In clinical pharmacology studies, there is no clinical experience of use at higher doses.
The maximum amount of NESP that can be safely administered in single or multiple doses has not been determined. Therapy with NESP can result in polycythemia if the hemoglobin is not carefully monitored and the dose appropriately adjusted. Cases of severe hypertension have been observed following overdose with darbepoetin alfa.
In the event of polycythemia, NESP should be temporarily withheld. If clinically indicated, phlebotomy may be performed.