NeoRecormon therapy is started by a doctor who is an expert on your condition. The first dose is usually given to you under medical supervision, because of the possibility of an allergic reaction.
NeoRecormon injections can then be given by a trained nurse, doctor or other professional. Once you have been shown how, you can also inject the solution yourself.
The NeoRecormon pre-filled syringe is ready for use. Each syringe should be used for a single injection only. Do not mix NeoRecormon with other injections or infusion solutions.
Instructions for use
First wash your hands!
1 Remove one syringe from the pack.
Check the liquid in the syringe:
- is it clear?
- is it colourless?
- is it free of particles? If the answer is NO to any question, do not administer the injection. Dispose of it and start again with a different syringe. If you answer yes to all three, remove the cap from the syringe and go to step 2.
2 Remove a needle from the pack, fix it securely on to the syringe and remove the protective cap
from the needle.
3 Expel air from the syringe and needle. Do this by lightly tapping on the upper half of the
syringe. This will cause any air bubbles to rise to the top. Then hold the syringe vertically and the needle upwards, and gently push the plunger upwards. Keep pushing the plunger until the amount of NeoRecormon in the syringe is as prescribed.
4 Clean the skin at the injection site using an alcohol wipe. Form a skin fold by pinching the
skin between thumb and forefinger.
5 Holding the syringe near the needle, insert the needle into the skin fold with a quick, firm
action. Inject the NeoRecormon solution. Withdraw the needle quickly and apply pressure over the injection site with a dry, sterile pad.
The dose of NeoRecormon depends on your disease condition, the way the injection is given (under the skin or into a vein) and your body weight. Your doctor will work out the right dose for you.
- Symptomatic anaemia caused by chronic kidney disease
Your injections are given under the skin or into a vein. If the solution is given into your vein it should be injected over about 2 minutes, eg people on haemodialysis will receive the injection via the arterio-venous fistula at the end of dialysis.
People who are not on haemodialysis will usually have injections under the skin.
Treatment with NeoRecormon is divided into two stages:
a) Correcting the anaemia The initial dose for injections under the skin is 20 IU per injection for every 1 kg of your body weight, given three times per week. After 4 weeks, the doctor will do tests and, if the treatment response is not sufficient, your dose may be raised to 40 IU/kg per injection, given three times per week. The doctor may continue to increase your dose at monthly intervals if necessary. The weekly dose can also be divided into daily doses. The initial dose for injections into veins is 40 IU per injection for every 1 kg of your body weight, given three times per week. After 4 weeks, the doctor will do tests and, if the treatment response is not sufficient, your dose may be raised to 80 IU/kg per injection, given three times per week. The doctor may continue to increase your dose at monthly intervals if necessary. For both types of injection, the maximum dose should not exceed 720 IU for every 1 kg of your body weight per week.
b) Maintaining sufficient red blood cell levels The maintenance dose: Once your red blood cells reach an acceptable level, the dose is reduced to half of the dose used to correct the anaemia. The weekly dose can be given once per week, or divided into three or seven doses per week. If your red blood cell level is stable on a once weekly dosing regimen, your dose may be switched to once every two weeks administration. In this case dose increases may be necessary. Every one or two weeks, the doctor may adjust your dose to find your individual maintenance dose. Children will start by following the same guidelines. In trials, children usually needed higher doses of NeoRecormon (the younger the child, the higher the dose). Treatment with NeoRecormon is normally a long-term therapy. However, it can be interrupted at any time, if necessary.
- Anaemia in premature infants
Injections are given under the skin.
The initial dose is 250 IU per injection for every 1 kg the infant weighs, three times a week.
Treatment with NeoRecormon should start as early as possible, preferably by day 3 of the infant?s life. Premature infants who have been transfused before the start of treatment with NeoRecormon are not likely to benefit as much as untransfused infants.
The treatment should last for 6 weeks.
- Adults with symptomatic anaemia receiving chemotherapy for cancer
Injections are given under the skin.
Your doctor may initiate treatment with NeoRecormon if your haemoglobin level is 10 g/dL or less. After initiation of therapy, your doctor will maintain your haemoglobin level between 10 and 12 g/dL.
The initial weekly dose is 30,000 IU. This may be given as one injection per week, or in divided doses as 3 to 7 injections per week. Your doctor will take regular blood samples. He or she may raise or lower your dose, or interrupt your treatment according to the test results.The haemoglobin values should not exceed a value of 12 g/dL.
The therapy should be continued for up to 4 weeks after the end of chemotherapy.
The maximum dose should not exceed 60,000 IU per week.
- People donating their own blood before surgery
Injections are given into a vein over 2 minutes, or under the skin.
The dose of NeoRecormon depends on your condition, red blood cell levels and how much blood will be donated before surgery.
The dose worked out by your doctor will be given twice per week for 4 weeks. When you donate blood, NeoRecormon will be given to you at the end of a donation session.
The maximum dose should not exceed
- for injections into veins: 1600 IU for every 1 kg of your body weight per week
- for injections under the skin: 1200 IU for every 1 kg of your body weight per week.
If you inject too much NeoRecormon
Do not increase the dose your doctor has given you. If you think you have injected more NeoRecormon than you should, contact your doctor. It is unlikely to be serious. Even at very high blood levels, no symptoms of poisoning have been observed.
If you forget to take NeoRecormon
If you have missed an injection, or injected too little, talk to your doctor.
Do not take a double dose to make up for any forgotten doses.
If you have any further questions on the use of this product, as your doctor or pharmacist.