Treatment has to be initiated under the supervision of a physician experienced in the management of patients with renal impairment. Posology Treatment of symptomatic anaemia in chronic kidney disease patients Anaemia symptoms and sequelae may vary with age, gender, and overall burden of disease; a physician’s evaluation of the individual patient’s clinical course and condition is necessary.
45 mmol/l). Subcutaneous use is preferable in patients who are not receiving haemodialysis to avoid puncture of peripheral veins. Due to intra-patient variability, occasional individual haemoglobin values for a patient above and below the desired haemoglobin level may be observed.
45 mmol/l). 45 mmol/l) are observed are described below. 62 mmol/l) in paediatric patients over a four-week period should be avoided. If it occurs, appropriate dose adjustment should be made as provided. 45 mmol/l). Caution should be exercised with escalation of treatment doses in patients with chronic renal failure.
1). 4). 2 microgram/kg body weight, administered once every month as a single subcutaneous injection. 6 microgram/kg bodyweight may be administered once every two weeks as a single intravenous or subcutaneous injection in patients on dialysis or not on dialysis.
621 mmol/l) over a month. Further increases of approximately 25% may be made at monthly intervals until the individual target haemoglobin level is obtained. 45 mmol/l), the dose is to be reduced by approximately 25%. If the haemoglobin level continues to increase, therapy should be interrupted until the haemoglobin level begins to decrease, at which point therapy should be restarted at a dose approximately 25% below the previously administered dose.
22 mmol/l) per week is expected. Dose adjustments should not be made more frequently than once a month. 21 mmol/l) may receive methoxy polyethylene glycol-epoetin beta administered once-monthly using the dose equal to twice the previous once-every-two-week dose.
Adult patients currently treated with an ESA:
Patients currently treated with an ESA can be switched to methoxy polyethylene glycol-epoetin beta administered once a month as a single intravenous or subcutaneous injection. The starting dose of methoxy polyethylene glycol-epoetin beta is based on the calculated previous weekly dose of darbepoetin alfa or epoetin at the time of substitution as described in Table 1.
The first injection should start at the next scheduled dose of the previously administered darbepoetin alfa or epoetin. 21 mmol/l), the monthly dose may be increased by approximately 25%. 45 mmol/l), the dose is to be reduced by approximately 25%.
If the haemoglobin level continues to increase, therapy should be interrupted until the haemoglobin level begins to decrease, at which point therapy should be restarted at a dose approximately 25% below the previously administered dose.
22 mmol/l) per week is expected. Dose adjustments should not be made more frequently than once a month. 5 Since the treatment experience is limited in patients on peritoneal dialysis, regular haemoglobin monitoring and strict adherence to dose adjustment guidance are recommended in these patients.
Paediatric patients from 3 months to less than 18 years of age currently treated with an ESA: Paediatric patients whose haemoglobin level has been stabilised by treatment with an ESA can be converted to methoxy polyethylene glycol-epoetin beta administered once every 4 weeks as an IV or SC […]