side effects from Procrit

[sdrake]

My dad has been on Procrit since being diagnosed over a year and a half ago. The oncologist upped his dosage to 80,000 several months ago. I know I have read on the forum about higher dosages causing potential problems, but I can’t find those posts now.
Dad has experiences some rapid, irregular heart beats along with some pain in his chest. He was referred to a cardiologist who did some testing. He found nothing wrong, and put dad on beta blockers which seem to be helping. Dad has been doing really well – his HGB has been in the 11-12 range for quite a while now, so they decreased his Procrit dosage. My question is could the higher dosage of Procrit have been part of the problem? Thanks for any insight.

Shari

[Neil]

Take a look at the Procrit web site. Think you will find dosages over 60,000 are not usually recommended. Side effects include blood clots, heart issues.
Was on Procrit for 32 months—40,000 units—no side effects at all
Heres a link to the Amgen prescribing info
http://www.procrit.com/common/prescribing_information/PROCRIT/PDF/ProcritBooklet.pdf

[sdrake]

Thanks, Neil. I’ll check out that information. Maybe even the 60,000 is pretty high? How is the Aranesp working for you?

Shari

[Caroline]

Shari,

My Dad was on Procrit for awhile and now he is on Aranesp. With both drugs the doctor watches carefully to make sure that Dad’s hemoglobin does not go up too high. The reason that he explained to me is that when the hemoglobin gets too high, the blood thickens and the heart has to work much too hard to pump it. The result can be a heart attack. Last week Dad’s hemoglobin was up to 149 so now I only give him his Aranesp needle once a month to give his hemoglobin time to drop down to 120 (normal) again. I believe that both drugs work on the same premise.

When Dad was on Procrit he was getting 80,000 units weekly. Now he is on Aranesp but he receives a much lower dosage. He gets the equivalent of less than one third of the dosage of Procrit.

I hope this helps.

Caroline

[sdrake]

Caroline,

Yikes! I don’t like the sound of that! It may explain Dad’s symptoms though. His dosage has been reduced for about a month now, and he says he is feeling better. Wasn’t your Dad on Procrit? Do I remember correctly that the Aranesp really brought his HGB up when the Procrit wasn’t doing much good? Maybe a switch would be good for my Dad too?

Thanks for your help!
Shari

[Neil]

Hi Shari,
The Aranesp is working well. We are still getting the dosage and interval adjusted. Currently get 400 mcg every 3 weeks. They will not give me a shot if my HGB is over 12.0. This applies to both Procrit and Aranesp. Not sure if Medicare set up this stipulation or if it was established by Amgen

[Caroline]

Shari,

My Dad took Procrit (called Eprex here in Canada) for a couple of months early this year. He also has Kidney Failure and when his Nephrologist found out about the Procrit he didn’t want Dad on it anymore because it taxes the kidneys. Instead Dad was switched to Aranesp which he responds very well to. Procrit kept Dad’s hemoglobin at 100. Aranesp makes it shoot up. He is on the lowest dose available and still after one shot his hemoglobin goes from 125 to 148. Then they give him a month with no shots and let the hemoglobin fall again. He gets his next shot this Friday morning.

Caroline

[Jim]

Quote:

Originally posted by Neil:
They will not give me a shot if my HGB is over 12.0. This applies to both Procrit and Aranesp. Not sure if Medicare set up this stipulation or if it was established by Amgen

I was told by my doc that this is a Medicare regulation.
JW

[Russ]

I don’t seem to get the lift out of Aranesp that others have indicated. I keep a chart of my treatments and CBCs and haven’t noticed any HGB increase related to a shot of Aranesp. (It just makes me nauseus – mostly about the 3rd day after 500mcgs). PBRC txes are best for raising my HGB which has ranged from a low of 8.2 up to 11.7 – normally about 9 to 10. Comment appreciated.

[Neil]

Hi Russ,
Not all patients respond to Aranesp or Procrit.
Some find it takes up to 6 weeks to see an increase in HGB. How long have you been on it?
What was your HGB before Aranesp?
Did your doc check your epo and iron stores before starting you on Aranesp?
If epo was normal to high chances are it would not work. Aranesp also needs iron to function. Those with low iron may need a supplement in order to have it stimulate the marrow into a red cell producing mode.

[Russ]

Neil, I’ve been on Aranesp since June 27, 2005. Averaging about 500mcg every 2 to 3 weeks, I asked doc to try 300mcg last Monday to reduce the nausea and it helped. My Hgb was 8.5 at start and was up to 10.5 in 4 weeks – part of that increase was 2 units of PBRCs. My hemo/onc did not check my EPO or iron before starting – can’t find if EPO has ever been checked but my ferritin is high over 1000. Thanks for your input.

[Russ]

Neil, My hemo/onc did not check my EPO or iron before starting however I just found an EPO test result for Sept 23, 2005. This was after a previous 500mcg of Aranesp on Sept. 6. The result was 34 mU/mL with a note the range is 4-27 mU/mL for 95% of individuals with normal hemocrit. (On that date my HCT was 33.1) Don’t know what this all means except perhaps the Aranesp is not working because of already high EPO. Any thoughts appreciated.

[patti]

Russ,

I would get your doc to check your EPO. With your iron as high as it is, if your EPO is normal I’m not sure it’s a good idea to stay on the Aranesp shots. Have you tried Procrit to see if it would work?

When we found out that mom’s EPO and iron were fine we took her off of the shots after 9 months because it was obvious they were doing nothing for her (we tried both Ara.and Pro.). I guess our feeling is why put another chemical in the body, especially if it’s not working? The other thing we talked to our NP about was that if the shots weren’t increasing her red blood cells they were probably increasing cells that we didn’t want (ie. body producing cells that weren’t maturing instead). In that case, we would only be adding to the progression of the disease. Which is exactly what we think we did for 9 months. Mom’s NP totally agreed with us, the doc did not. Keeping in mind that our NP has been 100% right everytime with mom and the doc 100% wrong for the past two years. We take her advice wholly over the docs. So, keep this in mind. I’m sure the doctor will disagree but they really don’t know the answer to that question and we didn’t want mom to be their guinea pig.

Patti

[Russ]

Patti, Thank you for your input. It scares me a bit since like your MIL, I’ve been on Aranesp a long time and it doesn’t seem to help. That plus the fact my BM blasts went from 10% to 18% (Apr. to Aug.) My Hemo/Onc. has been great but he does seem to feel Aranesp is the way to go.
Prayers go out for you and your MIL.

[Neil]

Hi Russ,
would think the higher EPO level is a result of the Aranesp shots since it was tested after a shot.
Your HGB increase from 8.2 to 11.7 is pretty darn good. If you go beyond 12.0 they will delay your next shot till you drop back down.
Your ferritin level is probably at 1000 as a result of your PBRC tx. Its not all that high and remember it takes 14-15 years of high ferritin to impact organs. It is unlikely it will increase further if you do not need any more PBRC tx. There is ample time to get it back down thru chealation.

[Author]

Posts