How much to use:
- Your doctor will determine the correct dose of EPREX. EPREX injection is administered either into a vein (intravenously) or just under the skin (subcutaneously). After instruction, you can administer it under the skin yourself if you wish. Your doctor can discuss with you whether injection into the vein or under the skin is preferable.
- For patients with anaemia due to kidney failure, EPREX should be given intravenously, (into a vein or a tube that goes into a vein) if intravenous access is routinely available (haemodialysis patients). For patients not yet on dialysis and those on peritoneal dialysis EPREX can be administered subcutaneously. The usual starting dose is 50 IU/kg three times per week for adults and 25 IU/kg three times per week for children, after which the dose may be changed by your doctor as needed.
- For patients who are scheduled for surgery and who are not storing their own blood the usual dose is 300 IU/kg body weight for 10 days before surgery, on the day of surgery and for 4 days after. Alternatively a dose of 600 IU/kg may be administered weekly for 3 weeks before surgery and on the day of surgery. The subcutaneous route is used.
- For anaemic cancer patients receiving chemotherapy, the initial dose is 150 IU/kg three times per week. After 4 weeks your doctor will check your response and increase the dose to 300 IU/kg three times weekly if response has been insufficient. If at any stage EPREX has produced too many red cells, your doctor will stop the drug and later re-start it at a lower dose. The subcutaneous route is used.
Injecting EPREX under the skin yourself
At the start of your therapy, EPREX may be injected by medical or nursing staff. However, your doctor may decide that it is right for you to learn how to inject EPREX under the skin (subcutaneously) yourself. You will receive appropriate training for you to do this. Under no circumstances should you attempt to inject yourself unless you have been trained to do so.
If EPREX is injected under the skin (subcutaneously), the amount injected is not normally more than one millilitre (1 mL) in a single injection.
EPREX is given alone and not mixed with other liquids for injection.
Only use EPREX if the solution is clear and colourless.
Do not shake EPREX prefilled syringes.Prolonged vigorous shaking may damage EPREX. If EPREX has been shaken vigorously, don't use it.
How to inject EPREX
The pre-filled syringes are fitted with the PROTECS(TM)needle guard device to help prevent needle stick injuries after use. This is indicated on the packaging.
- Take a syringe out of the refrigerator. The liquid needs to come to room temperature. This usually takes between 15 to 30 minutes.
- Check the syringe, to make sure it is the right dose, has not passed its expiry date, is not damaged, and the liquid is clear and not frozen.
- Choose an injection site.Good sites are the top of the thigh and around the tummy (abdomen) but away from the navel. Vary the site from day to day.
- Wash your hands. Use an antiseptic swab on the injection site, to disinfect it.
- Take the cover off the syringeby holding the barrel and pulling the cover off carefully without twisting it. Don't push the plunger, touch the needle or shake the syringe.
- Pinch a fold of skinbetween your thumb and index finger. Don't squeeze it.
- Push the needle in fully.Your doctor or nurse may have shown you how to do this.
- Check that you haven't punctured a blood vessel.Pull back slightly on the plunger. If you see blood, take the syringe out and try somewhere else.
- Push the plunger with your thumb as far as it will go to inject all of the liquid. Push it slowly and evenly, keeping the skinfold pinched. The needle guard will not activate unless the entire dose is given.
- When the plunger is pushed as far as it will go,take out the needle and let go of the skin.
- Take your thumb off the plunger.Allow the syringe to move up until the entire needle is covered by the needle guard.
- Press an antiseptic swabover the injection site for a few seconds after the injection.
- Dispose of your used syringein a safe container.
Only take one dose of EPREX from each syringe. If any liquid remains in the syringe after an injection, the syringe should be properly disposed of, not reused. EPREX prefilled syringes do not contain preservatives. Therefore, once a syringe has been opened, any
If you do not understand the instructions provided with this medicine, ask your doctor or pharmacist for help.
If you forget to use it
- Administer your dose as soon as you remember, and then continue to use it as you would normally.
- Do not administer a double dose to make up for the dose you missed.
If you have missed more than one dose, or are not
sure what to do, check with your doctor or
If you have trouble remembering when to use your
medicine, ask your pharmacist for some hints.
If you have used too much (overdose)
Immediately telephone your doctor or the Poisons Information Centre for advice, or go to Accident and Emergency at your nearest hospital.
Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.
Poisons Information Centre telephone numbers:
- Australia: 13 11 26
- New Zealand: 0800 POISON or 0800 764 766 Keep these telephone numbers handy.
Things you must do
- Always follow your doctor's instructions
If you are receiving dialysis treatment when you begin treatment with EPREX, your dialysis regimen may need to be adjusted. Your doctor will decide this.
You will need to have regular blood tests while you are using EPREX to see how you respond to treatment with EPREX. Your doctor will order regular blood tests to ensure that your medicine is continuing to work properly. If your haemoglobin levels are above 120 g/L, discuss reducing your EPREX dose with your doctor.
Your doctor will need to monitor your blood pressure regularly, especially at the beginning of treatment.
An increase in levels of small cells (called platelets) in your blood may occur, particularly when starting haemodialysis treatment.
- Tell your doctor if you become pregnant while
- If you are about to start taking a new medicine, tell your doctor and pharmacist that you are using EPREX.
- If you become increasingly tired, dizzy or breathless, you should talk to your doctor at once. Your doctor can decide whether EPREX is not working properly for you and will end the treatment if necessary.
- If you are due to have major surgery, your doctor will give you a medicine to reduce the risk of abnormal blood clotting.
- Remember to tell your doctor if you received EPREX or another erythropoietin-like medicine in the past and you experienced a worsening in your anaemia.
- Take special care with other products that stimulate red blood cell production: EPREX is one of a group of products that stimulate the production of red blood cells like the human protein erythropoietin does. If you are given a product in this group other than the one prescribed by your doctor during your treatment, speak to your doctor before using it. It is important that you continue to use the same product in the group unless your doctor says otherwise.
Things you must not do
- Do not use EPREX to treat any other complaint unless your doctor says so.
- Do not give this medicine to anyone else, even if their symptoms seem similar to yours.