Эпрекс

Эпрекс – the means stimulating formation of erythrocytes.

Pharmacological properties of Epreks

By the nature of Epreks the alpha, the received method of genetic engineering is a glycoprotein epoetiny. It concerns group of the pharmacological means stimulating formation of red blood cells – erythrocytes, and does not differ on properties from human erythropoetin.

The mechanism of effect of drug is that it stimulates division and a differentiation of predecessors of erythrocytes. Such influence has selective character, without influencing, for example, formation of white blood cells – leukocytes. By researches it is proved that Epreks has insignificant ability to cause antibody formation to it.

There are no proofs that Epreks has teratogenic or cancerogenic properties.

Release form

Drug is produced in glass syringes in the form of solution for injections.

Indications to Epreks's use

Эпрекс use in treatment of anemia at children and adults with a chronic renal failure, at people with oncological pathology of not myeloid origin (including for prevention of anemia), in case of anemia at the people infected with HIV and receiving a zidovudine in treatment.

If operation with extensive blood loss at adults against the background of anemia easy or moderate severity is planned, then for the prevention of extensive hemotransfusions in the subsequent and recovery of normal speed of formation of erythrocytes, use Epreks.

Contraindications

It is impossible to apply Epreks at intolerance of its components, a non-regulated hypertension, the expressed defeat of vessels of heart, brain, including at patients who had a heart attack or a stroke recently. Pregnancy and feeding by a breast, and also impossibility to carry out adequately prevention of formation of blood clots are also a contraindication to Epreks.

If the patient with a partial krasnokletochny aplasia received any erythropoetin in treatment, Epreks's use for it is not recommended.

Application instruction of Epreks

Drug is in sterile one-time syringes, it is intended for hypodermic and intravenous administration.

Before use surely it is necessary to be convinced of absence in liquid of visible particles. The syringe cannot be stirred up – it the alpha can destroy structure of an epoetin.

Intravenous administration is carried out within at least 1-5 minutes. Эпрекс it is impossible to mix with other drugs or to enter in the form of intravenous infusions.

At hypodermic introduction the volume of infusion should not be more than 1 ml, in case of its exceeding it is necessary to administer the drug to several places. Usually for hypodermic introduction choose a hip, a shoulder, an abdominal wall.

During a therapy course drug it is necessary to try to obtain optimum level of hemoglobin of blood of 120 g/l (for any floor) and not to exceed it. During treatment it is necessary to check the level of serumal iron in blood and at its decrease to add iron preparations to therapy.

At oncological diseases of Epreks appoint at the accompanying anemia, and also for the prevention of its emergence during a chemotherapy course if during the first course its hemoglobin decreased more than by 20 g/l. The initial dose of Epreks makes 150 ME/kg 3 times within a week, or 40 000ME once a week.

If 4 weeks later from an initiation of treatment hemoglobin at the patient rose by 10 g/l and more, and also reticulocytes in the analysis not less than 40 000 in 1 мкл, then it validates the chosen dose. If control indicators there are less these figures, then it is necessary to raise a dose the next 4 weeks to 300 ME/kg 3 times a week or 60 000 ME once a week.

If on this dose 4 weeks of treatment later reach a sufficient gain of hemoglobin and reticulocytes, the dosage is considered sufficient, and on it stop. If increase in hemoglobin and reticulocytes on the raised dose is less than recommended figures, then stop treatment.

If the gain of hemoglobin makes more, than 20 g/l in a month or will reach the desirable level of 120 g/l, Epreks's dose needs to be reduced by 25%. In case of exceeding of a hemoglobin content of blood of 120 g/l treatment epoetiny an alpha for a while is stopped, and renew after decrease in hemoglobin lower than 120 g/l in a dose, is 25% less than initial. Epreks's introduction is continued 1 more month after the termination of chemotherapy.

When collecting blood before the planned extensive surgical intervention of Epreks enter intravenously after the end of collecting blood. In this case it is appointed 2 times a week by 3 weeks in a row, at each visit to the doctor take away from the patient a portion of blood and keep it for transfusion to the same patient. Epreks's dose of 600 ME/kg 2 times a week.

To patients who plan operation, but do not participate in the program of collecting autologous blood and also if operation is already made, Epreks enter subcutaneously 600 МЕ/кг/нед, 3 weeks in a row.

Side effects

Эпрекс can cause such undesirable effects as dizzinesses, fever, pains joint and head, weakness, increase in pressure, a spasm, allergic reactions in the form of rashes, a skin itch, a small tortoiseshell or a Quincke's disease. Local reactions can be connected with an injection site and be shown in the form of burning, reddening, moderate morbidity in an injection site.