CRESP 40

CRESP 40 contains Darbepoetin Alfa (40 mcg), a recombinant erythropoiesis-stimulating agent (ESA). It is a long-acting analog of erythropoietin (EPO), a hormone that stimulates red blood cell (RBC) production in the bone marrow.

Importance

• Treats anemia in patients with:

  • Chronic kidney disease (CKD) (both dialysis and non-dialysis)

  • Chemotherapy-induced anemia (in cancer patients)

• Reduces the need for blood transfusions

• Improves quality of life by alleviating fatigue and weakness

Use

Indications

1. Anemia due to CKD

2. Anemia from chemotherapy (non-myeloid malignancies)

3. Anemia in HIV patients (on zidovudine therapy, in some cases)

Dosage & Administration

• CKD patients:

  • IV/SC injection: Starting dose 0.45 mcg/kg once weekly or 0.75 mcg/kg every 2 weeks

  • Adjusted based on hemoglobin (Hb) response (target 10–12 g/dL)

• Chemotherapy-induced anemia:

  • 2.25 mcg/kg SC weekly or 500 mcg SC every 3 weeks

Side Effects

Common:

• Hypertension (most frequent)

• Headache, dizziness

• Nausea, vomiting

• Muscle/joint pain

• Injection site reactions

Serious (Require Medical Attention):

• Thromboembolic events (blood clots, stroke, DVT)

• Pure red cell aplasia (PRCA) (rare, due to antibody formation)

• Severe hypertension

• Seizures (in CKD patients)

Storage

• Refrigerate at 2–8°C (Do not freeze.)

• Protect from light (Keep in original carton.)

• Do not shake (May denature the protein.)

• Single-use vial (Discard unused portion.)

Conclusion

CRESP 40 (Darbepoetin Alfa) is a critical therapy for managing anemia in CKD and cancer patients, reducing transfusion dependency. However, it requires strict Hb monitoring to avoid risks like thrombosis and hypertension. Should be used under specialist supervision