Darbepoetin alfa is used to treat anaemia in adults and in children with kidney disease. It is also used to treat anaemia in adults who are receiving treatment for cancer (except for bone marrow cancer).
Anemia is characterized as a low level of red blood cells. Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
Your doctor or nurse will administer the injection for you. If you or your caregiver had been given the proper training on the preparation and injection techniques of Darbepoetin alfa, you or your caregiver may do the administration.
Use this medicine exactly as directed by your doctor or according to the instructions on the label. Do not administer more or less than instructed by your doctor.
Darbepoetin alfa is available in a vial and as a single-use prefilled pen or syringe. Make sure you know how to use the specific device you have been given. If you have problems or do not understand the instructions, ask your doctor or pharmacist.
This medicine is to be injected subcutaneously (into the fatty layer under the skin, usually in the upper arm or buttocks, thigh or abdomen area).
How to use this medicine:
- Gather all the supplies you will need for injection (e.g. medicine, syringe, alcohol swab, cotton ball).
- Wash your hands with soap and water before using this medicine.
- Flip the protective color cap of the medicine (on the top of the vial). You will see a gray rubber stopper, do not remove this. Wipe the top of the gray rubber stopper with alcohol swab.
- Remove the needle cover of the syringe and needle recommended by your doctor. Draw air into the syringe by pulling back the plunger. The amount of air drawn from the syringe should be equal to the amount of dose (in mL or cc) prescribed by your doctor.
- Put the medicine on a flat surface then insert the needle down the gray rubber stopper.
- Push the plunger of the syringe down to inject the air; the air injected into the vial will allow the medicine to be easily withdrawn into the syringe.
- Keep the needle inside the vial. Turn the vial upside down. Slowly pull back the plunger and fill the syringe with your required dose.
- Keep the needle inside the vial, to remove air bubbles, gently tap the needle with your fingers until the air bubbles rise to the top of syringe. Push the air bubbles up by slowly pushing the plunger up. Pull the plunger back to your required dose.
- Lay the vial down on its side with the needle.
- Wipe the injection site with alcohol swabs and let it dry. Remove the prepared syringe and needle from the vial and hold it in your hand that will inject the medicine.
- Gently pinch the skin at the injection site using your other hand. Hold the syringe like a pencil and insert the needle into the pinched skin at a 45-degree angle (slight angle) or 90-degree angle (straight up and down) using a quick dart like motion.
- Gently press the plunger all the way down until the syringe is empty.
- Slowly let go of the skin and gently pull the needle out of the skin. Do not recap the needle.
- Place a cotton ball or gauze over the injection site and press for several seconds.
- Dispose your used needles and syringes according to your doctor or pharmacist’s instructions. Do not throw away in household trash.
Remember to rotate the injection sites. Do not inject into the same area all the time. New injection sites should be at least 1.5 inches away from the previous injection site. Do not inject near the navel (belly button), into moles, scars or areas where the skin is tender, bruised, red, hard or not intact.
The dose of Darbepoetin alfa will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the severity of your condition, effectiveness of therapy and your tolerability to this medicine.
Administer the missed dose as soon as you remember.
DO NOT double a dose under any circumstances.
If you often forget to administer your medicine, let your doctor and pharmacist know.
Do not use Darbepoetin alfa if you ever had an allergic reaction (rashes, breathlessness, swollen face) to similar medicines.
Alert your doctor if you have the following conditions:
- high blood pressure that is not controlled
- pure red cell aplasia (a condition in which the bone marrow stops making red blood cells, causing anaemia) that begins after treatment with Darbepoetin alfa or similar medicines
as this medicine may not be suitable for you.
Inform your doctor if you have the following conditions:
- disease of the heart or of the blood vessels e.g. heart attack, stroke, formation of blood clots in the blood vessels
- history of high blood pressure
- seizures or history of seizures
- sickle cell anaemia (a type of anaemia or low level of red blood cells)
- liver disease
- chronic kidney disease (gradual loss of kidney function over a period of months or years)
- severe anaemia or blood loss
Let your doctor know if you are pregnant or breastfeeding.
If you are going for dialysis or any surgery, inform your doctor that you are using Darbepoetin alfa.
Keep your appointments with your doctor. Your doctor needs to monitor your condition (e.g. blood pressure, signs of seizures) and check your response to this medicine regularly. Your doctor may also need to do routine blood tests such as haemoglobin (protein in red blood cells) levels and platelet counts while you are being treated with this medicine. Your iron (a mineral in the body essential for blood production) status should also be evaluated before and during treatment with Darbepoetin alfa.
Darbepoetin alfa may cause any of the following side effects: stomach pain, shortness of breath, cough, injection site pain and swelling of the ankles, feet, or hands.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs or symptoms of an allergic reaction e.g. rashes, breathlessness, swollen face
- signs and symptoms of formation of blood clots in the blood vessels e.g. chest pain, sudden confusion, trouble speaking, weakness or numbness in your face or in one of your limbs, loss of balance or coordination, leg pain, paleness or coolness of a leg, coughing up blood
- signs and symptoms of high blood pressure e.g. drowsiness, headache, confusion, eye problems, nausea, vomiting
- fits or seizures
- signs and symptoms of pure red cell aplasia e.g. pale skin, tiredness, dizziness
- severe rash with blisters, sores or peeling
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor or pharmacist if you are taking any medicine for certain immune disorders e.g. ciclosporin, tacrolimus.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Store in the refrigerator, between 2-8°C. Do not allow to freeze. If frozen, this medicine will become ineffective and should not be used. Protect from light.
Do not shake.
Medicines must not be used past the expiry date.