ProcritR (epoetin alfa)* (preferred) and EpogenR (epoetin alfa)* | Chronic Kidney Disease patients on dialysis Adults: 50-100 units/kg IV or SC TIW CKD patients not on dialysis Adults: 50-100 units/kg IV or SC TIW CKD (dialysis and non-dialysis patients) Do not increase dose more frequently than once every 4 weeks. Decreases in dose can occur more frequently. Use the lowest dose that will maintain a Hgb level sufficient to reduce the need for RBC transfusions.
| 6 months or to member's renewal date, whichever is longer |
Procrit (epoetin alfa)* (preferred) and Epogen (epoetin alfa)* | Zidovudine-treated patients Initial: 100 units/kg IV or SC TIW
If Hgb does not increase after 8 weeks of therapy, increase dose by approximately 50 to 100 units/kg at 4 to 8 week intervals until Hgb reaches a level needed to avoid RBC transfusions or 300 units/kg. Withhold if Hgb exceeds 12 g/dL. Resume therapy at a dose 25% below the previous dose when Hgb declines to less than 11 g/dL.
Discontinue if an increase in Hgb is not achieved at a dose of 300 units/kg for 8 weeks.
| 6 months or to member's renewal date, whichever is longer |
Procrit (epoetin alfa)* (preferred) and Epogen (epoetin alfa)* | Cancer Patients on Chemotherapy Initial Dose: 150 units/kg SC TIW or 40,000 units SC weekly until completion of a chemotherapy course.
Reduce dose by 25% if Hgb increases greater than 1 g/dL in any 2 week period or Hgb reaches a level needed to avoid RBC transfusion.
Withhold dose if Hgb exceeds a level needed to avoid RBC transfusion.
Reinitiate at a dose 25% below the previous dose when Hgb approaches a level where RBC transfusions may be required. After the initial 4 weeks of therapy, if Hgb increases by less than 1g/dL and remains below 10 g/dL, increase dose to 300 units/kg TIW or 60,000 units/week in adults.
Discontinue if after 8 weeks of therapy, there is no response as measured by Hgb levels or if RBC transfusions are still required.
| Authorized until the completion of chemotherapy course, 6 months or to member's renewal date, whichever is longer |
Procrit (epoetin alfa)* (preferred) and Epogen (epoetin alfa)* | Surgery Patients 300 units/kg/day SC for 10 days prior to surgery, on the day of surgery, continuing for 4 days after surgery OR 600 units/kg SC in once weekly doses 21, 14 and 7 days before surgery plus a 4th dose on day of surgery | Up to 15 doses |
Procrit (epoetin alfa)* (preferred) and Epogen (epoetin alfa)* | Hepatitis C Patients on combination therapy (pegylated interferon and ribavirin) 40,000 units/week SC, may increase to 60,000 units SC once weekly if hemoglobin level has not increased by at least 1 g/dL after 4 weeks of treatment | Coincide with duration of ribavirin authorization to maintain greater than or equal to 80% of the original ribavirin dose.
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Procrit (epoetin alfa)* (preferred) and Epogen (epoetin alfa)* | Myelodysplastic syndrome 150-300 units/kg/day SC (a 40,000 U weekly dose was also studied in some clinical trials) | 6 months or to member's renewal date, whichever is longer |
Aranesp | Anemia in CKD patients on dialysis: Initial: 0.45 mcg/kg IV or SC weekly, or 0.75 mcg/kg once every 2 weeks. IV route is recommended for patients on hemodialysis. If the Hgb level approaches or exceeds 11 g/dL, reduce or interrupt the dose.
Anemia in CKD patients not on dialysis: Initial: 0.45 mcg/kg IV or SC once at four week intervals.
If the Hgb level exceeds 10 g/dL, reduce or interrupt the dose and use the lowest dose of Aranesp sufficient to reduce the need for RBC transfusions
CKD (dialysis and non-dialysis patients): Do not increase dose more frequently than once every 4 weeks. Decreases in dose can occur more frequently. If Hgb rises rapidly (e.g. more than 1 g/dL in any 2 week period), reduce the dose by 25% or more as needed to reduce rapid responses.
For patients who do not respond adequately, if the Hgb has not increased by more than 1 g/dL after 4 weeks of therapy, increase the dose by 25%.
Use the lowest dose that will maintain a Hgb level sufficient to reduce the need for RBC transfusions.
| 6 months or to member's renewal date, whichever is longer |
Aranesp | Chemotherapy-induced anemia Starting dose is 2.25 mcg/kg SC once weekly or 500 mcg SC every 3 weeks until completion of chemotherapy course
If Hgb increases greater than 1 g/dL in any 2 week period or if Hgb reaches a level needed to avoid RBC transfusion, reduce dose by 40% (both weekly and every 3 week schedule)
If Hgb exceeds a level needed to avoid RBC transfusion, withhold dose until Hgb approaches a level where RBC transfusions may be required. Then reinitiate at a dose of 40% below the previous dose (both weekly and every 3 week schedule). If Hgb increases by less than 1 g/dL and remains below 10 g/dL after 6 weeks of therapy, increase dose to 4.5mcg/kg/week (weekly schedule). No dose adjustment is needed for every 3 week schedule.
Discontinue Aranesp if there is no response as measured by the Hgb levels or if RBC transfusions are still required after 8 weeks of therapy or following completion of a chemotherapy course.
Use the lowest dose necessary to avoid RBC transfusions.
| Authorized until the completion of chemotherapy course, 6 months or to member's renewal date, whichever is longer |
Aranesp | Myelodysplastic syndromes
150-300 mcg/week SC | 6 months or to member's renewal date, whichever is longer |
MirceraR (methoxypolyethylene glycol epoetin beta) | Anemia in CKD (dialysis and non-dialysis patients): 0.6 mcg/kg SC or IV every two weeks.
Anemia in CKD patients on dialysis: If the Hgb level approaches or exceeds 11 g/dL, reduce or interrupt the dose.
Anemia in CKD patients not on dialysis: If the Hgb level exceeds 10 g/dL, reduce or interrupt the dose and use the lowest dose of Mircera sufficient to reduce the need for RBC transfusions
| 6 months or to member's renewal date, whichever is longer |