Aranesp
Aranesp (darbepoetin alfa) is an injectable medication used to treat low red blood cell count (anemia). It's long-acting and doesn't have to be given as often as similar medications. About one-third of people who take Aranesp (darbepoetin alfa) may experience high blood pressure as a side effect. There are other serious risks with this medication, especially if you have certain types of cancer, so make sure your entire healthcare team knows your full medical history.
What is Aranesp (darbepoetin alfa)?
What is Aranesp (darbepoetin alfa) used for?
- Anemia due to chemotherapy
- Anemia due to chronic kidney disease (dialysis and non-dialysis)
How Aranesp (darbepoetin alfa) works
Aranesp (darbepoetin alfa) is an erythropoiesis-stimulating agent (ESA). It works similarly to a naturally-occurring hormone in our body (erythropoietin). Erythropoietin sends a signal to our body to make more red blood cells.
Drug facts
Side effects of Aranesp (darbepoetin alfa)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- High blood pressure (31%)
- Trouble breathing (17%)
- Swelling in the hands and legs (17%)
- Cough (12%)
Less Common Side Effects
- Rash
- Chest pain
- Dizziness when standing from a sitting lying position
Aranesp (darbepoetin alfa) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Seizures
- Heart attack: chest pain, stomach discomfort, sweating, nausea, dizziness
- Stroke: sudden numbness or weakness in the arm, leg, or face, confusion, trouble seeing, headache, difficulty walking
- Dangerously high blood pressure: nausea, vomiting, confusion, dizziness, blurry vision, anxiety
- Heart failure: tiredness, weakness, trouble breathing, swelling in the ankles and feet, chest pain
- Serious allergic reaction: swelling of the face or tongue, throat tightening, trouble breathing, welts, skin rash
- Serious skin reactions: fever, sore throat, tiredness, trouble swallowing, cough, body aches, rash, peeling or blistering skin
The following Aranesp (darbepoetin alfa) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Accumulation of pus
arm, back, or jaw pain
blurred vision
breathing problems (irregular, noisy, or trouble when resting)
chest pain, discomfort, tightness, or heaviness
chills
confusion
cough producing mucus
decrease in the amount of urine
dilated neck veins
dizziness, fainting, or lightheadedness
fast, slow, or irregular heartbeat
fatigue or tiredness (extreme or unusual)
headache
pain, tenderness, swelling, or warmth over the injection site
pounding in the ears
rapid breathing
rapid or pounding pulse
skin discoloration at the injection site
stomach pain
sunken eyes
sweating
swelling of the ankles, face, fingers, feet, hands, or lower legs
thirst
trouble with breathing
unconsciousness
vomiting
wrinkled skin
Less common
difficulty with speaking (slow speech or unable to speak)
double vision
seizures
trouble with thinking
trouble with walking
unable to move the arms, legs, or face muscles (including numbness and tingling)
Incidence not known
Blistering, peeling, or loosening of the skin
joint or muscle pain
red, irritated eyes
red skin lesions, often with a purple center
sores, ulcers, or white spots in mouth or on the lips
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
general feeling of discomfort or illness
lack or loss of strength
loss of appetite
muscle aches, pains, or stiffness
shivering
trouble with sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Aranesp (darbepoetin alfa)
Pros
- Long-lasting so it doesn't have to be injected as often as some similar medications
- Can be injected at home in certain situations and comes as a prefilled "SingleJect" syringe for easier administration
- Doesn't contain albumin, so it's less likely to cause an allergic reaction
Cons
- Can raise the risk of blood clots and other heart-related conditions
- No lower-cost generic available
- Only works if you have enough iron in your blood
- No proof that Aranesp (darbepoetin alfa) can improve quality of life, fatigue, or well-being
Pharmacist tips for Aranesp (darbepoetin alfa)
- Talk to your provider if you have a history of heart or blood clotting problems. ESA medications like Aranesp (darbepoetin alfa) can raise your risk of blood clots and lead to heart attacks or stroke. Report any chest pain, breathing problems, or confusion to your provider right away.
- Aranesp (darbepoetin alfa) can raise your blood pressure. Monitor your blood pressure as directed and take blood pressure-lowering medications as prescribed.
- Store Aranesp (darbepoetin alfa) in the refrigerator (not in the freezer). Keep it in its original carton to protect it from light. Don't shake it.
- Always inspect the medication before you prepare your injection. Make sure it's not cloudy, leaky, or containing any particles (solid chunks). If it has particles, is discolored, or foamy, don't use it. Instead, contact your provider or pharmacy about getting a replacement.
- Injection instructions will differ from person to person and some people on dialysis might have a port they can administer the medication through. Make sure you understand how to inject the medication properly before starting home injections. It's important to get the correct amount of medication.
- Throw away your needles, syringes, and leftover medication after each use. The vials and syringes are made for single-use and improper use can lead to serious infections.
Common questions about Aranesp (darbepoetin alfa)
No, Aranesp (darbepoetin alfa) isn't the same as Procrit (epoetin alfa), but they do belong to the same medication class and work well to treat certain anemias. A major difference is that Aranesp (darbepoetin alfa) lasts longer and doesn't need to be injected as often. While Aranesp (darbepoetin alfa) is approved for anemia caused by chemotherapy and chronic kidney disease, Procrit (epoetin alfa) is used in certain other conditions and can help reduce the need for blood transfusions after surgery.
After starting Aranesp (darbepoetin alfa), it will take time for you body to make new red blood cells. It can take 2-6 weeks for your hemoglobin to change. Your provider will order blood tests to check your blood cell count weekly, at least at the start of treatment. If your hemoglobin levels are still low after about a month of treatment, your provider might adjust your dose.
How long the side effects of Aranesp (darbepoetin alfa) last depends on what side effects you're experiencing and whether or not there are ways to manage them. For example, one of the most common side effect of Aranesp (darbepoetin alfa) is high blood pressure that's difficult to control. Your provider will check your blood pressure regularly throughout treatment and might recommend that you start blood pressure medications if needed. Another example is that Aranesp (darbepoetin alfa) can raise your risk for blood clots. This risk will be there as long as you're still receiving Aranesp (darbepoetin alfa) and as long as this medication stays in your body (up to 4 weeks, depending on your dose and medical condition). Your provider will try to minimize your risk for blood clots by making sure your hemoglobin stays within a safe level. Talk with your provider if you've questions about any particular side effect.
The manufacturer doesn't give clear guidance for how long Aranesp (darbepoetin alfa) can be left out of the refrigerator. According to the user guide, you should only take out Aranesp (darbepoetin alfa) from the refrigerator when you're ready to use it; don't try to save it to use at a later time. Make sure to only take out the vial or pre-filled syringe that you plan to use, and leave the rest in the refrigerator and protected from light. Talk with your provider or pharmacist if you've question about Aranesp (darbepoetin alfa) storage.
Aranesp (darbepoetin alfa) can be injected into the outer area of the upper arms, stomach, front of your middle thigh, and upper outer area of your butt. Don't inject the medication into areas that are tender, red, bruised, hard, or scarred. If you're on dialysis, your provider might instruct you to inject the medication into your special access port.
No, Aranesp (darbepoetin alfa) isn't chemotherapy. But it's sometimes prescribed for people who are receiving chemotherapy. This is because certain anticancer medications can cause low red blood cell count, so providers prescribe Aranesp (darbepoetin alfa) to help the body make more red blood cells.
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Risks and warnings for Aranesp (darbepoetin alfa)
Aranesp (darbepoetin alfa) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Higher risk of death and other serious events
- Risk factors: History of heart disease | Uncontrolled high blood pressure | High red blood cell level
Studies found that Aranesp (darbepoetin alfa) can raise the risk of death and serious heart conditions, such as a heart attack or stroke. The risk is higher in people with a history of heart-related conditions and those with higher levels of hemoglobin (a protein found in red blood cells). Make sure you have your labs drawn regularly so your provider can monitor your body's response.
Cancer survival and tumor growth
Aranesp (darbepoetin alfa) can lower the amount of blood transfusions needed, but can also lead to more tumor growth and overall shortened survival. To lower this risk, Aranesp (darbepoetin alfa) should only be used in certain situations and may not be a good option for people with certain curable cancers.
High blood pressure
Aranesp (darbepoetin alfa) can raise blood pressure and shouldn't be used in people who have uncontrolled high blood pressure. Aranesp (darbepoetin alfa) can be used once your blood pressure is controlled and it's important that you continue the medication and dietary changes that lowered your blood pressure. If your blood pressure becomes too high after starting Aranesp (darbepoetin alfa) your provider might pause the medication or lower your dose. They can also add more blood pressure-lowering medications.
Seizures in people with CKD
Aranesp (darbepoetin alfa) can raise the risk of having a seizure in people with CKD. Your provider will monitor this closely during the first few months. Contact your provider if you do have a seizure and report any pre-seizure symptoms such as a migraine or sensitivity to light or sound.
No response to Aranesp (darbepoetin alfa)
- Risk factors: Low iron levels | Bleeding | Infection | Inflammation
Sometimes Aranesp (darbepoetin alfa) doesn't work or stops working after a while. If your anemia doesn't respond to the medication, your provider will evaluate potential factors that might be the cause. One possible reason is having low iron levels, so it's important to take iron supplements if prescribed or directed.
Serious allergic reactions and skin reactions
Though rare, Aranesp (darbepoetin alfa) can cause serious allergic reactions or skin reactions (Stevens-Johnson Syndrome). Let your provider know right away if you experience symptoms such as trouble breathing, skin rash, welts, and peeling or blistering skin.
Aranesp (darbepoetin alfa) dosage
Carton| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 4 syringes of 100mcg/0.5ml | 1 carton | $2,978.41 | $2,978.41 |
| 4 syringes of 150mcg/0.3ml | 1 carton | $4,464.49 | $4,464.49 |
| 4 syringes of 25mcg/0.42ml | 1 carton | $749.29 | $749.29 |
| 4 syringes of 40mcg/0.4ml | 1 carton | $1,195.11 | $1,195.11 |
| 4 syringes of 60mcg/0.3ml | 1 carton | $1,789.55 | $1,789.55 |
| 4 vials of 100mcg/ml | 1 carton | $2,978.41 | $2,978.41 |
| 4 vials of 40mcg/ml | 1 carton | $1,195.11 | $1,195.11 |
| 4 vials of 60mcg/ml | 1 carton | $1,789.55 | $1,789.55 |
| 4 vials of 25mcg/ml | 1 carton | $748.12 | $748.12 |
| 4 syringes of 10mcg/0.4ml | 1 carton | $303.47 | $303.47 |
Syringe| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 200mcg/0.4ml | 1 syringe | $1,492.33 | $1,492.33 |
| 300mcg/0.6ml | 1 syringe | $2,235.37 | $2,235.37 |
| 500mcg/ml | 1 syringe | $3,721.45 | $3,721.45 |
| 100mcg/.5ml | 1 syringe | $749.29 | $749.29 |
| 25mcg/0.42ml | 1 syringe | $192.01 | $192.01 |
Vial| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 200mcg/ml | 3 vials | $4,464.49 | $1,488.16 |
Typical dosage for Aranesp (darbepoetin alfa)
Your provider will determine your dose based on factors such as your body weight, age, and hemoglobin level.
- Anemia due to chemotherapy
- The typical starting dose is 2.25 mcg/kg injected under the skin every week, or 500 mcg every 3 weeks until chemotherapy is finished.
- Anemia due to CKD
- Adults (not receiving dialysis): The typical recommended starting dose is 0.45 mcg/kg body weight injected under the skin or through the veins once every 4 weeks.
- Adults (receiving dialysis): The typical recommended starting dose is 0.45 mcg/kg body weight injected under the skin or through the veins once a week, or 0.75 mcg/kg injected once every 2 weeks.
- Children: The typical recommended starting dose is 0.45 mcg/kg body weight injected under the skin or through the veins once a week. If not receiving dialysis, the usual starting dose is 0.75 mcg/kg injected once every 2 weeks.
Interactions between Aranesp (darbepoetin alfa) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
How much does Aranesp (darbepoetin alfa) cost?
$192.01
Aranesp (darbepoetin alfa) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Aranesp (darbepoetin alfa) will not be safe for you to take.
- High blood pressure that's not controlled
- Pure red cell aplasia (PRCA) that begins after treatment with ESAs
What are alternatives to Aranesp (darbepoetin alfa)?
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