Aranesp vs Epogen – Comparison of Uses & Side Effects

Aranesp

It is the brand name of a drug called darbepoetin alfa, that belongs to a group of drugs called erythropoiesis-stimulating agents (ESAs).

Mechanism of Action

It works by causing the soft tissue inside the bones where blood cells are made to make more red blood cells.

Uses

This prescription medication is used to treat a lower than the normal number of red blood cells (anemia) caused by chemotherapy or chronic kidney disease.

Dosage

This medication is given every 1 to 4 weeks, depending on the condition you are treating. The usual recommended dose is 0.45 mcg/kg IV or subcutaneously.

Side Effects

Common side effects may include:

  • a feeling like you might pass out;
  • rapid weight gain;
  • unusual weakness;
  • shortness of breath
  • swelling in your arms or legs;
  • stomach pain;
  • low blood pressure during dialysis.

Rare side effects may include:

  • chest pain or pressure;
  • sudden numbness or weakness;
  • excessive sweating;
  • severe headache;
  • nosebleed;
  • nausea;
  • problems with vision or balance;
  • increased anxiety;
  • slurred speech;
  • cold feeling;
  • pounding in your neck or ears;
  • blurred vision.

Precautions

Before taking this erythropoiesis-stimulating agent, tell your healthcare provider if you have:

  • if you are allergic to latex;
  • cancer;
  • high blood pressure;
  • a seizure disorder;
  • heart disease;
  • a history of heart attack;
  • kidney disease (or if you are on dialysis).

Alcohol

Avoid drinking alcoholic beverages while taking this erythropoiesis-stimulating agent since alcohol use can substantially increase the risk of severe side effects.

Drug Interactions

It may negatively interact with other medications, especially:

  • lisinopril, a medication that is used to treat hypertension and congestive heart failure.

Pregnancy & Breastfeeding

It is not known whether this erythropoiesis-stimulating agent passes into breast milk or if it could affect the nursing infant. Tell your doctor if you are breast-feeding a baby.

It is not known whether this erythropoiesis-stimulating agent will harm a developing fetus. Tell your doctor if you are pregnant before using this medication.

Epogen

It is the brand name of a drug called epoetin alfa, that belongs to a group of drugs called erythropoiesis-stimulating agents (ESAs).

Mechanism of Action

It works by causing the bone marrow to make more red blood cells.

Uses

This prescription medication is used to treat anemia caused by chemotherapy in patients with certain types of cancer, chronic kidney disease, and the HIV medication zidovudine.

In addition, this medication is used before and after certain types of surgery to decrease the chance that blood transfusions will be required.

Dosage

The usual initial recommended dose is 50–100 Units/kg 3 times per week IV or SC. The usual maximum recommended dose is 150 Units/kg 3 times per week.

Side Effects

Common side effects may include:

  • itching or rash;
  • increased blood pressure;
  • vomiting;
  • muscle pain;
  • headache;
  • bone pain;
  • mouth pain;
  • joint pain;
  • pain or redness where the medication was injected;
  • nausea;
  • fever.

Rare side effects may include:

  • a seizure (convulsions);
  • sweating;
  • unusual tiredness;
  • severe headache;
  • pain spreading to your jaw or shoulder;
  • pale appearance of an arm or leg;
  • chest pain or pressure;
  • irregular heartbeats;
  • problems with vision or balance;
  • shortness of breath;
  • slurred speech;
  • sudden numbness or weakness;
  • severe chest pain;
  • muscle weakness or limp feeling;
  • pounding in your neck or ears;
  • irregular heartbeats;
  • increased thirst or urination.

Precautions

Before taking this erythropoiesis-stimulating agent, tell your healthcare provider if you have:

  • a history of heart attack or blood clots;
  • high blood pressure;
  • a seizure disorder;
  • kidney disease (or if you are on dialysis);
  • heart disease.

Alcohol

Avoid drinking alcoholic beverages while taking this erythropoiesis-stimulating agent since alcohol use can substantially increase the risk of severe side effects.

Drug Interactions

It may negatively interact with other medications, especially:

  • lisinopril;
  • Procrit (epoetin alfa).

Pregnancy & Breastfeeding

It is not known whether this erythropoiesis-stimulating agent will harm a developing fetus. Tell your doctor if you are pregnant before using this medication.

It is not known whether this erythropoiesis-stimulating agent passes into breast milk or if it could affect the nursing infant. Tell your doctor if you are breast-feeding a baby.

Bottom Line – Aranesp vs Epogen

Aranesp (active ingredient – darbepoetin alfa) is a man-made form of a protein that is used to treat anemia caused by chemotherapy or chronic kidney disease. It helps your body produce red blood cells.

Epogen (active ingredient – epoetin alfa) is a man-made form of a protein that is used to treat anemia caused by chemotherapy or chronic kidney disease, or anemia caused by taking zidovudine to treat HIV.

In addition, this medication is used to reduce the need for red blood cell transfusions in people having certain types of surgery. It helps your body produce red blood cells.

According to a 2014 study, Aranesp weekly or every 2 weeks is more efficient then Epogen in achieving target hemoglobin, with fewer dose changes and minor vascular access complications. 

Aranesp To Epogen Conversion

For conversion from epoetin alfa to darbepoetin alfa, a fixed conversion ratio of 200 IU epoetin alfa to 1 μg darbepoetin alfa is recommended by the producer. With this ratio, the peptide masses of the agents are equivalent.

But, later studies have indicated that the linear relationship between baseline epoetin alfa dose and maintenance darbepoetin alfa dose becomes curvilinear at epoetin alfa doses higher than 7000 units/week: at higher doses, less darbepoetin alfa is needed than a 200:1 conversion ratio would predict.

Nonetheless, a recent meta-analysis of 9 studies reported a reduction in total dose needed when patients were converted from epoetin alfa to darbepoetin alfa according to an initial dose-conversion ratio of 200:1.

Regarding their price, the average retail price for 1 carton (4 syringes) of Aranesp 100mcg/0.5ml is $3,150, while the average retail price for 4 vials (1ml) of Epogen 10000 units/ml is $685.

References

https://academic.oup.com/ndt/article/22/suppl_4/iv2/1876458
https://www.ncbi.nlm.nih.gov/pubmed/18971153
https://www.amgen.com/media/news-releases/2016/02/phase-3-study-demonstrate

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