Drug reference

darbepoetin alfa

Erythropoiesis-Stimulating Agent · Hematopoietic Agent

Erythropoiesis-Stimulating AgentHematopoietic Agent

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

4 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 10 →

CarfilzomibSevereDatabaseDDInter
LenalidomideSevereDatabaseDDInter
PomalidomideSevereDatabaseDDInter
ThalidomideSevereDatabaseDDInter

Mechanism

Darbepoetin alfa is an engineered epoetin that displays a longer circulatory half-life compared to other epoetins. It stimulates red blood cell production by binding to erythropoietin receptors on erythroid progenitor cells, promoting their proliferation and maturation.

Indications

anemia associated with chronic kidney diseaseanemia associated with cancer chemotherapy

Dosing

Adult: Chronic Kidney Disease: 0.45 μg/kg administered intravenously or subcutaneously once weekly or 0.75 μg/kg administered every 2 weeks. Dose adjustments depend on response, with a rise of less than 1 g/dL every 2 weeks generally considered safe.

Contraindications

pre-existing uncontrolled hypertension

Side effects

Common

headachetachycardiaedemashortness of breathnauseavomitingdiarrheainjection site stingingflu-like symptoms (arthralgias, myalgias)

Serious

thrombotic events
cancer recurrence (in cancer patients)
decreased on-study survival (in cancer patients)
hypertensive encephalopathy
seizures
death (if administered to target hemoglobin concentrations near normal physiological levels)

Drug interactions

Carfilzomib

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

Lenalidomide

Severe

Database

Source: DDInter

Pomalidomide

Severe

Database

Clinical effect not specified

Source: DDInter

Thalidomide

Severe

Database

Source: DDInter

Anticoagulants

Moderate

Textbook

During hemodialysis, patients receiving darbepoetin alfa may require increased anticoagulation.

Patients during hemodialysis may require increased anticoagulation. Monitoring for thrombotic events is recommended.

Source: G&G 14e · p902

Angiotensin Receptor Blockers (arbs)

Moderate

Database

Higher doses of darbepoetin alfa may be needed to achieve target hemoglobin levels in patients concurrently taking ARBs.

Monitor hemoglobin response closely. Adjust darbepoetin alfa dose as needed. This interaction is generally manageable and does not contraindicate co-administration.

Angiotensin Converting Enzyme (ace) Inhibitors

Moderate

Database

Higher doses of darbepoetin alfa may be needed to achieve target hemoglobin levels in patients concurrently taking ACE inhibitors.

Monitor hemoglobin response closely. Adjust darbepoetin alfa dose as needed. This interaction is generally manageable and does not contraindicate co-administration.

Iron Supplements (oral Or Intravenous)

Moderate

Database

Reduced efficacy of darbepoetin alfa, leading to a suboptimal increase in hemoglobin levels or requiring higher doses of darbepoetin alfa.

Ensure adequate iron stores before and during darbepoetin alfa therapy. Monitor serum ferritin and transferrin saturation regularly. Supplement with iron as needed, adjusting dose based on iron status.

Myelosuppressive Chemotherapy

Moderate

Database

Reduced or absent response to darbepoetin alfa, as the bone marrow is unable to produce red blood cells effectively.

Darbepoetin alfa is generally not recommended for patients receiving myelosuppressive chemotherapy with curative intent due to potential for tumor progression. If used for palliative care, monitor hemoglobin response closely and adjust darbepoetin alfa dose. The primary issue is the underlying chemotherapy's effect on the bone marrow.

Folic Acid Supplements

Mild

Database

Suboptimal response to darbepoetin alfa if folic acid deficiency is present.

Assess folate status, especially in patients with chronic kidney disease. Supplement with folic acid if deficient to optimize erythropoietic response.

2 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.