Epreks

Эпрекс Drug photo

The description is actual on 28.07.2016

  • Latin name: Eprex
  • ATH code: B03XA
  • Active ingredient: Epoetin alpha (Epoetin alfa)
  • Producer: Vetter of Farm Fertigung Gmbh and To. KG (Germany); Silag AG (Switzerland) 

Structure

Recombinant epoetin an alpha (depending on a dose) – 8,4 mkg; 16,8 mkg; 33,6 mkg or 84 mkg. Polysorbate, sodium chloride, sodium dihydrophosphate, sodium hydrophosphate, glycine, water for injections, as excipients.

Release form

Solution for hypodermic and intravenous administration 1000 ME, 2000 ME, 4000 ME, 10000 ME and 40000 ME in the syringe with the built-in device of protection.

Pharmacological action

Hemogenesis stimulator.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

The cleared glycoprotein stimulating an erythrogenesis. Epoetin an alpha is produced by cells of animals with the built-in gene which code synthesis of human erythropoetin. On properties does not differ from human. Protein fraction consists of 165 amino acids.

After introduction the quantity of erythrocytes, level of hemoglobin, reticulocytes increase. Epoetin an alpha stimulates an erythrogenesis, without influencing a leukopoiesis. In the minimum degree induces antibody formation. Cancerogenic properties were not studied. Teratogenecity of this means at the person was also not studied, however at rats teratogenic action is not revealed. At research it is revealed that there are no distinctions in the frequency of emergence of fibrosis of marrow in patients from the HPN which were receiving epoetin three years, and not receiving this means.

Pharmacokinetics

At hypodermic introduction concentration of drug in blood is lower, than at an intravenous way of introduction. Concentration of drug in blood increases slowly, reaches max in 18 hours. Bioavailability about 25%. An elimination half-life at hypodermic introduction 24 hours, at intravenous — 5-6 hours.

Indications to use

  • different types of anemias;
  • at HPN at the persons which are on a hemodialysis;
  • at oncological diseases (at not myeloid tumors);
  • at HIV-positive patients, against treatment by a zidovudine;
  • preventive introduction before extensive operation with the expected big blood loss at patients with anemia.

Contraindications

  • the arterial hypertension which is not controlled by administration of drugs;
  • hypersensitivity;
  • heavy pathology of brain, coronary, sleepy vessels, recently postponed myocardial infarction or ONMK;
  • pregnancy and lactation (it is possible according to strict indications);
  • krasnokletochny aplasia.

With care it is applied at epilepsy and epileptic activity, fibrinferment, a thrombocytosis, obliterating diseases of vessels, gout, a sickemia, coronary heart disease. Being a growth factor, can stimulate some malignant new growths, especially marrow.

Side effects

More often the meeting side reactions:

The found side reactions are more rare:

  • thrombocytopenia;
  • eritropoetinovy it is red a cellular aplasia;
  • stroke, intracerebral bleeding, hypertensive encephalopathy;
  • retina thrombosis;
  • small tortoiseshell, Quincke's edema;
  • hyperpotassemia.

Epreks, application instruction (Way and dosage)

It is applied intravenously or subcutaneously. The syringe cannot be stirred up as it leads to a denaturation of a glycoprotein and activity of drug is lost. Packaging is intended only for single use. If after an injection there is a solution, the syringe needs to be thrown out. In this regard, there are several doses and it is possible to choose Epreks suitable you, for example, 2000 or Epreks 40000 ME.

Intravenously enter on 10 ml of isotonic solution, duration of an injection from 1 to 5 minutes. It is forbidden to enter in the form of intravenous infusion. Subcutaneous injections (under skin of a shoulder, an abdominal wall, a hip) are carried out in volume to 1 ml if large volumes are appointed, use several points.

The chronic renal failure — is entered intravenously if the patient is on a hemodialysis and subcutaneously in other cases. A dose 50 ME on 1 kg of weight. The dose can increases if hemoglobin raises slightly. An upper limit of value of hemoglobin of 100-120 g/l for adults and 95-110 g/l for children.

Oncological diseases — the initial dose 150 ME on weight kg three times a week or 40000 ME is entered subcutaneously, once a week. If in a month a hemoglobin content and reticulocytes did not raise, appoint 300 ME to weight kg three times a week. If the level of hemoglobin of 120 g/l is reached reduce a dose by 25% from initial and in such mode continue treatment month after the termination of chemotherapy.

Anemia at HIV infection — 100 ME on weight kg three times a week 2 months. At not achievement of satisfactory effect the dose gradually increases on 50-100 ME on weight.

At achievement of effect pass to a maintenance dose which provides a hematocrit of 30-35% if it is higher, the dose decreases by 25%. Hemoglobin level the patients receiving a zidovudine should have no more than 120 g/l.

Preoperative preparation and postoperative treatment — carry out hypodermic introduction 600 ME on weight kg a week, in 3 weeks prior to operation and in day of operation. If the preoperative period short, is appointed every day on 300 ME to weight kg in 10 days prior to operation and by 4 days after operation.

Overdose

Overdose is shown by extreme degree of manifestation of side effects. At very high level of hemoglobin bloodletting is applied.

Interaction

The drugs oppressing an erythrogenesis weaken effect of this medicine. Change of concentration of cyclosporine therefore control of its level in blood and dose adjustment is necessary is possible. It is impossible to enter into mixes with other medicines. It is not admissible to extract drug from original capacity and to pour his another. Epoetin an alpha does not influence pharmacokinetic characteristics of a trastuzumab at its use for oncological patients.

Terms of sale

It is released according to the recipe.

Storage conditions

Temperature of storage is 2-8 °C.

Period of validity

1,5 years.

Epreks's analogs

Epokrin, Eritrostim, Rekormon, Epomaks, Eralfon.

About Epreks

At heavy anemia in addition to introduction of iron preparations use of recombinant erythropoetin is justified, for example, Epreks, Epomaks — it considerably increases efficiency of treatment. It is necessary to remember that only the combination to iron preparations provides normal. Primenenieritropoeza of this drug is promoted utilization orally by gland, and it comes to marrow where provides the strengthened erythrogenesis.

During pregnancy the iron deficiency anemia, and, judging by responses often develops, to women with heavy anemia this drug after determination of level of erythropoetin in serum and according to strict indications was appointed, considering risks and the expected advantage.

"… On the 35th week pricked intravenously 4000 ME five times, transferred easily".

Erythropoetins became an important component of treatment of the anemia arising against treatment of a himiopreparatama of malignant new growths. This drug was appointed after any myelosuppressive treatment if hemoglobin less 80-85ú/l, sometimes even preventively.

"… Before chemotherapy the doctor registered to prick this means once a week".

Great opportunities appeared in treatment of renal anemia at patients with HPN after use of recombinant erythropoetins. In this case they are considered as means of replacement therapy and increase quality of life and increase survival of patients with HPN.

  • "… After bleeding hemoglobin fell, within three weeks pricked Epreks at the end of each dialysis — rose to 95 g/l".
  • "… On a hemodialysis. To Kohl on 4000 pieces a week. Hemoglobin more than 90 g/l does not rise".
  • "… Did to me after each dialysis, subcutaneously. At me hemoglobin began to grow very quickly therefore reduced up to 2 injections a week".

Among side effects arterial hypertension, a grippopodobny syndrome, a hyperpotassemia, increase of viscosity of blood was noted. And, arterial hypertension is dozozavisimy complication.

Zdravzona

  • Epreks solution for injections 2000 ME 0,5ml No. 6 shpritsyyansen-Silag
  • Epreks solution for injections of 10000 ME 1 ml No. 6 shpritsyyansen-Silag
  • Epreks solution for injections 4000 ME 0,4ml No. 6 shpritsyyansen-Silag
  • Epreks solution for injections of 40000 ME 1 ml No. 6 shpritsyyansen-Silag
  • Epreks solution for injections of 40000 ME 1 ml No. 1 shpritsyansen-Silag
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Apteka24

  • Epreks solution for injections of 2000 PIECES/ml 0.5ml No. 6 Janssen (Belgium)
Section: For blood
in more detail

Education: Graduated from Sverdlovsk medical school (1968 - 1971) as "Paramedic". Graduated from the Donetsk medical institute (1975 - 1981) as "An epidemiologist, a hygienist". Passed postgraduate study in the Central scientific research institute of epidemiology Moscow (1986 - 1989). An academic degree – the candidate of medical sciences (degree is awarded in 1989, protection – the Central scientific research institute of epidemiology Moscow). Numerous advanced training courses are studied in epidemiology and infectious diseases.

Experience: Work as the manager of department of disinfection and sterilization of 1981 - 1992. Work as the manager of department of especially dangerous infections of 1992 - 2010. Teaching activity at Medical institute 2010 - 2013.

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