Cancer Patients on Chemotherapy: The recommended dose of erythropoietin for adults is 150-300 Units/kg SC TIW or 40,000 Units SC once in a week. Baseline endogenous serum erythropoietin levels varied among patients with cancer related anemia. Treatment of patients with grossly elevated serum erythropoietin levels (eg. >200 mUnits/mL) is not recommended. The hematocrit should be monitored on a weekly basis in patients receiving erythropoietin therapy until hematocrit becomes stable.
Zidovudine-treated HIV-Infected Patients: Starting Dose: For adult patients with serum erythropoietin that the endogenous serum erythropoietin level be determined (prior to transfusion). Available evidence suggests that patients receiving zidovudine with endogenous serum erythropoietin levels >500 mUnits/mL are unlikely to respond to therapy with erythropoietin.
Surgery Patients: The recommended dose of erythropoietin is 300 Units/kg/day subcutaneously for 10 days before surgery, on the day of surgery and for 4 days after surgery. Prior to initiating treatment with erythropoietin, a hemoglobin should be obtained to establish that it is >10 to ≤13 g/dL. An alternate dose schedule is 600 Units/kg erythropoietin subcutaneously in once weekly doses (21, 14, and 7 days before surgery) plus a fourth dose on the day of surgery.
All patients should receive adequate iron supplementation. Iron supplementation should be initiated no later than the beginning of treatment with erythropoietin and should continue throughout the course of therapy.
Preparation and Administration of Erythropoietin: Do not shake as vigorous shaking may denature any glycoprotein, rendering it biologically inactive. Use aseptic techniques in drug administration. Use one dose pre-filled syringe. Discard unused portion, do not dilute or administer in conjunction with other solutions.