Parenteral Manual


Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Erythropoeisis regulating hormone
Original Date: 
August 2005
Revised Date: 
October 2009
  • Treatment of anemia with chronic renal failure
  • Under investigation for treatment of anemia in cancer patient
Reconstitution and Stability: 
  • Supplied in pre-filled syringes:
    - 10 mcg                       - 60 mcg
    - 20 mcg                       - 80 mcg
    - 30 mcg                       - 100 mcg
    - 40 mcg                       - 150 mcg
    - 50 mcg
  • Do not use part-syringes
  • Store in fridge; do not shake, protect from light
  • Stable 7 days at room temperature

- Solutions Compatible: 0.9% NaCl

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: no information

- Incompatible:  DO NOT mix with other solutions or medications


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IV Direct

Usual dilution: undiluted
Infusion time: >1 minute

IV Intermittent Infusion NO
IV Continuous Infusion NO




(For neonatal dosages, refer to Neonatal IV Drug Manual.)

- Renal failure-associated anemia: 

  • 0.45 mcg/kg IV/SC once weekly
  • Some patients can be controlled with dosing every 2 weeks
  • Dose is adjusted based on hemoglobin levels, titrate to hemoglobin <120 g/L
  • Round dose to nearest available pre-filled syringe

- Cancer-related anemia (Adults only):                

  • 2.25 mcg/kg IV/SC once weekly
  • Maximum: 4.5 mcg/kg/ dose    
Potential hazards of parenteral administration: 
  • Hypertension, hypotension
  • Flu-like symptoms
  • Local irritation (pain, redness, swelling/itching, vascular access thrombosis)
  • CHF, sepsis, cardiac arrhthmias
  • Headache, myalgia
  • Diarrhea
  • Seizures
  • Blood pressure should be followed closely
  • It may take 2-6 weeks from the time of a dose change until a significant change in hemoglobin occurs
  • Patients need to have adequate iron stores in order to respond to darbepoetin; supplementation with iron is usually required
  • Contraindicated in patients with uncontrolled hypertension
  • IV darbepoetin pay be given at any stage during a dialysis session into venous limb of dialyser
  • this medication does NOT contain albumin or human blood products

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