Darbepoetin Alfa (Aranesp®)
Pronounced: DAR-be-POE-e-tin AL-fa
Classification: Erythropoiesis-Stimulating Agent
About: Darbepoetin Alfa (Aranesp®)
Darbepoetin alfa works by stimulating red blood cell production in the bone marrow. In our bodies, a decrease in the number of red blood cells or hemoglobin level causes the kidneys to release a protein called erythropoietin, which in turn stimulates the bone marrow to make more red blood cells. Darbepoetin alfa is a man-made version of erythropoietin, which can also stimulate red blood cell production.
Darbepoetin alfa is not a cancer treatment, but a supportive care medicine. This means it is used to counteract the effects of cancer and its treatments. This medication can also be used to treat anemia caused by chronic kidney disease.
How to Take Darbepoetin Alfa
Darbepoetin alfa is most often given as a subcutaneous injection (given under the skin), but can also be given intravenously (into a vein, or IV). The actual dose is based on your body size and will be determined by your healthcare provider. You may receive darbepoetin alfa at your treatment site or self-administer at home.
Storage and Handling
Do not shake or freeze darbepoetin alfa. Store vials in the refrigerator and protect them from light. Keep the vials out of the reach of children. Do not reuse single dose vials, syringes or needles. Do not throw the vials, syringes, or needles in the household trash. Dispose of all used needles and syringes in a puncture-proof disposable container with a lid. The FDA provides further information about the disposal of vials, syringes and needles.
Where do I get this medication?
Depending on your insurance coverage, this medication may be supplied by a home infusion company or through a specialty pharmacy. If covered through your pharmacy plan, your oncology team will work with your prescription drug plan to identify an in-network specialty pharmacy for distribution of this medication and shipment directly to your home.
This medication may be covered under your major medical plan or your prescription drug plan. Patient assistance may be available to qualifying individuals depending upon prescription drug coverage. Co-pay cards, which reduce the patient co-pay responsibility for eligible commercially (non-government sponsored) insured patients, may also be available. Your care team can help you find these resources, if they are available.
Possible Side Effects
There are a number of things you can do to manage the side effects of darbepoetin alfa. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:
Blood Clots, Heart Attack and Stroke
This medication can increase the risk of blood clots, stroke and heart attack. If you experience symptoms of these problems, you should contact your healthcare provider immediately or go to an emergency room. Symptoms can include: swelling, redness or pain in an extremity, a cool or pale arm or leg, chest pain or pressure, pain in your arm, back, neck or jaw, shortness of breath, numbness or weakness on one side of the body, trouble talking, confusion or mental status changes.
Risk of Tumor Progression
Studies of this medication have found that it may make some tumors grow faster, or result in people dying sooner from their cancer. Because of this, the lowest dose possible will be administered to avoid a red blood cell transfusion. This medication should only be given to patients whose cancer treatment is causing anemia. It should be discontinued following the completion of the course of chemotherapy. You will be monitored for tumor progression during treatment.
High Blood Pressure
This medication can cause high blood pressure (hypertension). Patients should have their blood pressure checked regularly during therapy. Any hypertension should be treated appropriately. If hypertension cannot be controlled, the medication may be stopped. Report any headache or dizziness to your provider.
In some cases, patients can have an allergic reaction to this medication. Signs of a reaction can include: shortness of breath or difficulty breathing, chest pain, rash, flushing or itching or a decrease in blood pressure. If you notice any changes in how you feel during the injection/infusion, let your nurse know immediately.
Development of Antibodies
A very rare side effect is the possibility that your body may make antibodies against erythropoietin. These antibodies can block or reduce your body's ability to make red blood cells, causing severe anemia. Symptoms of severe anemia include worsening tiredness, lack of energy, and/or shortness of breath. If you experience these symptoms, call your healthcare provider.
This medication can increase your risk for seizures, especially in patients with a history of seizures or epilepsy. Be sure your healthcare team is aware of any anti-seizure medications you are taking. Report any seizure activity to your healthcare team immediately.
Darbepoetin alpha can cause skin problems, including Stevens Johnson Syndrome (a rare, but serious allergic reaction that affects the skin and mucous membranes). It typically starts as a rash or painful blisters and can progress to serious damage to the skin and in some cases, death. It is important that you report any rash to your oncology care team immediately. Signs and symptoms of severe skin reactions may also include a rash with itching, blisters, sores, peeling or areas of skin coming off. If you have any signs or symptoms of a severe skin reaction, stop using this medication and call your healthcare provider or get medical help right away.
Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. If you do become pregnant while taking this medication, contact your care team immediately. You should consult with your healthcare team before breastfeeding while receiving this medication.