A long-acting medicine that helps the body make red blood cells
Darbepoetin alfa
A long-acting injection that helps the body make red blood cells, used to treat anaemia in kidney disease and some cancer treatment.
What is Darbepoetin alfa?
Darbepoetin alfa is a long-acting erythropoiesis-stimulating agent, meaning it encourages the bone marrow to make more red blood cells. It is given by injection to treat anaemia, mainly in people with kidney disease and sometimes in those having chemotherapy. Its main risks come from pushing the blood count too high: raised blood pressure, a greater chance of blood clots, and, in cancer, the possibility of speeding up tumour growth. For these reasons the blood count is kept within a target range and iron levels and blood pressure are monitored.
Education and reference only. This is a plain-language guide to Darbepoetin alfa — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Darbepoetin alfa is a manufactured version of a natural substance the body uses to tell the bone marrow to make red blood cells. It is used to treat anaemia, a shortage of red blood cells, particularly the anaemia that comes with long-term kidney disease, and in some people whose anaemia is caused by chemotherapy. It is a long-acting form, so it can be given less often than some similar medicines. It is given by injection, under the skin or into a vein, and is prescribed and supervised by specialist or kidney teams.
How it works
Red blood cells carry oxygen around the body, and they are made in the bone marrow in response to a natural hormone produced mainly by the kidneys. In kidney disease, the body makes too little of this hormone, leading to anaemia. Darbepoetin alfa acts in place of that hormone, prompting the bone marrow to produce more red cells and so improving the anaemia and the tiredness and breathlessness it causes. Because the marrow needs iron to build red cells, treatment works best when iron levels are kept up, which is why iron is monitored alongside it.
Company & origin
Originated / developed by: Specialist manufacturer.
A medicine used in the UK to treat anaemia, particularly in kidney disease and in some people having chemotherapy.
Practical use
How to take Darbepoetin alfa
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given by injection, under the skin or into a vein, by the team or sometimes by a trained patient or carer.
- Attend regular blood tests so the dose can be adjusted to keep your blood count in the target range.
- Have your blood pressure checked regularly and report headaches or symptoms of high blood pressure.
- Take any iron supplements you are given, as the body needs iron to make red cells in response.
- Tell the team if your tiredness is not improving, as the dose or other causes may need reviewing.
Weighing it up
Advantages & disadvantages of Darbepoetin alfa
Advantages
- Effectively treats anaemia of kidney disease and some chemotherapy-related anaemia.
- Long-acting, so it can be given less often than some similar medicines.
- Can reduce the need for blood transfusions in suitable people.
Disadvantages
- Can raise blood pressure and increase the risk of blood clots if the blood count goes too high.
- In cancer, it may speed up tumour growth if not used carefully within targets.
- Needs regular injections and blood tests, and works best only when iron levels are adequate.
Practical use
Good to know
The most important thing to understand is that more is not better: pushing the red blood count or haemoglobin too high carries real risks, including raised blood pressure, a greater chance of dangerous blood clots, and, in people with cancer, the possibility of the medicine speeding up tumour growth. Because of this, the aim is to correct the anaemia gradually to a target range rather than to make the blood completely normal. Blood pressure is watched closely, as it can rise, and iron levels are checked because the marrow needs enough iron to respond. If the medicine does not seem to be working, the team looks for causes such as low iron or inflammation. It is given by injection and used under specialist supervision with regular blood tests.
Who should not take it / use with caution
- People who have had a serious allergic reaction to darbepoetin should not use it.
- It is avoided in people with uncontrolled high blood pressure until that is brought under control.
- It is used with great caution in people at high risk of blood clots, and its use in cancer is weighed carefully against the risks.
Monitoring
- Regular blood counts to keep the red blood count or haemoglobin within the target range.
- Checking blood pressure regularly, as it can rise.
- Monitoring iron levels to make sure the marrow can respond to treatment.
Side effects
- Raised blood pressure, sometimes with headaches.
- An increased risk of blood clots, including in the legs or lungs.
- Pain or reaction where the injection is given, and flu-like symptoms in some people.
- Rarely, a serious problem where the body stops responding to the medicine and to its natural form.
Key interactions
- It works best alongside adequate iron, so iron supplements are often given with it.
- Its effect can be blunted by inflammation, infection or other causes of anaemia, which the team looks for.
- Tell the team about all your medicines and any history of blood clots or high blood pressure.
Available as: A solution for injection, given under the skin or into a vein, often in a pre-filled syringe or pen.
Answers
Darbepoetin alfa: frequently asked questions
What is darbepoetin used for?
It treats anaemia, a shortage of red blood cells, mainly in people with kidney disease and sometimes in those having chemotherapy.
Why is my blood count not aimed at normal?
Pushing the blood count too high raises the risk of high blood pressure and clots, so the aim is a target range rather than a completely normal level.
Why do I need iron with it?
The bone marrow needs iron to make red blood cells in response to the medicine, so iron is monitored and often given to help it work.
Can it affect cancer?
In people with cancer it may speed up tumour growth if used outside careful targets, so its use is weighed up and monitored by the specialist team.
Why is my blood pressure checked?
Darbepoetin can raise blood pressure, so it is monitored regularly and any uncontrolled high blood pressure is treated before continuing.
The wider class
About Erythropoiesis-stimulating agent (long-acting)
Darbepoetin alfa belongs to the erythropoiesis-stimulating agent (long-acting) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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