dcsimg Aranesp® (darbepoetin alfa) – ESA Conversion

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Converting patients on dialysis from epoetin alfa to QW Aranesp®

<1,500   6.25 *
1,500 to 2,499   6.25 6.25
2,500 to 4,999   12.5 12.5
5,000 to 10,999   25 25
11,000 to 17,999   40 40
18,000 to 33,999   60 60
34,000 to 89,999   100 100
≥90,000   200 200

Aranesp® is administered less frequently than epoetin alfa

  • Administer Aranesp® once weekly in patients who were receiving epoetin alfa 2 to 3 times weekly.
  • Administer Aranesp® once every 2 weeks in patients who were receiving epoetin alfa once weekly.
  • Maintain the route of administration (intravenous or subcutaneous injection).
  • The dose conversion in the chart above does not accurately estimate the once-monthly dose of Aranesp®.

Use the FDA-approved ESA conversion table in the Aranesp® PI to
convert patients on dialysis from epoetin alfa to Aranesp®1

  • Pediatric patients with CKD: Aranesp® safety and efficacy were similar between adults and pediatric patients with CKD who were over 1 year of age when patients were transitioned from treatment with epoetin alfa to Aranesp®. Aranesp® safety and efficacy have not been established in the initial treatment of anemic pediatric patients with CKD or in the transition from another erythropoietin to Aranesp® in pediatric CKD patients less than 1 year of age.

There is no single DCR when converting from epoetin alfa to Aranesp®1

  • Depending on the dose of epoetin alfa at the time of substitution, the Aranesp®:epoetin alfa DCR may range from 200:1 to 900:1.

DCRs vary from patient to patient, based on previous weekly dose
of epoetin alfa.1

Important Safety Information

  • For lack or loss of hemoglobin response to Aranesp®, initiate a search for causative factors. If typical causes of lack or loss of hemoglobin response are excluded, evaluate for PRCA.
  • Cases of PRCA and of severe anemia, with or without other cytopenias that arise following the development of neutralizing antibodies to erythropoietin have been reported in patients treated with Aranesp®.
    • This has been reported predominantly in patients with CKD receiving ESAs by subcutaneous administration.
    • PRCA has also been reported in patients receiving ESAs for anemia related to hepatitis C treatment (an indication for which Aranesp® is not approved).
    • If severe anemia and low reticulocyte count develop during treatment with Aranesp®, withhold Aranesp® and evaluate patients for neutralizing antibodies to erythropoietin.
    • Permanently discontinue Aranesp® in patients who develop PRCA following treatment with Aranesp® or other erythropoietin protein drugs. Do not switch patients to other ESAs.

Scroll down for additional
Important Safety Information.

Abbreviations and References:
CKD = chronic kidney disease; DCR = dose conversion ratio; ESA = erythropoiesis-stimulating agent; QW = once weekly.
Reference: 1. Aranesp® (darbepoetin alfa) prescribing information, Amgen.