Marogen(Chugai Pharmaceutical Co., Ltd., Japan).
Anaemia associated with renal impairment in pre-dialysis
and dialysis patients, and in patients receiving cancer
chemotherapy
Potentially hazardous interactions with other drugs
Risk of hyperkalaemia with ACE inhibitors and
angiotensin-II antagonists.
The metabolic fate of both endogenous and recombinant
erythropoietin is poorly understood. Current evidence
from studies in animals suggests that hepatic metabolism
contributes only minimally to elimination of the intact
hormone, but desialylated epoetin (i.e. terminal sialic
acid groups removed) appears to undergo substantial
hepatic clearance via metabolic pathways and/or binding.
Desialylation and/or removal of the oligosaccharide side
chains of erythropoietin appear to occur principally in
the liver; bone marrow also may have a role in catabolism
of the hormone. Elimination of desialylated drug by the
kidneys, bone marrow, and spleen also may occur; results
of animal studies suggest that proximal renal tubular
secretion may be involved in renal elimination.
