Recommended Dose: Chronic renal failure patients: Starting dose of Epotiv Prefilled Inj. therapy is 50 U/kg, 3 times per week by slow s.c. or i.v. injection over 1~2 minutes. Further dose increase should be determined according to initial response. Dose may be increased by 25U/kg every four weeks, if needed.
Mode of Administration: Dose may be increased by 25U/kg every four weeks, if needed. Also, when the increasing rate of hemoglobin is more than 2g/dl after 50U/kg is administered, dose should be adjusted by omitting one of the three doses per week. The target range of the treatment is about 10g/dl as hemoglobin concentration (30% hematocrit). If therapeutic effect of Epotiv Prefilled lnj. Inj. in anemia is achieved, 25-50U/kg as a maintenance dose is generally administered 2~3 times per week. It is known that the target range of hemoglobin is 10-12g/dl. The patients who started the therapy at a low level of hemoglobin (6g/dl) need higher maintenance dose than those who didn't start the therapy at less than 8g/dl of hemoglobin and dose should be adjusted depending on age. In any case, maximum dose should not exceed 200U/kg in a single day 3 times per week. Iron stores should be evaluated prior to or during the therapy and iron should be administered, if necessary. In case of aluminum poisoning or infectious disease patients, response may be diminished. Even in case of patients not requiring dialysis, maintenance dose should be determined depending on the severity of anemic symptoms or age, however, it has been reported that 36-38% of hematocrit was sustained for more than 6 months.
In case of patients on hemodialysis, it is recommendable erythropoietin is injected after hemodialysis. And it is desirable erythropoietin be injected slowly over more than 5 minutes to the patients with flu-like symptoms.
Epotiv Prefilled lnj. should not be administered by intravenous infusion.