Nipotin
Generic Name
nipotin-4000-iu-injection
Manufacturer
Reputable Pharmaceutical Company
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nipotin 4000 iu injection | ৳ 1,900.00 | N/A |
Description
Overview of the medicine
Nipotin-4000 IU Injection is an erythropoiesis-stimulating agent (ESA) containing Epoetin alfa. It is used to treat anemia caused by chronic kidney disease, chemotherapy for certain types of cancer, or in certain surgical procedures to reduce the need for blood transfusions. It works by stimulating the bone marrow to produce red blood cells.
Uses & Indications
Dosage
Adults
Dosage varies significantly based on indication, patient weight, and hemoglobin levels. Typically, 50-150 IU/kg three times weekly subcutaneously or intravenously, adjusted to achieve target hemoglobin levels (e.g., 10-12 g/dL).
Elderly
No specific dose adjustment is generally required, but monitor carefully for side effects.
Renal_impairment
Primary indication for CKD anemia. Dosing is adjusted based on hemoglobin response and target levels.
How to Take
Administer subcutaneously or intravenously. Do not shake the vial. Inspect visually for particulate matter and discoloration prior to administration. Single-use vial.
Mechanism of Action
Epoetin alfa is a recombinant human erythropoietin that stimulates erythropoiesis by mimicking the action of naturally occurring erythropoietin, a hormone produced by the kidneys. It binds to erythropoietin receptors on erythroid progenitor cells in the bone marrow, stimulating their proliferation and differentiation into mature red blood cells.
Pharmacokinetics
Onset
Onset of erythropoiesis is typically within 7-10 days, but hemoglobin levels increase gradually over weeks.
Excretion
Metabolites are excreted, primarily via the kidneys, but intact drug is not substantially excreted renally.
Half life
Approximately 4-13 hours following subcutaneous administration; 4-8 hours following intravenous administration in patients with chronic kidney disease.
Absorption
Administered subcutaneously or intravenously. Subcutaneous absorption is slow and complete, with peak serum concentrations occurring 5-24 hours post-administration. Intravenous administration results in immediate and complete bioavailability.
Metabolism
Primarily metabolized in the body through enzymatic degradation and receptor-mediated endocytosis, not significantly by the liver.
Side Effects
Contraindications
- Uncontrolled hypertension
- Pure Red Cell Aplasia (PRCA) with anti-epoetin antibodies
- Known hypersensitivity to Epoetin alfa or any component of the formulation
- Patients with serious or life-threatening allergic reactions to Epoetin alfa
Drug Interactions
No significant direct drug interactions have been identified for Epoetin alfa. However, agents affecting erythropoiesis could theoretically alter its effect.
No specific drug interactions are commonly reported for Epoetin alfa.
Storage
Store in a refrigerator (2°C to 8°C). Do not freeze. Protect from light. Do not shake.
Overdose
Overdose can lead to symptoms of polycythemia (excessive red blood cells) such as increased blood viscosity, which may result in serious cardiovascular events. Management involves phlebotomy to reduce hematocrit and supportive care.
Pregnancy & Lactation
Use in pregnancy only if potential benefit outweighs potential risk to the fetus. It is unknown if Epoetin alfa is excreted in human milk; caution is advised during breastfeeding.
Side Effects
Contraindications
- Uncontrolled hypertension
- Pure Red Cell Aplasia (PRCA) with anti-epoetin antibodies
- Known hypersensitivity to Epoetin alfa or any component of the formulation
- Patients with serious or life-threatening allergic reactions to Epoetin alfa
Drug Interactions
No significant direct drug interactions have been identified for Epoetin alfa. However, agents affecting erythropoiesis could theoretically alter its effect.
No specific drug interactions are commonly reported for Epoetin alfa.
Storage
Store in a refrigerator (2°C to 8°C). Do not freeze. Protect from light. Do not shake.
Overdose
Overdose can lead to symptoms of polycythemia (excessive red blood cells) such as increased blood viscosity, which may result in serious cardiovascular events. Management involves phlebotomy to reduce hematocrit and supportive care.
Pregnancy & Lactation
Use in pregnancy only if potential benefit outweighs potential risk to the fetus. It is unknown if Epoetin alfa is excreted in human milk; caution is advised during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years when stored correctly, check specific product label.
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA)
Patent Status
Patent expired for generic epoetin alfa; specific formulations/brands may have patents
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of Epoetin alfa in treating anemia across various indications, demonstrating improved hemoglobin levels and reduced transfusion requirements.
Lab Monitoring
- Hemoglobin and hematocrit (at least weekly until stable, then regularly)
- Blood pressure (regularly)
- Serum ferritin and transferrin saturation (for iron status)
- Platelet count
Doctor Notes
- Monitor hemoglobin closely; do not exceed 12 g/dL to avoid adverse cardiovascular outcomes.
- Assess iron status before and during treatment; iron supplementation may be required.
- Educate patients on symptoms of thrombosis and appropriate actions.
Patient Guidelines
- Report any signs of blood clot (e.g., chest pain, difficulty breathing, swelling/pain in leg) immediately.
- Do not stop treatment without consulting your doctor.
- Monitor blood pressure regularly at home if advised.
- Do not shake the vial.
Missed Dose Advice
If a dose is missed, administer it as soon as possible. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.
Driving Precautions
This medicine may cause dizziness or seizures in some individuals. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a balanced diet.
- Engage in moderate physical activity as advised by your doctor.
- Avoid smoking and excessive alcohol consumption.
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