سعر ارانيسب 40 مكجم 4 سرنجات معباة للحقن 40 مكجم/0.4 مل 2024

Aranesp (darbepoetin alfa 40 micrograms in 0.4 mL (100 mcg/mL)) solution for injection in pre-filled syringe, a long-acting erythropoiesis-stimulating agent by Amgen Europe B.V. (Netherlands), imported into Egypt; pack of 4 pre-filled syringes.

• Treatment of symptomatic anaemia associated with chronic renal failurePopulation: Adults and paediatric patientsEuropean Medicines Agency (EMA)
• Treatment of symptomatic anaemia in adult cancer patients with non-myeloid malignancies receiving chemotherapyPopulation: AdultsEuropean Medicines Agency (EMA)
• US label: anaemia due to chronic kidney disease (on and not on dialysis), and anaemia due to concomitant myelosuppressive chemotherapy in non-myeloid malignancies with at least two additional months of planned chemotherapy; not shown to improve quality of life, fatigue or well-beingPopulation: Adults and paediatric CKD patientsDailyMed (U.S. National Library of Medicine)

• Chronic renal failure patients: very common hypersensitivity and hypertension; common stroke, rash/erythema and injection-site pain; uncommon convulsions, thromboembolic events, dialysis vascular access thrombosis, injection-site bruising and haemorrhage; frequency not known: pure red cell aplasia, SJS/TEN, erythema multiforme, blistering, skin exfoliation.International label, same formulation · European Medicines Agency (EMA)
• Cancer patients: very common hypersensitivity; common hypertension, thromboembolic events including pulmonary embolism, rash/erythema, oedema and injection-site pain; uncommon convulsions, injection-site bruising and haemorrhage; frequency not known: SJS/TEN, erythema multiforme, blistering, skin exfoliation.International label, same formulation · European Medicines Agency (EMA)

• Hypersensitivity to darbepoetin alfa or any excipient; poorly controlled hypertension.International label, same formulation · European Medicines Agency (EMA)
• US label: uncontrolled hypertension; pure red cell aplasia that begins after treatment with Aranesp or other erythropoietin protein drugs; serious allergic reactions to Aranesp.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• US boxed warning: ESAs increase the risk of death, myocardial infarction, stroke, venous thromboembolism, vascular access thrombosis and tumour progression or recurrence. In CKD, targeting haemoglobin above 11 g/dL increased these risks; use the lowest dose sufficient to reduce transfusions. In cancer, ESAs shortened survival and/or increased tumour progression in breast, non-small cell lung, head and neck, lymphoid and cervical cancers; use only for anaemia from myelosuppressive chemotherapy, not when the anticipated outcome is cure, and discontinue after chemotherapy is completed.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Chronic renal failure: maintenance haemoglobin should not exceed 12 g/dL; targeting haemoglobin above 12 g/dL increased the risk of death, serious cardiovascular and cerebrovascular events including stroke, and vascular access thrombosis; high cumulative doses may add risk, so escalate doses with caution.International label, same formulation · European Medicines Agency (EMA)
• Cancer patients: epoetins may stimulate tumour growth and have not been shown to improve survival; studies showed shortened time to tumour progression or survival in some cancers when targeting high haemoglobin. In some situations blood transfusion should be preferred; base the decision on an individual benefit-risk assessment.International label, same formulation · European Medicines Agency (EMA)

• Ciclosporin, tacrolimus (substances highly bound to red blood cells)No interactions shown clinically, but blood levels of drugs highly bound to red cells may change as haemoglobin rises: monitor levels and adjust their dose.European Medicines Agency (EMA)

• No adequate and well-controlled studies in pregnant women; animal studies do not indicate direct harmful effects on pregnancy, embryo-foetal development, parturition or postnatal development, and fertility was not altered. Use with caution in pregnancy.International label, same formulation · European Medicines Agency (EMA)
• US label: limited data in pregnant women are insufficient to determine a drug-associated risk of major birth defects or miscarriage; in animal studies Aranesp increased early post-implantation loss at doses approximating the recommended starting doses; weigh maternal benefit against possible fetal risk.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Unknown whether excreted in human milk; a risk to the suckling child cannot be excluded; decide whether to stop breast-feeding or stop/abstain from Aranesp, considering the benefits to child and mother.International label, same formulation · European Medicines Agency (EMA)

• Darbepoetin alfa: Stimulates erythropoiesis by the same mechanism as endogenous erythropoietin (binding the erythropoietin receptor on erythroid progenitor cells); its two extra N-linked carbohydrate chains give a longer terminal half-life than r-HuEPO.