The drug is a medicine from the group of glycoproteins. Its cost starts from two thousand nine hundred rubles. In our article, we will consider cheap analogues of "Epocrine" and instructions for use.
Composition and pharmacological effects of the drug
One ampoule contains an active component called epoetin alpha, which is a recombinant human erythropoietin. Its mass fraction is 1000 IU, 2000 IU, 4000 IU, 10000 IU.
This drug activates mitosis along with the maturation of red blood cells from the cells that are the precursors of the red blood cell series. In its composition, immunological and biological properties, epoetin alpha is completely identical to natural human erythropoietin. The withdrawal of this component leads to an increase in hematocrit and hemoglobin, as well as to an improvement in blood supply and heart function.
In particular, the pronounced effect of the use of epoetin alpha is observed in case of anemia due to chronic kidney failure. In extremely rare cases, with prolonged use of epoetin for the treatment of anemic conditions, the formation of neutralizing antibodies to erythropoietin with the subsequent development of partial red cell aplasia can be noted.
Pharmacokinetics
After entering, the concentration of the active component in the blood increases rather slowly. The maximum concentration is observed after twelve hours. Bioavailability ranges from twenty-five to thirty-nine percent.
Indications
The drug "Epocrine" is used in a number of the following cases:
- This medication is primarily used for anemia, as well as for the treatment of patients suffering from chronic kidney failure.
- For the prevention and treatment of anemia among patients with neoplasms that have arisen as a result of performing antitumor treatment.
- As part of the prevention and treatment of anemia, which is caused by the use of "Zidovudine" among HIV-infected patients.
- For the prevention and treatment of anemia in patients suffering from myeloma, and in addition, non-Hodgkin’s lymphoma of low malignancy.
- In the presence of chronic lymphocytic leukemia.
- For the treatment of patients with rheumatoid arthritis.
- As part of the prevention and treatment of anemia among premature babies born with low birth weight.
- In order to reduce the volume of transfused blood with extensive surgery and acute blood loss.
Contraindications
This medicine is contraindicated in the following cases:
- In the presence of partial red cell aplasia after previous treatment with any erythropoietins.
- In the event of uncontrolled arterial hypertension.
- Against the background of the impossibility of carrying out adequate anticoagulant treatment.
- Within one month after an experienced myocardial infarction.
- Against the background of unstable angina pectoris.
- In the case of an increased risk of deep vein thrombosis and against the background of the occurrence of thromboembolism during a pre-dose blood collection program immediately before surgery.
- With porphyria and hypersensitivity to the components of the drug.
With great care, the drug should be prescribed to patients suffering from thrombosis, malignant tumors, and in addition, sickle cell anemia. Caution should also be taken in patients with moderate anemia, epilepsy, and chronic liver failure.
In the instructions for use, analogues of "Epocrine" are not indicated.
Drug dosage
When treating anemia in patients suffering from kidney failure, Epocrine is administered intravenously. And for those patients who are on hemodialysis, this is done through an arteriovenous shunt. In case of a change in the method of administration, the drug is used in the previous dosage, and then it can be adjusted if necessary. Treatment with the Epocrine drug includes the following two stages:
- The first stage is the correction stage. When you enter the drug "Epocrine", the initial dosage is 30 IU per kilogram three times a week. With intravenous administration, the initial dosage is 50 IU / kg. The correction period continues until the patient reaches the most optimal hemoglobin level (from 100 to 120 grams per liter in adults and from 95 to 110 in small patients). The hematocrit should be between thirty and thirty-five percent. These indicators need to be monitored weekly.
- Stage of maintenance treatment. To support hematocrit at the level of thirty-five percent, the dosage of the drug used at the adjustment stage should subsequently be reduced by one and a half times. Then, the supporting dosage of "Epocrine" is selected individually, taking into account the dynamics of hemoglobin and hematocrit. After stabilization of the hematological index, a quick transition to the use of the drug once every two weeks is possible. Analogs of "Epocrine" 1000 IU can be purchased at any pharmacy.
Instructions for the use of "Epocrine" for the treatment of anemia
When treating anemia in patients with a solid tumor, it is recommended to determine the endogenous erythropoietin index before using the medicine. If the concentration of serum erythropoietin is less than 200 IU / ml, the initial dosage of the drug with intramuscular use is 150 IU / kg. With the drip, the initial dose of the drug is reduced to 100 IU / kg. If there is no response, a dose increase of up to 300 IU / kg is possible. A subsequent increase in dosage seems to be simply impractical. It is not recommended to prescribe "Epocrine" for patients in whom the serum content of endogenous erythropoietin is more than 200 IU / ml.
For the treatment of anemia caused by the use of Zidovudine in patients with HIV infection, intramuscular use of the drug at a dosage of 150 IU / kg three times a week is considered effective provided that the endogenous serum erythropoietin is less than 500 IU / ml and the dosage is “ Zidovudine "- less than 4 grams per week. With drip, the dose of the medication in question is reduced by one and a half times.
The expediency of using Epocrine for the treatment of anemia in patients suffering from diseases such as myeloma, non-Hodgkin’s lymphomas of low malignancy and chronic lymphocytic leukemia is due to incorrect synthesis of endogenous erythropoietin due to the development of anemia. If the hemoglobin content is less than 100 gram / l and erythropoietin is below 100 IU / l, the Epocrine drug is administered at an initial dosage of 100 IU / kg three times a week.
Laboratory monitoring of hemodynamic parameters is carried out weekly. If necessary, the dosage of the drug is adjusted upward or downward every four weeks. In the event that, against the background of reaching a weekly dosage of 600 IU / kg, an increase in the amount of hemoglobin is not observed, then "Epocrine" is canceled, since its further use is simply ineffective.
The feasibility of using Epocrine for the treatment of anemia among patients with rheumatoid arthritis is explained by the fact that with this pathology, suppression of the synthesis of endogenous erythropoietin under the influence of an increased concentration of inflammatory cytokine is observed. The drug "Epocrine" in this case is administered by the drip method at a dosage of 50 IU / kg three times a week. In the case of an increase in hemoglobin content of less than 10 grams after four weeks of therapy, the dosage of the drug increases to 200 IU / kg three times a week. A further increase in dosing is simply not practical.
For the treatment of anemia in premature babies born with low birth weight, Epocrine is administered dropwise at a dose of 200 IU / kg three times a week starting from the sixth day of life until the target hemoglobin and hematocrit are reached, but not more than six weeks.
In order to prevent anemia with extensive surgery and acute blood loss, the Epocrine medicine is administered intramuscularly three times a week at a dosage of 150 IU / kg until the hemoglobin and hematocrit levels are completely normalized.
Next, find out what adverse reactions can occur during treatment with "Epocrine". Analogs will be considered below.
Side effects
When using this medication to treat patients, the following side effects are possible:
- The appearance of flu-like syndrome. Against this background, dizziness may be noted at the beginning of treatment along with drowsiness, fever and headaches.
- Perhaps the development of a dosage-dependent arterial hypertension in combination with a worsening of the course of this disease. In some cases, a hypertensive crisis is not excluded, along with a sharp increase in pressure with symptoms of encephalopathy (while there are headaches and confusion). Generalized clonic convulsions are also possible.
- A decrease in the concentration of ferritin is not excluded, and in addition, hyperphosphatemia and hyperkalemia.
- The appearance of allergic reactions is likely. For example, a mild rash may be observed along with hives, itching, angioedema, eczema, and so on.
- In the framework of local reactions, hyperemia is possible along with burning, mild or moderate pain at the injection site.
- Among other adverse reactions, thrombocytosis can be noted along with a tendency to the appearance of arterial hypotension. Complications associated with respiratory failure are also possible. Very rarely, an exacerbation of porphyria can be noted.
Analogues of the drug "Epocrine" most often provoke the same side effects.
Overdose
In case of an overdose, an increase in adverse reactions is possible. In this case, antihypertensive drugs are prescribed as part of the treatment. If the latter are ineffective, the Epocrine preparation should be definitely canceled. In the case of a high level of hemoglobin and hematocrit, bloodletting is prescribed.
Cheap analogues of "Epocrine"
The drug currently has the following cheap analogues:
- The drug "Aprin" will cost consumers 1,500 rubles. This medicine is taken for anemia, and in addition, for the treatment of kidney failure and peritoneal dialysis. This analogue of “Epocrine” is prescribed for HIV-infected patients, as well as for non-myeloid tumors, including against the background of cytostatic treatment.
- The medicine "Eralfon" costs about 1600 rubles. This cheap analogue of "Epocrine" is also used if the patient has anemia. The rest of the testimony coincides with the previous counterpart "Aeropin".
- The analogue of "Epocrine" "Eprex" costs about 1300 rubles. It is prescribed for anemia, peritoneal dialysis, for non-myeloid tumors and so on.
Binocrit
It is the Russian analogue of "Epocrine". The drug is released in the form of a solution for injection.
It is indicated for the symptomatic treatment of anemia, which is associated with chronic renal failure (CRF) with and without dialysis, in adults and children from 1 year. This is confirmed by the instruction to the analogue of "Epocrine".
Medication is contraindicated:
- with increased sensitivity to the active and auxiliary substances in the composition of the drug;
- partial red cell aplasia (PKCA) that arose after treatment with erythropoietin;
- uncontrolled arterial hypertension;
- patients who cannot receive effective therapy for the prevention of thrombosis;
- myocardial infarction or stroke that occurred within 1 month before the planned therapy; unstable angina pectoris; patients with a high risk of deep vein thrombosis and a history of thromboembolic disease;
- severe damage to the coronary, peripheral, carotid arteries, as well as cerebral vessels.
Caution is required to take the drug for malignant neoplasms, epileptic syndrome (including a history), chronic renal and hepatic insufficiency, thrombocytosis, thrombosis (history), acute blood loss, sickle-cell anemia, hemolytic anemia, glandular B12 or conditions.
"Rapoetin-SP"
It is considered an analogue of "Epocrine" 2000 IU. The active substance is epoetin alpha.
Indicated for anemia: in chronic renal failure, HIV infection during treatment with Zidovudine, hemodialysis, cytostatic chemotherapy, in premature newborns; preparing patients for surgery in which massive blood loss is possible.
Contraindicated in case of hypersensitivity, uncontrolled arterial hypertension, iron deficiency conditions, pregnancy, breastfeeding.
The Epocrine 2000 IU analogue often provokes hypertension, headache, fatigue, asthenia, dizziness, arthralgia, chest pain, nausea, vomiting, diarrhea, swelling, thrombophilia, cramps, and a skin reaction at the injection site.
Do not use in combination with solutions of other agents. The hematocrit should be regularly monitored to prevent a decrease in effectiveness and the development of resistance.
Ipidacrine: an analogue or not?
Is "Epocrine" an analogue of "Ipidacrine"? The drugs in question have different active substances, so they are only distant substitutes for each other. In "Epocrine" the active substance is a component called epoetin alpha, and in "Epidacrine" it is the epidacrine of the same name with the name of the drug.
The drug "Ipidacrine" acts as a reversible cholinesterase inhibitor, it can interfere with the hydrolysis of acetylcholine, lengthening its effect. This medication blocks the potassium channels of the membranes, which directly contributes to their depolarization. The drug under consideration stimulates synaptic transmission in the nerve and muscle ends, and in addition, the effect on acetylcholine smooth muscle is enhanced.
This medicine restores nervous and muscle transmission along with stimulation in the nervous system. In the process of its use in patients, the tone increases along with the contractility of the smooth muscles of the organs, the secretion of the salivary glands increases along with the contractile activity of the myometrium and the tone of the skeletal muscles. The drug "Ipidacrine" produces a stimulating effect on the nervous system in combination with a separate manifestation of sedation. The use of this medication improves memory and learning. Preparations containing the active substance called ipidacrine include Axamon, along with Amiridine, Ipigrix and Neuromidine.
Reviews about "Epocrine" and analogues
About the drug "Epocrine" people respond differently in their comments. It is often noted that this drug effectively helps with anemia.
Patients, as well as doctors, praise the drug’s analogues for its effectiveness and assistance in the treatment of non-Hodgkin’s lymphoma of low malignancy and chronic lymphocytic leukemia. Among other things, the comments on these drugs report on the feasibility of their use in acute blood loss.
As for negative reviews, most often we are talking about the high cost of "Epocrine" and similar drugs, and in addition, the frequent occurrence of certain adverse reactions. For example, people complain of headaches, cramps, and flushing during treatment.
We reviewed the description of "Epocrine" and analogues.