Preferred route of administration is IM or SC • Toxicity: Rapid IV administration may cause hypotension • neurotoxicity and increased susceptibility to certain infections have occurred with long-term use • Deferasirox: Orally administered iron chelator for treatment of hemochromatosis
Anemia, especially anemia associated with chronic renal failure, HIV infection, cancer, and prematurity • prevention of the need for transfusion in patients undergoing certain types of elective surgery IV or SC administration 1–3 times per week •EpoetinalfaAgonist of erythropoietin receptors expressed by red cell progenitors Stimulates erythroid proliferation and differentiation, and induces the release of reticulocytes from the bone marrow
Darbepoetin alfa: Long-acting glycosylated form administered weekly
Methoxy polyethylene glycol-epoetin beta: Long-acting form administered 1–2 times per month • Toxicity: Hypertension, thrombotic complications, and, very rarely, pure red cell aplasia • to reduce the risk of serious cerebrovascular events, hemoglobin levels should be maintained <12 g/dL
Pegfilgrastim: Long-acting form of filgrastim that is covalently linked to a type of polyethylene glycol
Tbo-filgrastim: Similar to filgrastim
GM-CSF (sargramostim): Myeloid growth factor that acts through a distinct GM-CSF receptor to stimulate proliferation and differentiation of early and late granulocytic progenitor cells, and erythroid and megakaryocyte progenitors; clinical uses are similar to those of G-CSF, but it is more likely than G-CSF to cause fever, arthralgia, myalgia, and capillary leak syndrome
Plerixafor: Antagonist of CXCR4 used in combination with G-CSF for mobilization of peripheral blood cells prior to autologous transplantation in patients with multiple myeloma or non-Hodgkin’s lymphoma who responded suboptimally to G-CSF alone
Romiplostim: Subcutaneously administered thrombopoietin agonist approved for treatment of chronic immune thrombocytopenia with insufficient response to corticosteroids, intravenous immunoglobulin, or splenectomy.
Eltrombopag: Orally active thrombopoietin agonist approved for treatment of chronic immune thrombocytopenia with insufficient response to corticosteroids, intravenous immunoglobulin, or splenectomy; and for treatment of thrombocytopenia in hepatitis C to allow the use of interferon-based therapies.
Deferoxamine Generic, Desferal
Epoetin alfa Erythropoietin (EPO), Epogen, Procrit
Filgrastim (G-CSF) Neupogen, Granix
Folic acid (folacin, pteroylglutamic acid) Generic
Oral: See Table 33–3.
Iron dextran (parenteral) INFeD, Dexferrum
Oral, parenteral Generic cyanocobalamin or hydroxocobalamin
Nasal Nascobal, CaloMist
Aapro MS et al, European Organisation for Research and Treatment of Cancer: 2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumours. Eur J Cancer 2011;47:8.
Albaramki J et al: Parenteral versus oral iron therapy for adults and children with chronic kidney disease. Cochrane Database Syst Rev 2012;(1):CD007857.