IT IS GIVEN BY S/C OR IV INJECTION IN AN INITIAL DOSE OF 450 NANOGRAMS/KG ONCE WEEKLY, AS A SINGLE INJECTION. IN PATIENTS ON HAEMODIALYSIS, THE INTRAVENOUS ROUTE IS RECOMMENDED TO REDUCE THE RISK OF DEVELOPING NEUTRALISING ANTIBODIES AND PURE RED CELL APLASIA. THE DOSE SHOULD BE ADJUSTED AT INTERVALS OF NOT LESS THAN 4 WEEKS, ACCORDING TO RESPONSE, UNTIL THE TARGET HAEMOGLOBIN CONCENTRATION IS ACHIEVED.
IN GENERAL, ADJUSTMENTS ARE MADE BY INCREASING OR DECREASING THE DOSE BY ABOUT 25%. MAINTENANCE DOSES MAY THEN BE CONTINUED ONCE WEEKLY. PATIENTS MAY BE CONVERTED FROM WEEKLY DOSES TO ONCE EVERY 2 WEEKS, AND SHOULD RECEIVE A DOSE THAT IS EQUAL TO TWICE THE DOSE THAT HAD BEEN GIVEN ONCE WEEKLY. ALTERNATIVELY, FOR PATIENTS WHO ARE NOT ON DIALYSIS, AN INITIAL DOSE OF 750 NANOGRAMS/KG SUBCUTANEOUSLY ONCE EVERY 2 WEEKS MAY BE USED, FOLLOWED BY DOSE ADJUSTMENT. WHEN THE TARGET HAEMOGLOBIN CONCENTRATION IS ACHIEVED, A MAINTENANCE DOSE MAY BE GIVEN ONCE A MONTH; THIS IS EQUAL TO TWICE THE DOSE THAT HAD BEEN GIVEN ONCE EVERY 2 WEEKS.
FOR ANAEMIA IN CHEMOTHERAPY PATIENTS WITH NON-MYELOID MALIGNANCIES :
IT IS GIVEN S/C IN AN INITIAL DOSE OF 6.75 MICROGRAMS/KG ONCE EVERY 3 WEEKS; IF THE RESPONSE IS INADEQUATE AFTER 9 WEEKS, FURTHER THERAPY WITH DARBEPOETIN ALFA MAY NOT BE EFFECTIVE. ALTERNATIVELY, IT MAY BE GIVEN IN AN INITIAL DOSE OF 2.25 MICROGRAMS/KG ONCE WEEKLY. IF THE RESPONSE IS INADEQUATE AFTER 4 TO 6 WEEKS, THE DOSE MAY BE INCREASED TO 4.5 MICROGRAMS/KG ONCE WEEKLY, AND CONTINUED UNTIL APPROXIMATELY 4 WEEKS AFTER THE END OF CHEMOTHERAPY. HOWEVER, IF THE RESPONSE IS STILL INADEQUATE 4 WEEKS AFTER DOUBLING THE DOSE, FURTHER THERAPY WITH DARBEPOETIN ALFA MAY NOT BE EFFECTIVE.