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Daprodustat: Brands, Price & Uses in Bangladesh
Daprodustat is indicated for the treatment of anemia due to chronic kidney disease (CKD) in adult patients who have been receiving dialysis for at least four months.
About Daprodustat
Indications of Daprodustat
Daprodustat is indicated for the treatment of anemia due to chronic kidney disease (CKD) in adult patients who have been receiving dialysis for at least four months. This is the only FDA-approved (established) indication for Daprodustat.
- Established/approved use: Anemia of CKD in adult dialysis-dependent patients (hemodialysis or peritoneal dialysis), as an alternative to injectable erythropoiesis-stimulating agents (ESAs).
- Not approved / insufficient evidence: Daprodustat is not indicated for anemia in non-dialysis-dependent CKD patients; safety in this population has not been established and adverse events were more frequent in trials of non-dialysis patients.
- Not indicated as a substitute for emergency red blood cell transfusion.
Daprodustat should only be used to raise hemoglobin to the minimum level needed to avoid the need for red blood cell transfusion, under the supervision of a physician experienced in managing renal anemia.
Dosage & Administration of Daprodustat
Dosing Principles
Daprodustat is dosed individually based on the patient's baseline hemoglobin level and, if applicable, their prior ESA dose. The goal is to use the lowest dose sufficient to reduce the need for red blood cell transfusions, without exceeding a target hemoglobin of 11 g/dL.
| Clinical scenario | Recommended starting dose |
|---|---|
| ESA-naive dialysis patients | 4 mg orally once daily |
| Patients converting from a stable ESA dose | Dose determined from a conversion table based on prior ESA dose (typically ranges from 1 mg to 12 mg once daily) |
Dose Titration
- Hemoglobin should be monitored every 2 weeks after initiation or dose change until stable, then approximately every 4 weeks.
- Dose adjustments (increase or decrease by one dose level, e.g., in defined increments up to a maximum of 24 mg once daily) are made no more often than every 4 weeks, based on hemoglobin trend and rate of rise.
- If hemoglobin rises too rapidly (more than 1 g/dL in 2 weeks) or exceeds 11 g/dL, the dose should be reduced or interrupted.
Missed Dose
If a dose of Daprodustat is missed, it should be taken as soon as remembered on the same day; do not double the dose the next day.
Side Effects of Daprodustat
The most common adverse reactions associated with Daprodustat (occurring in ≥10% of patients in clinical trials) include:
- Hypertension (worsening or new-onset)
- Thrombotic vascular events (including vascular access thrombosis)
- Abdominal pain
Other reported adverse effects include diarrhea, nausea, and peritonitis (in peritoneal dialysis patients). Serious but less common effects include gastrointestinal erosions/bleeding, and elevated liver enzymes. See Precautions and Warnings for the boxed warning regarding thrombotic and cardiovascular risk.
Contraindications of Daprodustat
Daprodustat is contraindicated in patients with:
- Known hypersensitivity to Daprodustat or any component of the formulation.
- Uncontrolled hypertension.
- Concomitant use of strong CYP2C8 inhibitors (e.g., gemfibrozil), due to markedly increased Daprodustat exposure (see Interactions).
Frequently Asked Questions about Daprodustat
What is Daprodustat used for?
Daprodustat is an oral medicine used to treat anemia caused by chronic kidney disease (CKD) in adults who are on dialysis. It works by helping the body make more of its own erythropoietin, a hormone that stimulates red blood cell production.
Is Daprodustat a substitute for injectable EPO (erythropoietin) treatment?
Yes, for dialysis patients Daprodustat is an oral alternative to injectable erythropoiesis-stimulating agents (ESAs). Your doctor will determine the right starting dose based on your hemoglobin level and prior ESA use, if any.
What are the most serious risks of Daprodustat?
Daprodustat carries a boxed warning for an increased risk of death, heart attack, stroke, blood clots, and vascular access clotting, similar to injectable ESAs. Your doctor will use the lowest effective dose and monitor your hemoglobin and blood pressure regularly to reduce this risk.
Can I take Daprodustat if I am pregnant or breastfeeding?
Data on Daprodustat use during pregnancy are limited, and animal studies suggest possible harm to the fetus at high doses. Daprodustat should be used in pregnancy only if clearly needed, after discussing the potential risks and benefits with your physician. Similarly, discuss breastfeeding plans with your doctor before using Daprodustat.
What medicines should I avoid while taking Daprodustat?
Avoid taking Daprodustat with gemfibrozil or similar strong CYP2C8 inhibitors, as this combination is contraindicated due to markedly increased drug levels. Also tell your doctor about any phosphate binders, rifampin, or other medicines you take, as these can affect how Daprodustat works.
Can children use Daprodustat?
No. The safety and efficacy of Daprodustat in children have not been established, and it is not approved for pediatric use.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.