Have you gone to giving Epo SC?

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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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Specializes in m/s, Community, dialysis.

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.

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Specializes in Med Surg, Home Health, Dialysis, Tele.

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. :)

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Specializes in Dialysis.

our PD patients give themselves their EPO SubQ, but that's standard, I guess.

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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/content/topic.do?topickey=~gbbcyvkvnb9kli

subcutaneous versus intravenous administration of erythropoietin improves its efficiency for the treatment of anaemia in haemodialysis patients

http://ndt.oxfordjournals.org/cgi/content/abstract/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]

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Specializes in med-surg, dialysis.

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.

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Specializes in m/s, Community, dialysis.
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

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Specializes in Dialysis (acute & chronic).

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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