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Darbepoetin Alfa

Darbepoetin alfa is a man-made form of protein that helps your body produce red blood cells.

Darbepoetin alfa is used to treat anemia caused by chemotherapy or chronic kidney disease.


  • This medication may be given by subcutaneous (layer of tissue between the skin and the muscle) injection into the arm, abdomen, or thigh.
  • This medication may also be given by infusion into a vein (intravenously, IV).
  • The amount of darbepoetin alfa that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.


Get emergency medical help if you have signs of an allergic reaction (hives, wheezing, difficult breathing, severe dizziness or fainting, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Darbepoetin alfa can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use darbepoetin alfa. Seek emergency medical help if you have:

  • heart attack symptoms- chest pain or pressure, shortness of breath, pain spreading to your jaw or shoulder, nausea, sweating;
  • signs of a stroke- sudden numbness or weakness (especially on one side of the body), confusion, sudden severe headache, slurred speech, problems with vision or balance;
  • signs of a blood clot- pain, swelling, warmth, redness, cold feeling, or pale appearance of an arm or leg; or
  • increased blood pressure- severe headache, blurred vision, pounding in your neck or ears, anxiety, nosebleed.

Call your doctor at once if you have:

  • a light-headed feeling, like you, might pass out;
  • unusual weakness or tiredness;
  • a seizure (convulsions); or
  • shortness of breath (even with mild exertion), swelling, rapid weight gain.

Common side effects may include:

  • low blood pressure during dialysis;
  • cough, trouble breathing;
  • stomach pain; or
  • swelling in your arms or legs.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.


Usual Adult Dose for Anemia Associated with Chronic Renal Failure:-

Chronic Kidney Disease (CKD) Patients Not on Dialysis:

Initial dose:- 0.45 mcg/kg IV or subcutaneously once every 4 weeks as appropriate


  • Initiate treatment only when hemoglobin is less than 10 g/dL, rate of hemoglobin decline indicates the likelihood of requiring RBC transfusion, and reducing the risk of alloimmunization and/or other RBC transfusion-related risks is a goal.

CKD Patients on Dialysis

Initial dose: 0.45 mcg/kg IV or subcutaneously once a week or 0.75 mcg/kg once every 2 weeks as appropriate


  • Initiate treatment when hemoglobin is less than 10 g/dL.
  • IV route is recommended for patients on hemodialysis.

Usual Adult Dose for Anemia Associated with Chemotherapy:-

Initial dose:- 2.25 mcg/kg subcutaneously once a week or 500 mcg subcutaneously once every 3 weeks

Duration of therapy:- Until completion of a chemotherapy course


  • Initiate treatment if hemoglobin is less than 10 g/dL and a minimum of 2 additional months of chemotherapy is planned.
  • Use the lowest dose necessary to avoid RBC transfusions.

Use:- Treatment of anemia in patients with non-myeloid malignancies where anemia is due to the effect of concomitant myelosuppressive chemotherapy.

Usual Pediatric Dose for Anemia Associated with Chronic Renal Failure:-

Less than 18 Years:

Initial dose:-

  • Chronic Kidney Disease (CKD) Patients Not on Dialysis: 0.45 mcg/kg IV or subcutaneously once a week or 0.75 mcg/kg once every 2 weeks
  • CKD Patients on Dialysis: 0.45 mcg/kg IV or subcutaneously once a week

Comments:- Initiate treatment when hemoglobin is less than 10 g/dL.


  • Before starting darbepoetin alfa treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
  • Darbepoetin alfa should be used with caution in people with high blood pressure. The manufacturer suggests that darbepoetin alfa should not be used in people with uncontrolled high blood pressure.
  • Use with caution in patients with a history of seizures as darbepoetin alfa increases their risk of having a seizure.
  • Inform your health care professional if you are pregnant or may be pregnant before starting this treatment. Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus).
  • Before treatment, correct or exclude deficiencies of iron, vitamin B12, and/or folate, as well as other factors that may impair erythropoiesis (inflammatory conditions, infections, bleeding).
  • Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • It is not known whether darbepoetin alfa is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when darbepoetin alfa is given to a nursing woman.


  • The manufacturer suggests that iron supplements may be helpful while taking darbepoetin alfa. However, you should consult with your doctor before starting this therapy.
  • You may experience some nausea and vomiting within days of receiving this drug, but small frequent meals, chewing gum, lozenges, and good mouth care may help.
  • Avoid contact sports or activities that could cause injury.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.


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