Epokrin

Epokrin – drug of group of glycoproteins.

Pharmacological action of Epokrin

Epokrin represents rekombinatny erythropoetin whose action is directed to stimulation of an erythrogenesis.

It is capable to activate a mitosis and maturing of erythrocytes from progenitors. Rekombinatny эпоэтин type an alpha is synthesized in cells of mammals which contain the gene capable to code human erythropoetin.

The structure of an epoetin of mammals, and also its immunological and biological properties are similar to human erythropoetin.

At introduction of an epoetin the alpha in a human body occurs increase in level of a hematocrit and hemoglobin, blood supply of fabrics and cardiac performance improves.

The greatest efficiency of drug is noted at those types of anemias that are caused by a chronic renal failure.

In rare instances prolonged use of an epoetin at treatment of anemias is capable to cause formation of neutralized antibodies to human erythropoetin, at the same time the partial krasnokletochny aplasia sometimes develops.

Release form

According to the instruction to Epokrin, drug is produced in the form of solution for injections which can have various content of active agent: 1000, 4000, 2000 or 10000 ME. Solution represents colourless liquid, is packed into ampoules which one pack contains 10 pieces.

Indications to Epokrin's use

Epokrin is recommended to apply in the following cases:

• at anemia at patients with a renal failure in a chronic form (including being on a hemodialysis);
• as prevention and for treatment of the anemia which arose after performing long antineoplastic therapy;
• for prevention and at treatment of anemia which origin was a use of a zidovudine for the patients infected with HIV;
• as prevention and at treatment of anemia at patients with the diagnosed multiple myeloma, with nekhodzhkinsky lymphoma which degree of a zlokachestvennost is defined as "low", with a pseudorheumatism and a chronic lymphoid leukosis;
• for prevention and at treatment of anemia at the premature children born with body weight less than 1500;
• to reduce volumes of the transfused blood at acute blood losses and surgical interventions.

Contraindications

Epokrin has a number of contraindications, the instruction to Epokrin recommends to get acquainted with them before drug intake. Epokrin it is not necessary to apply in the following cases:

• at a partial krasnokletochny aplasia if earlier therapy using erythropoetin was already carried out;
• at uncontrollable arterial hypertension;
• at impossibility of performing adequate anticoagulating treatment;
• during the period within a month after a myocardial infarction;
• at unstable stenocardia;
• at the increased risk of developing of a thrombembolia and a deep vein thrombosis;
• at a porphyria;
• at hypersensitivity to any of Epokrin's components.

With care Epokrin appoint to the following groups of patients:

• to patients with various malignant new growths;
• to patients with thrombosis (including in the anamnesis);
• to patients with crescent cellular anemia;
• patient with epilepsy;
• patient with a chronic liver failure;
• to patients with moderate anemia without zhelezodefitsit.

Application instruction of Epokrin

Epokrin at treatment of anemia to patients with HPN is entered subcutaneously or intravenously. Change of a way of introduction demands dose adjustment only in case of need (it is necessary to consider that achievement of identical therapeutic effect at п / to introduction requires 20-30% less drug, than at in/in). An optimum hemoglobin content (HB) in blood of patients with anemia at HPN: adults have from 100 to 120 g/l, children have from 95 to 110 g/l.

Treatment by Epokrin is subdivided into two stages:

• correction stage at which the initial dose of Epokrin at п / to introduction makes 30 ME/kg three times a week (at in/in – 50 ME/kg with the same frequency). The stage lasts until the optimum level of concentration of HB is reached. Control should be made weekly. At the same time situations are possible: a) at increase in a hematocrit from 0,5 to 1% within a week – the dose is not changed; b) the hematocrit grows less than in a week – to increase a dose by 0,5% in 1,5 rubles; c) gain speed more than 1% for the same period – to reduce a dose in 1,5 rubles; d) the hematocrit does not change or decreases – the analysis of the reasons of resistance is necessary;
• stage of a maintenance therapy. It is necessary to hold a hematocrit at the level of 30-35%, for this purpose Epokrin's dose applied at a correction stage is reduced by 1,5 times. Then the maintenance dose of Epokrin is selected taking into account individual dynamics of hemoglobin and a hematocrit. Stabilization of hematologic indicators allows to appoint Epokrin's introduction during once to 1-2 weeks.

The initial and final dosage of Epokrin is defined according to a disease, a state and age of the patient:

• before an initiation of treatment and prevention of anemia by Epokrin at patients with solid tumors it is necessary to determine the level of endogenous erythropoetin. If it is less than 200 ME/ml, the initial dose at in introduction has to make 150 ME/kg (at п / to introduction – 100 ME/kg). Increase in a dose up to 300 ME/kg (at most) in the absence of the answer is allowed;
• at treatment and as prevention of the anemia connected using a zidovudine at HIV-positive patients a zidovudine dose no more than 4,2 g a week are recommended in/in Epokrin's introduction in number of 100-150 ME/kg only if, and the level of endogenous erythropoetin does not exceed a mark in 500 ME/ml;
• prevention and treatment of anemia at patients with a pseudorheumatism is performed by Epokrin п / to in a dosage of 50-75 ME/kg three times a week. Then, in case of increase in maintenance of HB less than on 10 g/l, it is possible to increase a dose to 150-200 ME/kg (maximum), to leave frequency former;
• prevention and treatment of anemia at the children born with low body weight: the dosage makes 200 ME/kg of weight three times a week. It is necessary to begin from the 6th day of life and up to achievement of normal indicators of a hematocrit and hemoglobin, however not longer than 6 weeks;
• prevention of anemia at acute blood losses and operations is performed in/in or п / to Epokrin's introduction in number from 100 to 150 ME/kg. At normalization of hemolitic indicators of therapy cancel.

Side effects of Epokrin

It is necessary to read attentively the instruction to Epokrin as use of drug is capable to cause emergence of side reactions, among them:

• drowsiness, dizziness, headache, arthralgia, mialgiya;
• deterioration in a course of arterial hypertension, hypertensive crisis;
• hyperpotassemia, hyperphosphatemia, decrease in content of ferritin in blood serum;
• hyperemia, burning, morbidity in a drug injection site;
• itch, urticaria, eczema;
• thrombocytosis, aggravation of a porphyria, disturbance of breath and ABP.

Storage conditions

It is necessary to store Epokrin at a temperature from 2 to 8 °C no more than 2 years.