Shanthoetin

Shanpoethin is a biogenic stimulant, i.e. Has a vegetable origin and is used to treat severe, moderate and mild forms of anemia (low hemoglobin).

Indications Shanthoetin

Shanzoetin is prescribed for low hemoglobin, which is associated with chronic renal failure in adult patients and children who undergo an artificial procedure for cleaning the body of toxic substances and excess fluid (dialysis). Also, the drug is used to treat anemia in cancer patients undergoing chemotherapy and who can not receive blood transfusion for health reasons.

The drug is used to raise hemoglobin in HIV-infected patients and in mild to moderate form of anemia, both in adults and children, and also if necessary before performing a severe operation.

Release form

Shanzoetin is available as a solution in syringes, clear or slightly dull colorless. The drug is produced by one syringe in a carton.

Pharmacodynamics

The main substance of Shanpoethin is epoetin alfa (complex proteins that increase the production of erythrocytes in the bone marrow). Epoetin-alpha is produced in mammalian cells with a specific gene that encodes the human erythropoietin hormone.

By its amino acid composition, epoetin alfa does not differ from the human hormone to erythropoietin. Isolation of erythropoietin occurs with urine in patients with anemia.

Erythropoietin is a complex protein that stimulates cell division, as well as a hormone that promotes the formation of leukocytes in the human body.

Epoetin alfa does not differ in its biological effect from erythropoietin. After the administration of the drug, the level of erythrocytes, reticulocytes (erythrocyte precursors), hemoglobin and iron absorption increases rapidly. With the help of human bone marrow cells, scientists have established that epoetin alfa selectively increases erythrocyte production and does not affect the process of leukocyte formation. Damaging effect on bone marrow cells is not revealed.

Pharmacokinetics

With intravenous administration of Shanpoetin, the half-life in the body is 4 to 6 hours.

After subcutaneous administration of the drug, the level of active substance in the plasma is much lower than when the drug is administered intravenously. The concentration in the plasma gradually increases and after about 12-18 hours reaches its maximum limit, the half-life is about 24 hours. When administered subcutaneously, the body absorbs the drug by about 20%.

Dosing and administration

In chronic renal failure, Shanpoethin should be administered intravenously. The dosage of Shanpoethin is 50 IU / kg. During the adjustment period, the dosage can be increased if the hemoglobin does not rise by a minimum of 1 g / dL per month. 

In case of renal insufficiency and ischemia of the heart, it is necessary to control the level of hemoglobin and to ensure that it does not exceed the upper limit of the maximum level (after reaching the maximum maximum limit, the dosage of the drug is reduced). 

During the treatment of adult patients, as well as children who are on artificial cleansing of blood from toxic products, the drug is administered intravenously, with the treatment divided into two stages:

1. Correction (50 MO / kg, 3 times a week, you can also conduct a phased increase in the dose, if necessary);
2. Supporting stage (dosage reduction to maintain hemoglobin level at the optimal level).

With oncological pathologies, the drug is administered subcutaneously.

At extremely low hemoglobin levels in patients after chemotherapy, the initial dosage can be 150 IU / kg 3 times a week, then, taking into account the level of hemoglobin (rose or remained at the same level), a specialist can adjust the dosage (lower or increase the dose accordingly) .

In the treatment of patients with HIV infection, two stages are also used: corrective and supportive. Treatment begins with 100 IU / kg three times a week, the course of treatment is two months. If after this, hemoglobin remained at the same level, or rose slightly, the dosage can be increased to 300 IU / kg. If after this positive dynamics in the treatment does not occur, then in the future, increasing the dose will be already ineffective.

In the treatment of patients taking part in the out-patient operation, before serious operations, the drug is administered intravenously in an amount of 300 IU / kg 3 times a week, with a course of three weeks, then the dosage is adjusted. Before the therapy with Shanpoetin, you need to take into account the existing contraindications regarding the collection of autologous blood.

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Use Shanthoetin during pregnancy

Shanzoetin in the treatment of pregnant women is used only as prescribed by the doctor, when the benefit of treatment for a woman exceeds the possible risks to the fetus. Data on whether erythropoietin-alpha can not penetrate into breast milk.

Contraindications

With the development of true erythrocyte aplasia as a result of treatment with any form of erythropoietin, patients should not receive the drug Shantepoetin.

Shanboethin is contraindicated with increased susceptibility to the drug components.

In addition, it is necessary to take into account all the contraindications available in the program for autonomy (persons who take their blood for the subsequent transfusion to them) and those patients who are assigned to the operation of the musculoskeletal system (not participating in the out-of-office activities). 

The use of Shangoethin is not used in severe carotid, cerebrovascular, peripheral arterial, etc. Diseases, in particular, patients who have recently undergone a cerebral vascular crisis or a myocardial infarction, and also when the patient is prohibited to use antithrombotic prophylaxis for certain reasons.

Side effects Shanthoetin

At the first stage of treatment Shanpoetin, cold symptoms (dizziness, weakness, headaches and muscle pains, etc.) may appear.

With chronic renal failure, there is usually an increase in blood pressure. Sometimes there are hypertensive crises, as well as headaches, confusion, convulsions of the trunk or extremities.

In rare cases, thrombocytosis developed.

It is possible (extremely rare) to develop thrombotic vascular complications (ischemia or myocardial infarction, stroke, veins, etc.). However, there is no precise relationship between the use of Shantoetin and the development of these complications.

The probability of thrombosis of the shunt exists in patients with a tendency to increased arterial pressure, with the expansion of veins, stenosis (narrowing of blood vessels). 

In chronic renal failure after prolonged treatment with erythropoietins, development of erythrocytic aplasia (red cell) is possible.

During treatment with Shanpoetin, rashes, itching, swelling of the skin and subcutaneous tissue may occur.

Very rarely develop complications that disrupt the function of respiration or provoke a decrease in pressure. The development of various immune responses to epoetin alfa is virtually impossible.

With the introduction of Shanpoetin, local reactions may occur (usually at the injection site), with subcutaneous administration such reactions develop more often than with the intravenous route of administration.

With chronic renal failure, the level of uric acid and creatinine in the blood can increase, the concentration of potassium, phosphorus in the blood serum increases.

Overdose

With an overdose of Shanpoethin, the pharmacological actions of the drug can achieve the ultimate therapeutic manifestation. With increased hemoglobin, phlebotomy (bleeding) may be required, and symptomatic treatment is also performed.

Interactions with other drugs

There is no evidence that Shanzoetin can affect the therapeutic effect of other drugs.

However, cyclosporine comes into contact with erythrocytes, so there is a possibility of interaction of these two drugs. When treating simultaneously with Shapoetin and cyclosporin, it is necessary to monitor the level of cyclosporine in the blood and, if necessary, adjust the dosage.

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Storage conditions

Shanpoethin should be stored at a temperature of 2 to 8 ⁰ C, in a dark place inaccessible to children. The drug should not be shaken and frozen.

Shelf life

Shelf life is 2 years from the date of manufacture indicated on the package.