Superman

[CarolineG]

My Dad was on Procrit 40,000 units weekly for 5 months. It kept his hemoglobin steady at 97-99. Then because of his kidneys he was switched to Aranesp 150 weekly. After 2 weeks his hemoglobin went up to 120. After 2 more weeks it went up to 143. They have had to discontinue the use of Aranesp for the time being until his hemoglobin drops to 120-125. When the hemoglobin gets too high, the blood gets thicker and causes the heart to have a more difficult time pumping it. Since Dad already has an enlarged heart from working overtime, they thought it would be best to let his blood rest for a little while.
The thing that confuses me is that I was told the Procrit and Aranesp are practically the same drug….synthetic erythropoietin. That can’t be when one kept Dad’s hemoglogin level and the other one raised it beyond what the doctor ever thought would be possible.
Does anyone know what the difference between the two drugs could be?

Thanks,
Caroline

[Brenda P]

I’m just a pharmacist, not a doctor, but I know Aranesp is VERY similar to Procrit, (EPO is a huge protein and Aranesp has just a different little tail.)

The thing is, Aranesp has a longer half life; it sticks around longer in the body. I would ask why they changed because with the procrit at least you could hold the dose and the hgb stimulating effect would wear off more quickly.

[CarolineG]

Hi Brenda,

Thanks for your answer.

The reason they changed Dad from Procrit to Aranesp was because of Kidney Failure. He has Glomerulonephritis. I am sure that is what they called it.

Dad’s Oncologist had him on Procrit (Eprex here in Canada). 5 months later Dad’s Nephrologist changed him to Aranesp. His reasoning was that it is ‘easier on the already damaged kidneys.’ We were a bit worried that the Oncologist would get offended when the Nephrologist just went ahead and made the change but he seemed fine with the idea. As he put it, “I’m not the Kidney Specialist. It was a toss of the dice as to which drug I was going to start your Dad on first. I started with Eprex. Aranesp works just as well.”

4 weeks later we went back to see the Nephrologist and he put the Aranesp on hold until Dad’s Hgb comes back down. And even then, when they begin the needles again, Dad will only get one per month to begin with instead of one per week.

Thanks again.
Caroline

[sdrake]

Caroline,

I’m glad the Aranesp is working for your Dad. Who would ever think that we would have to worry about hgb getting too high?

I don’t have any answers, just questions. My Dad has been on Procrit since last February. It doesn’t seem to do much. When he is able to take Vidaza his hgb goes up, and his wbc gets really low. When his ANC gets too low, they delay the Vidaza, and his hgb drops again. He has had two transfusions in the last 6 weeks while waiting for the ANC to come back up. The whole point of this rambling is, I wonder if Aranesp would work better for him than Procrit.

sdrake

[shirlsgirl]

Hi Caroline,

Your Dad’s hemoglobin has really rebounded with Aranesp, that’s great! Hoping that this is a trend of better things to come.

Take care,

Jody

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