Aranesp (Darbepoetin Alfa)

Aranesp can increase the risk of serious cardiovascular events, thromboembolic events, and stroke. Use of this medication can also elevate mortality rates and tumor progression in patients with certain cancers. The drug should be administered under the supervision of healthcare professionals with careful monitoring of hemoglobin levels.

Aranesp should not be used if you are allergic to darbepoetin alfa or if you have:

• High blood pressure that is untreated or uncontrolled. If you are taking any blood thinners (such as Eliquis and Xarelto, be sure to inform your doctor). 
• Aranesp or Epoetin Alfa can cause pure red cell aplasia (PRCA, a type of anemia).

Some people who receive radiation and Aranesp may experience a shorter remission time. Darbepoetin alfa may also shorten survival times for certain types of cancer, including breast cancer, non-small cell lung cancer, head and neck cancer, cervical cancer, and lymphoid cancer. It would help if you discussed the risks and benefits of using this medication with your doctor.

Describe to your doctor any of the following:

• heart disease, high blood pressure;
• kidney disease (or if you are on dialysis);
• diabetes
• a stroke, heart attack, or blood clot;
• a seizure; or
• a latex allergy.

Your doctor will direct you to inject this medication under the skin or into a vein. This medication should be injected into the veins of patients undergoing hemodialysis.

You should follow your healthcare provider’s preparation and usage instructions if you use this medication at home.

Mixing this medication with other drugs or IV solutions is not recommended.

Make sure this product does not contain any particles or discolorations before using. Do not use the liquid if either of these are present.

Clean the injection site with rubbing alcohol before each dose if you are injecting this medication under the skin. Injection sites should be changed every time to reduce the risk of skin injury.

Depending on your medical condition, weight, and response to treatment, you will receive the appropriate dosage. It is important to have blood tests done often to monitor the effectiveness of this medication and to determine the proper dose for you. For more information, consult your doctor.

To get the most benefit from this medication, take it regularly. Use it according to the instructions on the same day of the week each week to make it easier for you to remember.

Take this drug only as prescribed by your doctor, and don’t increase the dose or take it more frequently or longer than recommended. There will be no improvement in your condition, and you will have a greater chance of contracting side effects.

Your red blood cell count may increase within 2 to 6 weeks. Continuing to have symptoms or worsening symptoms should be reported to your doctor.

There may be other side effects not listed here.

You may experience headaches, body aches, diarrhea, coughing, stomach/abdominal pain, or injection site pain. Tell your doctor or pharmacist immediately if these effects persist or worsen.

It is important to remember that your doctor prescribed this medication because they judged that the benefit to you outweighs the side effects. There are a few severe side effects associated with this medication.

Especially in patients with long-term kidney failure, darbepoetin alfa may cause or worsen high blood pressure. In the first three months after treatment, red blood cells can increase too rapidly, causing this effect.

Before beginning treatment with this medication, your blood pressure should be well controlled. It is essential to check your blood pressure regularly. Get your blood pressure checked by your doctor if you do not know how to do it. Follow your doctor’s instructions about diet changes and starting or adjusting your high blood pressure medication if high blood pressure develops or worsens. Strokes, heart attacks, and further kidney problems can be prevented by lowering high blood pressure. You can avoid this side effect by keeping all lab appointments regularly to have your red blood cell count/hemoglobin level checked.

Your body may develop antibodies to this medication after some time, so it may suddenly stop working well after some time. It is possible to create severe anemia as a result. Symptoms of anemia (such as feeling tired, lacking energy, pale skin, and shortness of breath) should be reported to your doctor immediately.

You should tell your doctor if you experience any severe side effects, including shortness of breath, swelling ankles/feet, unusual fatigue, and unusual/sudden weight gain).

In the event of any severe side effects, such as seizures, seek medical attention right away.

There is a rare risk of complications from blood clots from this medication (such as heart attack, stroke, and blood clots in the legs or lungs). It is essential to seek medical assistance if you are experiencing shortness of breath, rapid breathing, chest/jaw/left arm pain, unusual sweating, confusion, sudden dizziness/fainting, groin/calf pain/swelling/warmth, sudden/severe headaches, trouble speaking, weakness on one side of the body, sudden vision changes, or blood clots in the vascular access point of your hemodialysis machine.

Rarely does this drug cause a severe allergic reaction. Be sure to seek medical attention if you experience any symptoms of a severe allergic reaction: rash, itching/swelling (especially of the face/mouth/throat), severe dizziness, or difficulty breathing.

If you are experiencing side effects, consult your doctor. If you have a side effect, contact the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch for more information.

Your medications might work differently or have serious side effects if they interact with each other. There may be other drug interactions not mentioned on this webpage. Share a list of all the products you use (including prescription and nonprescription drugs and herbal products) with your doctor. You should always seek your doctor’s approval before starting, stopping, or changing medications.

It is best to store the medication in the refrigerator between 36 and 46 degrees Fahrenheit (2-8 degrees Celsius). Keep away from freezing. Light should be kept away from it. Until ready to use, keep the medication in its original carton. Before using the medication, let it come to room temperature. Immediately discard any unused medication after each dose. Do not flush medications down the toilet or pour them into a drain unless instructed. Keep all medications away from children and pets. If this product has expired or is no longer needed, properly dispose of it.

It is difficult to determine whether Aranesp use during pregnancy is associated with significant congenital disabilities or miscarriages based on the limited information available. At doses approximating the clinically recommended starting dose, Aranesp increased early post-implantation loss in animal studies. When prescribing Aranesp to a pregnant woman, consider the potential benefits and risks to the fetus. For the indicated population, there is no information on the estimated background risk of miscarriage and significant birth defects. There is a background risk of birth defects, loss, or other adverse outcomes in all pregnancies. Clinically recognized pregnancies in the U.S. general population are estimated to carry background risks of major birth defects and miscarriage of 2-4% and 15- 20%, respectively.

Aranesp can be rather expensive in the United States without proper healthcare insurance. Not all insurance covers medications under Aranesp’s category. The out-of-pocket for this medication can be hefty.

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