taking into account the potential benefits and risks, including the risk of thromboembolism and mortality. When collecting samples to monitor treatment efficacy, blood should be drawn before administering the next ESA dose to accurately assess baseline hemoglobin levels, as recommended by clinical guidelines 1.
  • For patients on hemodialysis, samples should be collected before the dialysis session to avoid hemodilution effects.
  • ESAs work by stimulating red blood cell production in the bone marrow, so proper timing of sample collection is crucial for accurate assessment of treatment response and appropriate dose adjustments.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

ESA Injection Samples

  • The erythropoiesis-stimulating agents (ESAs) erythropoietin and darbepoetin are used to prevent transfusions among chemotherapy-associated anemia patients and chronic kidney disease (CKD) patients 2.
  • Clinical trials and meta-analyses have identified risks associated with ESA administration, including mortality, tumor progression, and venous thromboembolism (VTE) in chemotherapy-associated anemia patients, and myocardial infarction, stroke, VTE, or mortality in CKD patients 2, 3, 4.
  • The route of administration for ESAs can be either intravenous (IV) or subcutaneous (SC), with SC administration resulting in a dose-sparing effect in some patients on hemodialysis 5.
  • Patient and nursing considerations, such as convenience, patient preferences, and comfort, should be taken into account when deciding on the route of administration for ESAs 5.
  • Studies have compared the effectiveness of different ESAs, such as darbepoetin alfa and epoetin alfa, in achieving transfusion independence and increasing hemoglobin concentrations in critically ill patients and cancer patients 6, 3, 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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