Espogen Dosage/Direction for Use

Chronic renal failure (CRF) patients: Starting dose of Espogen therapy is 50U/kg, 3 times per week by slow s.c or i.v. injection over 1-2 minutes. Further dose increase should be determined according to initial response. Dose may be increased by 25U/kg every four weeks, if needed. Also, when the increasing rate of hemoglobin is more than 2g/dl after 50U/kg is administered, dose should be adjusted by omitting one of the three doses per week. The target range of the treatment is about 10g/dl as hemoglobin concentration (30% as hematocrit). If therapeutic effect of Espogen in anemia is achieved, 25-50U/kg as a maintenance dose is generally administered 2-3 times per week. It is known that the target range of hemoglobin is 10-12g/dl. The patients who started the therapy at a low level of hemoglobin (6g/dl) need higher maintenance dose than those who didn't start the therapy at less than 8g/dl of hemoglobin and dose should be adjusted depending on age. In any case, maximum dose should not exceed 200U/kg in a single day 3 times per week. Iron stores should be evaluated prior to or during the therapy and iron should be administered, if necessary. In case of aluminum poisoning or infectious disease patients, response may be diminished. Even in case of patients not requiring dialysis, maintenance dose should be determined depending on the severity of anemic symptoms or age, however, it has been reported that 36-38% of hematocrit was sustained for more than 6 months.
Cancer patients on chemotherapy:The recommended initial dose of Espogen is 150 U/kg as a subcutaneous injection three times a week. The dose of Espogen can be increased up to 300 U/kg three times a week. If the hematocrit exceeds 40%, the dose of Espogen should be withheld until it falls to 36%. The dose of Espogen should be reduced by 25% when treatment is resumed or the dose is titrated to maintain the desire hematocrit. If the initial dose of Espogen includes a very rapid hematocrit response, the dose should be reduced. The hematocrit should be monitored on a weekly basis until hematocrit becomes stable.
HIV-Infected patients: The recommended starting dose of Espogen is 100U/kg as an intravenous or subcutaneous injection three times a week for 8 weeks. The dose can be increased by 50 to 100U/kg three times a week. If patients have not responded satisfactorily to a 300U/kg three times a week, it is unlikely that they will respond to higher doses. If the hematocrit exceeds 40%, the dose of Espogen should be withheld until it falls to 36%. The dose of Espogen should be reduced by 25% when treatment is resumed or the dose is titrated to maintain to desire hematocrit.