Chronic kidney disease (CKD)
Anemia due to chronic kidney disease

PROCRIT® is indicated for the treatment of anemia due to chronic kidney disease (CKD), including patients on dialysis and not on dialysis to decrease the need for red blood cell (RBC) transfusion.

When treating anemia in CKD patients not on dialysis
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Important dosing and administration information1
In pregnant women, lactating women, neonates, and infants, use only single-dose vials (the benzyl alcohol–free formulation). Do not mix PROCRIT® with bacteriostatic saline (which also contains benzyl alcohol) when administering PROCRIT® to these patient populations.

When initiating or adjusting therapy, monitor hemoglobin levels at least weekly until stable, then monitor at least monthly.
When adjusting therapy consider hemoglobin rate of rise, rate of decline, ESA responsiveness and hemoglobin variability. A single hemoglobin excursion may not require a dosing change.
  • Do not increase the dose more frequently than once every 4 weeks. Decreases in dose can occur more frequently. Avoid frequent dose adjustments.
  • If the hemoglobin rises rapidly (e.g., more than 1 g/dL in any 2-week period), reduce the dose of PROCRIT® by 25% or more as needed to reduce rapid responses.
  • For patients who do not respond adequately, if the hemoglobin has not increased by more than 1 g/dL after 4 weeks of therapy, increase the dose by 25%.
  • For patients who do not respond adequately over a 12-week escalation period, increasing the PROCRIT® dose further is unlikely to improve response and may increase risks. Use the lowest dose that will maintain a hemoglobin level sufficient to reduce the need for RBC transfusions. Evaluate other causes of anemia. Discontinue PROCRIT® if responsiveness does not improve.
For adult patients with CKD on dialysis:
  • Initiate PROCRIT® treatment when the hemoglobin level is less than 10 g/dL.
  • If the hemoglobin level approaches or exceeds 11 g/dL, reduce or interrupt the dose of PROCRIT®.
  • The recommended starting dose for adult patients is 50 to 100 Units/kg 3 times weekly intravenously or subcutaneously. The intravenous route is recommended for patients on hemodialysis.
For adult patients with CKD not on dialysis:
  • Consider initiating PROCRIT® treatment only when the hemoglobin level is less than 10 g/dL and the following considerations apply:
    • The rate of hemoglobin decline indicates the likelihood of requiring a RBC transfusion and,
    • Reducing the risk of alloimmunization and/or other RBC transfusion-related risks is a goal
  • If the hemoglobin level exceeds 10 g/dL, reduce or interrupt the dose of PROCRIT®, and use the lowest dose of PROCRIT® sufficient to reduce the need for RBC transfusions.
  • The recommended starting dose for adult patients is 50 to 100 Units/kg 3 times weekly intravenously or subcutaneously.
For pediatric patients with CKD:
  • Initiate PROCRIT® treatment only when the hemoglobin level is less than 10 g/dL.
  • If the hemoglobin level approaches or exceeds 12 g/dL, reduce or interrupt the dose of PROCRIT®.
  • The recommended starting dose for pediatric patients (ages 1 month or older) is 50 Units/kg 3 times weekly intravenously or subcutaneously.
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Flexible and individualized dosing options
Sample PROCRIT® starting dose for a 70-kg patient

50 U/kg TIW =
3,500 U TIW
  75 U/kg TIW =
5,250 U TIW
  100 U/kg TIW =
7,000 U TIW
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Dosing algorithm for adults

  • PROCRIT® is contraindicated in patients with uncontrolled hypertension, pure red cell aplasia (PRCA) that begins after treatment with PROCRIT® or other erythropoietin protein drugs, or serious allergic reactions to PROCRIT®. PROCRIT® from multiple-dose vials contains benzyl alcohol and is contraindicated in neonates, infants, pregnant women, and lactating women.
*Approximately 10,000 U, 15,000 U, or 20,000 U SC or IV used per week based on sample starting doses of 50 U/kg TIW, 75 U/kg TIW, or 100 U/kg TIW, respectively, for a 70-kg patient.
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References
  1. PROCRIT® (epoetin alfa) Prescribing Information. Janssen Products, LP.
 
Indications and Important Safety Information
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INDICATIONS
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IMPORTANT SAFETY INFORMATION
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