Hemax Dosage/Direction for Use

Treatment of anaemia of chronic renal failure patients: Arterial tension should be controlled before treatment and strictly monitored under it. The recommended initial dose in adult anemia associated with chronic renal failure patients is 50-100 IU/kg by intravenous (IV) or subcutaneous (SC) routes, three times a week (TIW). After four weeks of treatment, the dose should be corrected according to the haemoglobin level increase: If increase equals 1 g/dl or above: maintain the same dose; If increase is below 1 g/dl: the dosage of epoetin alpha may increase by approximately 25%.
Once the target value has been achieved, the dose can be reduced by 30% and administration may be by SC route if the patient had started IV treatment. The maintenance dose must be individualised for each patient. Ten percent of patients under dialysis require 25 IU/kg or less 3 times weekly and another 10% requires 200 IU/Kg 3 times weekly; the average maintenance dose is 75 IU/kg 3 times weekly. Dose adjustments should be performed between intervals not shorter than 4 weeks, since response to dose changes is evidenced after 2 to 6 weeks. In paediatric patients, the recommended initial dose is the same as that for adults. The maintenance dose will depend on body weight. The usually applied doses, 3 times weekly, are: body weight below 10 kg: 75 to 150 IU/kg/dose; body weight between 10 and 30 kg: 60 to 150 IU/kg; body weight above 30 kg: 30 to 100 IU/kg. The dose should be gradually reduced up to the lowest acceptable level that will keep the target hematocrit and haemoglobin levels.
Treatment of anaemia in HIV-infected patients zidovudine-induced anemia: Hemax reduces transfusion requirements and increases haematocrit level in zidovudine-associated anemia in HIV-infected patients, resulting in a significant improvement in the quality of life. Patients with endogenous erythropoietin levels below 500 mU/mL respond better to treatment; therefore, it is advisable to evaluate endogenous erythropoietin before treatment.
The recommended initial dose is 100 IU/kg 3 times weekly for 8 weeks. Response can be assessed after 8 weeks of treatment. If no satisfactory response is obtained, this dose can be escalated by 50 IU/kg increases to a maximum of 300 IU/kg TIW. Response to epoetin treatment may decrease in case of infectious or inflammatory conditions.
Treatment of anaemia in cancer patients on chemotherapy: In this population, epoetin increases hematocrit and decreases transfusion requirements between the 1st and 4th month of treatment. Two Hemax administration schedules can be applied: TIW administration: The recommended initial dose is 150 U/kg/dose three times a week SC. If there is no response after 4 weeks, the dose can be increased by 50 U/kg/dose each time up to a maximum of 300 U/kg 3 times weekly. If haemoglobin level reaches 12 g/dl or if it increases more than 1 g/dl within 2 weeks, the dose must be reduced by 25%. If hematocrit is above 40%, administration can be interrupted until such value reaches 36%. The dose must be reduced by 25% when treatment is re-initiated and thereafter, followed by evaluation through the target hematocrit level. In paediatric patients aged 6 months to 18 years old, reported doses were 25 to 300 IU/kg IV or SC three to seven times a week; Single weekly administration: Initial dose for adults is 40,000 IU, SC, once a week. If haemoglobin did not increase 1 g/dl in 4 weeks-free of transfusions, Hemax dose should be increased to 60,000 IU. If Hemax treatment triggers a rapid response, e.g., haemoglobin increase above 1 g/dl in 2 weeks, the dose should be reduced by 25%.
Anaemia of prematurity: Subcutaneous dose of 250 IU/kg 3 times a week, the treatment should be started as soon as possible and it should last 6 weeks.