• To treat anemia in chronic kidney failure
• To treat anemia caused by chemotherapy

Darb-ESA 25mcg injection is an erythropoiesis-stimulating protein produced by recombinant DNA technology. The erythropoietin receptor on the surface of erythroid progenitor cells in the bone marrow is bound by Darb-ESA 25mcg injection and activated. This activation sets off a signaling cascade that increases the erythroid progenitor cells' ability to survive, proliferate, and differentiate, ultimately increasing the generation of red blood cells.

Inform your healthcare provider about all the medicines you take, including prescription medications, over-the-counter medications, nutritional or vitamin supplements, and herbal products. Certain medications may interact with Darb-ESA 25mcg injection and reduce effectiveness by causing undesirable side effects.

• Store in a refrigerator (2°C to 8°C).
• Do not freeze.
• Store in the original package to protect from light.
• Keep the injection away from the reach of children and pets.
• It should be kept dry and protected from light and moisture.
• It is important to get the dose at the scheduled time. If you missed the schedule, contact your doctor and reschedule the dose.

The injection is to be administered subcutaneously, or beneath the skin. Your doctor will provide you instruction on how to use this pre-filled pen for self-injection.  If you are not well-trained, do not attempt to inject the pre-filled pens. Never put the medication intravenously. Visit the hospital or clinic in the area if you require assistance administering the medication.

The dosage and frequency of Darb-ESA 25mcg injection will depend on various factors, including the patient's age, weight, overall health and condition being treated. It's important to follow the dosing instructions provided by a healthcare provider, and not to adjust the dosage or frequency without consulting with them first.

If a dose is missed, it should be taken as soon as possible unless it's within 6 hours of the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed.

Side effects are unwanted symptoms caused by medicines. Even though all drugs cause side effects, not everyone gets them.

Common

• Swelling in the face and body
• Low blood pressure
• Abdominal pain
• Shortness of breath
• cough

Serious

• Heart problems
• Severe skin reactions
• Anemia
• Seizure attack
• Lung problems

You will be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to. Do not shake the vial or syringe. You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. You should stay well-hydrated, maintain a healthy diet rich in iron and other nutrients, and avoid activities that may increase your risk of injury or bleeding. It is recommended to monitor your blood counts at regular intervals. Eat less foods that contain high-sodium such as packaged snacks, canned soups, processed meats, and fast food, as too much salt can cause hypertension and fluid retention. Remember to attend all scheduled appointments and follow-up visits with your healthcare provider to ensure your treatment is effective and any side effects are managed appropriately.

1. Amgen Limited, Electronics Medicines Compendium(emc), [ Revised on March 2022] [ Accessed on March 2024], https://www.medicines.org.uk/emc/files/pil.7993.pdf
2. Amgen Inc,  United States Food and Drug Administration (US FDA), [ Revised on July 2015] [ Accessed on March 2024], https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/103951s5363lbl.pdf
3. Amgen Inc, [Revised on January 2019], [Accessed on March 2024],  https://www.pi.amgen.com/-/media/Project/Amgen/Repository/pi-amgen-com/aranesp/ckd/aranesp_pi_hcp_english.pdf