Epiao Dosage/Direction for Use

Dosage: Anemia of renal failure: Epoetin Alfa (EPIAO) should be administered under direct medical supervision.
It can be administered intravenously or subcutaneously, dividing into 2-3 times weekly or once a week. The dose should be adjusted according to patient's haemoglobin concentration, age and other related factors. The following dose schedule is recommended: Initial dose: Weekly dividing dosing: The recommended initial dose is 100-150 IU/kg weekly for HD patients, and 75-100 IU/kg weekly for ND patients. If the increment of hematocrit (Hct) is less than 0.5 vol% per week after 4 weeks, the dose can be increased by 15-30 IU/kg weekly.
The maximum increase dose should not exceed 30 IU/kg/week. The target increase of Hct is at the range of 30-33 vol% but not exceeding 36 vol%.
Once a week dosing: The recommended dose is 10,000 IU/week for HD or PD adult patients.
Maintenance dose: Weekly dividing dosing: When the content of Hct reaches 30-33 vol% or hemoglobin (Hb) reaches 100-110 g/L, the dose should be adjusted to two-thirds of the initial dose. Hct should be monitored every 2-4 weeks to prevent excessive erythropoiesis and keep Hct and Hb at an adequate level.
Once a week dosing: When the content of Hct and haemoglobin (Hb) reach the above target, the dose frequency can be reduced (e.g., once every two weeks). The dose can be further adjusted according to the level of Hct and Hb.
Peri-operative patients: Elective surgery patients (except cardiac surgery) with Hb between 100-130 g/L can receive Epoetin Alfa (EPIAO) 150 IU/kg subcutaneously, 3 times weekly, starting 10 days prior to, and for 4 days after the surgery. Epoetin Alfa (EPIAO) can relieve Anemia during and after the surgery, reduce transfusion requirements, and correct anaemia after surgery. Oral iron supplement should be given at the same time in order to avoid iron deficiency.
Anemia in cancer patients on chemotherapy: Treatment with Epoetin Alfa (EPIAO) is not recommended for patients with endogenous baseline EPO level more than 200 mu/ml. It is demonstrated that patients with lower baseline serum EPO level respond more vigorously to Epoetin Alfa (EPIAO) than patients with higher baseline EPO level.
Weekly dividing dosing: The recommended initial dose is 150 IU/kg, 3 times a week by subcutaneous injection. If there is no significant increase of Hct or reduction of transfusion requirement after 8 weeks' treatment, the dose can be increased to 200 IU/kg, 3 times a week by subcutaneous injection. If the hematocrit exceeds 40%, the dose of Epoetin Alfa (EPIAO) should be withheld until the hematocrit falls to 36%. The dose of Epoetin Alfa (EPIAO) should be reduced by 25% when treatment is resumed and titrated to maintain the desired hematocrit. If the initial dose of Epoetin Alfa (EPIAO) results in a rapid hematocrit response (e.g., an increase of more than 4% in any 2-week period), the dose of Epoetin Alfa (EPIAO) should be reduced.
Once a week dosing: Weekly 36,000 IU of Epoetin Alfa (EPIAO) is recommended to be used subcutaneously if the blood Hb is <110 g/L in male or <100 g/L in female patients.
The treatment duration is 8 weeks. The administration should be discontinued if Hb rises to 120 g/L in less than 8 weeks and resumed if it decreases to <110 g/L in male and <100 g/L in female patients. The dose should be reduced appropriately if the absolute increase of haemoglobin exceeds 13 g/L within 2 weeks.
Instruction of administration: For single-use vials, use aseptic procedure, attach a sterile needle to a sterile syringe, and withdraw the required volume of Epoetin Alfa (EPIAO) solution into the syringe for intravenous or subcutaneous injection.
For prefilled syringes, open the outer package, take off the rubber capper on the front of syringe, then make intravenous or subcutaneous injection.