Have you gone to giving Epo SC?

  1. 0
    I'm at a clinic now where all the Epo is given SC. I know the big for-profit companies have been fighting Medicare on this, because they make a lot of money on Epo.

    But, I have seen that the pts' H&Hs go up faster, and stay in acceptable range longer, and on lower doses using SC administration. Of course, the pts don't like getting shots q tx.

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  2. 7 Comments...

  3. 0
    The H&H goes up faster if its given SC? Why not give the patient the choice? Ask them if they will take it SC and have the doctor write either/or. Never heard that it made a difference, but am all for it if it works.
  4. 0
    We still give it through the Saline line during HD. So many of my pts actually comment about the length of the needles and how he/she is happy that it is not SC.
  5. 0
    our PD patients give themselves their EPO SubQ, but that's standard, I guess.
  6. 0
    Quote from blondeamazonrn
    the h&h goes up faster if its given sc? why not give the patient the choice? ask them if they will take it sc and have the doctor write either/or. never heard that it made a difference, but am all for it if it works.
    hemodialysis — epo given subcutaneously three times a week will maintain the hematocrit at the same level and at a lower dose than intravenous epo. in almost all published studies, subcutaneous administration is associated with a 25 to 50 percent epo dose reduction [1-8]. as an example, an unblinded 26 week study evaluated 208 chronic hemodialysis patients who were randomized to either subcutaneous or intravenous therapy; the target hematocrit was 30 to 33 percent [6]. the average weekly dose of epo was 32 percent less for those randomly assigned to the subcutaneous regimen (94 versus 150 u/kg). the average hematocrit and hemoglobin levels were similar for both groups, and only one patient randomized to subcutaneous therapy withdrew because of pain.
    continued...
    http://www.uptodate.com/patients/con...gbbcyvkvnb9kli


    subcutaneous versus intravenous administration of erythropoietin improves its efficiency for the treatment of anaemia in haemodialysis patients
    http://ndt.oxfordjournals.org/cgi/co...ct/10/supp6/40

    urinary loss of erythropoietin after intravenous versus subcutaneous epoetin-beta in preterm infants.

    langer j, obladen m, dame c.
    klinik für neonatologie, campus virchow-klinikum, charité-universitätsmedizin, berlin, germany.
    hematopoietic and non-hematopoietic effects of recombinant erythropoietin (epo) given to preterm infants are controversially discussed. because renal loss of epo was significantly higher after intravenous versus subcutaneous epoetin-beta administration, we suggest a reconsideration of whether subcutaneous recombinant epo is more efficient and safer because of lower peaks of circulating epo.
    pmid: 18410782 [pubmed - indexed for medline]
  7. 0
    Are you giving the Epo during tx or after tx? We had one pt that was in a study being conducted by the VA. We had to give him his epo after tx was completed. His ranges stayed within goal most of the time with just a very small dose.
  8. 0
    Quote from workingmomRN
    Are you giving the Epo during tx or after tx? We had one pt that was in a study being conducted by the VA. We had to give him his epo after tx was completed. His ranges stayed within goal most of the time with just a very small dose.
    During
  9. 0
    We had switched to Epogen SC about 15 years ago and followed our patients H&H's for about 6 months. we did not see any great results and the patient's complained about the injections, so we switched back.


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