INDICATION

Aranesp® is indicated for the treatment of anemia in patients with non-myeloid malignancies where anemia is due to the effect of concomitant myelosuppressive chemotherapy, and upon initiation, there is a minimum of two additional months of planned chemotherapy.


LIMITATIONS OF USE

Aranesp® has not been shown to improve quality of life, fatigue, or patient well-being.

Aranesp® is not indicated for use:

  • In patients with cancer receiving hormonal agents, biologic products, or radiotherapy, unless also receiving concomitant myelosuppressive chemotherapy.
  • In patients with cancer receiving myelosuppressive chemotherapy when the anticipated outcome is cure.
  • As a substitute for RBC transfusions in patients who require immediate correction of anemia.

Scroll down for Important Safety Information, including Boxed WARNINGS.

Aranesp® is dosed at 2.25 mcg/kg QW or 500 mcg Q3W2

Before initiating:

  • Evaluate iron status; administer supplemental iron therapy as needed
  • Correct or eliminate other causes of anemia

Initiate:

  • Only when Hb < 10 g/dL
  • Only when 2 additional months of myelosuppressive non-curative chemotherapy are planned
  • Only with the lowest dose necessary to avoid RBC transfusion

After initiating:

  • Monitor Hb weekly until stable and sufficient to minimize need for RBC transfusion
  • Monitor less frequently if Hb remains stable
  • Maintain iron repletion

Dose adjustment:

  • If Hb increases by > 1 g/dL in any 2-week period or reaches a level needed to avoid RBC transfusion, reduce dose by 40%
  • If Hb exceeds a level needed to avoid RBC transfusion, withhold dose until Hb approaches a level where RBC transfusions may be required and reinitiate at a dose 40% below the previous dose
  • If Hb increases by < 1 g/dL and remains < 10 g/dL after 6 weeks of therapy:
    • If dosing QW, then increase dose to 4.5 mcg/kg/week
    • If dosing Q3W, then no dose adjustment

Stop Aranesp® when:

  • Chemotherapy ends
  • If after 8 weeks of therapy:
    • There is no response as measured by Hb level, or
    • RBC transfusions are required

See full Prescribing Information for complete Dose Adjustment information.

Aranesp® SingleJect® prefilled syringe

Aranesp® SingleJect® prefilled syringe

Aranesp® single-dose vial

Aranesp® single-dose vial

LEARN ABOUT
Important considerations when dosing Aranesp® with chemotherapy administration



ARANESP® (DARBEPOETIN ALFA) INDICATION

Aranesp® is indicated for the treatment of anemia in patients with non-myeloid malignancies where anemia is due to the effect of concomitant myelosuppressive chemotherapy, and upon initiation, there is a minimum of two additional months of planned chemotherapy.

LIMITATIONS OF USE

Aranesp® has not been shown to improve quality of life, fatigue, or patient well-being.

Aranesp® is not indicated for use:

  • In patients with cancer receiving hormonal agents, biologic products, or radiotherapy, unless also receiving concomitant myelosuppressive chemotherapy.
  • In patients with cancer receiving myelosuppressive chemotherapy when the anticipated outcome is cure.
  • As a substitute for red blood cell (RBC) transfusions in patients who require immediate correction of anemia.

IMPORTANT SAFETY INFORMATION INCLUDING BOXED WARNINGS

WARNING: ESAs INCREASE THE RISK OF DEATH, MYOCARDIAL INFARCTION, STROKE, VENOUS THROMBOEMBOLISM, THROMBOSIS OF VASCULAR ACCESS AND TUMOR PROGRESSION OR RECURRENCE

Chronic Kidney Disease:

  • In controlled trials, patients experienced greater risks for death, serious adverse cardiovascular reactions, and stroke when administered erythropoiesis-stimulating agents (ESAs) to target a hemoglobin level of greater than 11 g/dL.
  • No trial has identified a hemoglobin target level, Aranesp® dose, or dosing strategy that does not increase these risks.
  • Use the lowest Aranesp® dose sufficient to reduce the need for red blood cell (RBC) transfusions.

Cancer:

  • ESAs shortened overall survival and/or increased the risk of tumor progression or recurrence in clinical studies of patients with breast, non-small cell lung, head and neck, lymphoid, and cervical cancers.
  • Because of these risks, prescribers and hospitals must enroll in and comply with the ESA APPRISE Oncology Program to prescribe and/or dispense Aranesp® to patients with cancer. To enroll in the ESA APPRISE Oncology Program, visit www.esa-apprise.com or call 1-866-284-8089 for further assistance.
  • To decrease these risks, as well as the risk of serious cardiovascular and thromboembolic reactions, use the lowest dose needed to avoid RBC transfusions.
  • Use ESAs only for anemia from myelosuppressive chemotherapy.
  • ESAs are not indicated for patients receiving myelosuppressive chemotherapy when the anticipated outcome is cure.
  • Discontinue following the completion of a chemotherapy course.
  • Aranesp® is contraindicated in patients with:
    • Uncontrolled hypertension
    • Pure red cell aplasia (PRCA) that begins after treatment with Aranesp® or other erythropoietin protein drugs
    • Serious allergic reactions to Aranesp®
  • In controlled clinical trials of patients with cancer, Aranesp® and other ESAs increased the risks for death and serious adverse cardiovascular reactions. These adverse reactions included myocardial infarction and stroke.
  • In controlled clinical trials, ESAs increased the risk of death in patients undergoing coronary artery bypass graft surgery (CABG) and the risk of deep venous thrombosis (DVT) in patients undergoing orthopedic procedures.
  • Control hypertension prior to initiating and during treatment with Aranesp®.
  • 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.
  • Serious allergic reactions, including anaphylactic reactions, angioedema, bronchospasm, skin rash, and urticaria may occur with Aranesp®. Immediately and permanently discontinue Aranesp® if a serious allergic reaction occurs.
  • Adverse reactions (≥ 1%) in clinical studies in cancer patients receiving chemotherapy were abdominal pain, edema, and thrombovascular events.

Please see Full Prescribing Information, including Boxed WARNINGS, and Medication Guide.

Abbreviations
ESA = erythropoiesis-stimulating agent
Hb = hemoglobin
QW = once weekly
Q3W = once every 3 weeks
RBC = red blood cell