Adults

Dosage varies by indication and patient response. For CKD-associated anemia, initial dose typically 50 IU/kg three times weekly IV or SC, adjusted to maintain target Hb (10-12 g/dL). Maintenance doses can be given once weekly or less frequently. For chemotherapy-induced anemia, 150-300 IU/kg three times weekly or 40,000-60,000 IU once weekly SC.

Elderly

No specific dosage adjustment based solely on age; however, monitor for comorbidities and concomitant medications. Start with the lowest effective dose and adjust as needed.

Renal_impairment

Primary indication. Dosage is individualized based on hemoglobin levels and patient response. Regular monitoring of Hb and iron status is crucial.

Onset

Erythroid response (reticulocytosis) seen within 7-10 days, significant increase in hemoglobin typically within 2-6 weeks.

Excretion

Mainly excreted by the kidneys (small amount of intact drug), but mostly degraded and eliminated.

Half life

IV: Approximately 4-13 hours; SC: Approximately 13-28 hours.

Absorption

Subcutaneous (SC) administration leads to sustained absorption over several hours; Intravenous (IV) administration provides immediate and complete bioavailability.

Metabolism

Primarily catabolized in the liver and bone marrow, and by erythroid progenitor cells.

Iron Supplements

Often co-administered to ensure adequate iron stores for optimal erythropoietic response. Epoetin beta is less effective without sufficient iron.

Other Erythropoietic Agents

Should not be used concurrently with other ESAs.