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Care During Chemotherapy and Beyond

Darbepoetin Alfa

Generic Name: Darbepoetin Alfa

Trade Name: AranespĀ®

Aranesp is the trade name for darbepoetin alfa. In some cases, health care professionals may use the trade name aranesp when referring to the generic drug name darbepoetin alfa.

Drug Type: Darbepoetin alfa is a biologic response modifier. It is an erythropoiesis stimulating protein. (For more detail, see "How this drug works" section below).

What Darbepoetin Alfa is Used For:

  • Darbepoetin alfa is a support medication. It does not treat cancer.
  • Anemia associated with chronic kidney disease (CKD).
  • Anemia is caused by chemotherapy cancer treatment.
  • Symptomatic anemia associated with myelodysplastic syndromes (MDS).

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Darbepoetin Alfa is Given:

  • This medication may be given by subcutaneous (layer of tissue between the skin and the muscle) injection into the arm, abdomen or thigh.
  • This medication may also be given by infusion into a vein (intravenously, IV).
  • The amount of darbepoetin alfa that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.

Side effects of Darbepoetin Alfa:

Important things to remember about the side effects of darbepoetin alfa:

  • Most people do not experience all of the side effects listed.
  • Darbepoetin Alfa side effects are often predictable in terms of their onset and duration.
  • Darbepoetin Alfa side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent side effects.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
  • Side effects of darbepoetin alfa may also be attributed to the cancer and/or chemotherapy treatment.

The following side effects are common (occurring in greater than 30%) for patients taking darbepoetin alfa:

These side effects are less common side effects (occurring in about 10-29%) of patients receiving darbepoetin alfa:

Rare but serious side effects associated with darbepoetin alfa is increase of serious heart complications, heart attack, stroke, blood clots and death when given to try to increase the hemoglobin in your blood. Other rare but serious side effects are a shortened lifespan and the potential for the cancer to get worse or spread. Health care providers will us the lowest dose of darbepoetin alfa needed to avoid giving blood transfusions.

Due to the potential risks associated with darbepoetin alfa therapy, healthcare providers will need to discuss the risks and benefits of using darbepoetin alfa with the patient. Patients will need to help complete an acknowledgement form with their healthcare provider that states the risks and benefits of using darbepoetin alfa has been explained to them.

It is important patients report any side-effects they experience to their healthcare provider immediately. Patients will need to have their blood pressure monitored closely as well as provide blood samples so tests can be done to make sure it is safe to continue using darbepoetin alfa.

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Tremors or seizures
  • Difficulty breathing
  • Chest pain

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Nausea (interferes with ability to eat and unrelieved with prescribed medication).
  • Diarrhea (4-6 episodes in a 24-hour period).
  • Swelling of face, hands, feet, arms or legs.
  • Extreme fatigue (unable to carry on self-care activities).
  • Swelling, redness and/or pain in one leg or arm and not the other.

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

  • Before starting darbepoetin alfa treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
  • Darbopoetin alfa should be used with caution in people with high blood pressure. The manufacturer suggests that darbepoetin alfa should not be used in people with uncontrolled high blood pressure.
  • Use with caution in patients with history of seizures as darbepoetin alfa increases their risk of having a seizure.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus).
  • Prior to treatment, correct or exclude deficiencies of iron, vitamin B12, and/or folate, as well as other factors that may impair erythropoiesis (inflammatory conditions, infections, bleeding).
  • Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • It is not known whether darbepoetin alfa is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when darbepoetin alfa is given to a nursing woman.

Dabepoetin Alfa Self-Care Tips:

  • The manufacturer suggests that iron supplements may be helpful while taking darbepoetin alfa. However, you should consult with your doctor before starting this therapy.
  • You may experience some nausea and vomiting within days of receiving this drug, but small frequent meals, chewing hum, lozenges, and good mouth care may help.
  • Avoid contact sports or activities that could cause injury.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and testing:

You will be checked regularly by your doctor while you are taking darbepoetin alfa, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) will also be ordered by your doctor. Your blood pressure will be checked regularly.

How Darbepoetin Alfa Works:

Colon-Stimulating Factors:

In the body's bone marrow (the soft, sponge-like material found inside the bones) blood cells are produced. There are three major types of blood cells; white blood cells, which fight infection; red blood cells, which carry oxygen to and remove waste products from organs and tissues; and platelets, which enable the blood to clot. Cancer treatments such as chemotherapy and radiation therapy can effect cells which put a person at risk for developing infections, anemia and bleeding problems. Colony-stimulating factors are substances that stimulate the production of blood cells and promote their ability to function. They do not directly affect tumors but through their role in stimulating blood cells they can be helpful as support of the person's immune system during cancer treatment.

Darbepoetin alfa is a man-made erythropoiesis protein, similar to a natural substance in your body called erythropoietin (e-rith-ro-poy-e-tin), which is produced by the kidneys. Erythropoietin is then carried through the bloodstream to the bone marrow to make more red blood cells. Darbepoetin alfa acts like this natural substance, which during chemotherapy and in patients with cancer cannot always stimulate enough red blood cell production. Patients are anemic from multiple causes including anemia of chronic disease.

Hemoglobin is the iron-containing substance in red blood cells that delivers oxygen throughout the body. The normal hemoglobin range is approximately 12 to 18 g/dl, and varies according to age and gender. Doctors may prescribe darbepoetin alfa to chemotherapy patients whose hemoglobin levels have fallen below normal levels.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

References:

Aranesp (Darbepoetin Alfa) [package insert on Internet]. Thousand Oaks (CA): Amgen Inc. 2015 July [cited 2016 Jan 17]. Available from: http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0fd36cb9-c4f6-4167-93c9-8530865db3f9#_5_7_Pure_Red

Darbepoetin Alfa. Lexicomp Online [updated 2013; cited 2016 Jan 17]. Lexi-Drugs. Hudson, Ohio. Lexi-Comp, Inc.; January 17, 2016.

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