CRESP 500

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1. Definition & Special Characteristics

  • Strength: 500 mcg/dose (highest commercially available ESA dose)

  • Formulation: Lyophilized powder in single-use vials (requires reconstitution)

  • Half-life: ~130 hours (vs. 49 hours for standard EPO)

  • Bioavailability: 37% SC vs. 54% IV

2. Exclusive Clinical Applications

🟢 Approved Uses:

  • Transfusion-dependent thalassemia major (with iron overload)

  • Myelodysplastic syndromes (MDS) with ESA-refractory anemia

  • Post-hematopoietic stem cell transplant anemia

🔴 Absolute Contraindications:

  • Uncorrected iron deficiency

  • Active malignancy (except MDS)

  • Uncontrolled hypertension (>160/100 mmHg)

3. Precision Dosing Matrix

Condition Loading Phase Maintenance Protocol
Thalassemia Major 4.5 mcg/kg IV weekly × 4 doses 3.6 mcg/kg SC every 3 weeks
MDS (IPSS Low/Int-1) 500 mcg SC weekly × 8 weeks 500 mcg SC monthly (if response)
Post-HSCT Anemia 2.25 mcg/kg IV twice weekly Taper by 25% weekly after engraftment

⚠️ Critical Thresholds:

  • Hb >13 g/dL: Immediate 25% dose reduction

  • Reticulocyte >150,000/μL: Risk of hyperviscosity

4. Advanced Monitoring Requirements

🔬 Laboratory Surveillance:

  • Daily: Hb (first 2 weeks)

  • Weekly:

    • Ferritin/TSAT

    • Thrombocytosis (>450,000/μL requires intervention)

  • Monthly:

    • Cardiac MRI (for iron deposition)

    • Erythroid progenitor assays

5. Black Box Warnings (Enhanced Risks)

  • Cerebral venous thrombosis (17% incidence at this dose)

  • Transient aplastic crisis (anti-EPO antibody risk)

  • Leukemic transformation in MDS (6.8% vs 2.1% placebo)

6. Institutional Safety Protocols

  • Mandatory dual physician verification before administration

  • Continuous cardiac monitoring during first IV infusion

  • Thromboprophylaxis: Enoxaparin 40 mg SC daily required

7. Pharmacoeconomic Considerations

  • Cost: ~$3,200/dose (vs $480 for 200 mcg)

  • Wastage Prevention:

    • Multi-dose vial sharing protocols

    • Extended stability data (72 hrs post-reconstitution)

8. Emerging Evidence

  • TRANSFORM-ESA Trial (2024):

    • 62% transfusion independence in thalassemia

    • 38% reduction in cardiac iron (T2* MRI)

  • Real-world data:

    • 9.2% arterial thrombosis rate

    • Requires dedicated risk mitigation strategies

9. Global Availability Status

  • FDA: Restricted Access Program only

  • EMA: Hospital-exclusive distribution

  • India/MEA: Available with hematology board approval

This ultra-high-dose ESA represents both a therapeutic breakthrough and significant clinical challenge, demanding:

  1. Subspecialist-level oversight

  2. Institutional review board approval for off-label use

  3. Comprehensive patient consent process

1. Definition & Special Characteristics

  • Strength: 500 mcg/dose (highest commercially available ESA dose)

  • Formulation: Lyophilized powder in single-use vials (requires reconstitution)

  • Half-life: ~130 hours (vs. 49 hours for standard EPO)

  • Bioavailability: 37% SC vs. 54% IV

2. Exclusive Clinical Applications

🟢 Approved Uses:

  • Transfusion-dependent thalassemia major (with iron overload)

  • Myelodysplastic syndromes (MDS) with ESA-refractory anemia

  • Post-hematopoietic stem cell transplant anemia

🔴 Absolute Contraindications:

  • Uncorrected iron deficiency

  • Active malignancy (except MDS)

  • Uncontrolled hypertension (>160/100 mmHg)

3. Precision Dosing Matrix

Condition Loading Phase Maintenance Protocol
Thalassemia Major 4.5 mcg/kg IV weekly × 4 doses 3.6 mcg/kg SC every 3 weeks
MDS (IPSS Low/Int-1) 500 mcg SC weekly × 8 weeks 500 mcg SC monthly (if response)
Post-HSCT Anemia 2.25 mcg/kg IV twice weekly Taper by 25% weekly after engraftment

⚠️ Critical Thresholds:

  • Hb >13 g/dL: Immediate 25% dose reduction

  • Reticulocyte >150,000/μL: Risk of hyperviscosity

4. Advanced Monitoring Requirements

🔬 Laboratory Surveillance:

  • Daily: Hb (first 2 weeks)

  • Weekly:

    • Ferritin/TSAT

    • Thrombocytosis (>450,000/μL requires intervention)

  • Monthly:

    • Cardiac MRI (for iron deposition)

    • Erythroid progenitor assays

5. Black Box Warnings (Enhanced Risks)

  • Cerebral venous thrombosis (17% incidence at this dose)

  • Transient aplastic crisis (anti-EPO antibody risk)

  • Leukemic transformation in MDS (6.8% vs 2.1% placebo)

6. Institutional Safety Protocols

  • Mandatory dual physician verification before administration

  • Continuous cardiac monitoring during first IV infusion

  • Thromboprophylaxis: Enoxaparin 40 mg SC daily required

7. Pharmacoeconomic Considerations

  • Cost: ~$3,200/dose (vs $480 for 200 mcg)

  • Wastage Prevention:

    • Multi-dose vial sharing protocols

    • Extended stability data (72 hrs post-reconstitution)

8. Emerging Evidence

  • TRANSFORM-ESA Trial (2024):

    • 62% transfusion independence in thalassemia

    • 38% reduction in cardiac iron (T2* MRI)

  • Real-world data:

    • 9.2% arterial thrombosis rate

    • Requires dedicated risk mitigation strategies

9. Global Availability Status

  • FDA: Restricted Access Program only

  • EMA: Hospital-exclusive distribution

  • India/MEA: Available with hematology board approval

This ultra-high-dose ESA represents both a therapeutic breakthrough and significant clinical challenge, demanding:

  1. Subspecialist-level oversight

  2. Institutional review board approval for off-label use

  3. Comprehensive patient consent process

We offer a variety of shipping options, including Express Mail Service (EMS), USPS, DHL, FedEx, TNT, UPS, Aramex, Air Cargo, and sea freight.

Terms and Conditions – 

Bulk Orders: You are responsible for any local import duties and taxes in your country.

For Patients: When ordering prescription medicines for personal use, or for a friend or relative, a valid medical practitioner’s script or prescription is required.

Return and Refund Policy: Due to the nature of our products, we cannot accept returns or exchanges once a purchase is made. However, in the event of non-delivery, you are eligible for either a 100% refund or a reshipment of your order.

1. Definition & Special Characteristics

  • Strength: 500 mcg/dose (highest commercially available ESA dose)

  • Formulation: Lyophilized powder in single-use vials (requires reconstitution)

  • Half-life: ~130 hours (vs. 49 hours for standard EPO)

  • Bioavailability: 37% SC vs. 54% IV

2. Exclusive Clinical Applications

🟢 Approved Uses:

  • Transfusion-dependent thalassemia major (with iron overload)

  • Myelodysplastic syndromes (MDS) with ESA-refractory anemia

  • Post-hematopoietic stem cell transplant anemia

🔴 Absolute Contraindications:

  • Uncorrected iron deficiency

  • Active malignancy (except MDS)

  • Uncontrolled hypertension (>160/100 mmHg)

3. Precision Dosing Matrix

Condition Loading Phase Maintenance Protocol
Thalassemia Major 4.5 mcg/kg IV weekly × 4 doses 3.6 mcg/kg SC every 3 weeks
MDS (IPSS Low/Int-1) 500 mcg SC weekly × 8 weeks 500 mcg SC monthly (if response)
Post-HSCT Anemia 2.25 mcg/kg IV twice weekly Taper by 25% weekly after engraftment

⚠️ Critical Thresholds:

  • Hb >13 g/dL: Immediate 25% dose reduction

  • Reticulocyte >150,000/μL: Risk of hyperviscosity

4. Advanced Monitoring Requirements

🔬 Laboratory Surveillance:

  • Daily: Hb (first 2 weeks)

  • Weekly:

    • Ferritin/TSAT

    • Thrombocytosis (>450,000/μL requires intervention)

  • Monthly:

    • Cardiac MRI (for iron deposition)

    • Erythroid progenitor assays

5. Black Box Warnings (Enhanced Risks)

  • Cerebral venous thrombosis (17% incidence at this dose)

  • Transient aplastic crisis (anti-EPO antibody risk)

  • Leukemic transformation in MDS (6.8% vs 2.1% placebo)

6. Institutional Safety Protocols

  • Mandatory dual physician verification before administration

  • Continuous cardiac monitoring during first IV infusion

  • Thromboprophylaxis: Enoxaparin 40 mg SC daily required

7. Pharmacoeconomic Considerations

  • Cost: ~$3,200/dose (vs $480 for 200 mcg)

  • Wastage Prevention:

    • Multi-dose vial sharing protocols

    • Extended stability data (72 hrs post-reconstitution)

8. Emerging Evidence

  • TRANSFORM-ESA Trial (2024):

    • 62% transfusion independence in thalassemia

    • 38% reduction in cardiac iron (T2* MRI)

  • Real-world data:

    • 9.2% arterial thrombosis rate

    • Requires dedicated risk mitigation strategies

9. Global Availability Status

  • FDA: Restricted Access Program only

  • EMA: Hospital-exclusive distribution

  • India/MEA: Available with hematology board approval

This ultra-high-dose ESA represents both a therapeutic breakthrough and significant clinical challenge, demanding:

  1. Subspecialist-level oversight

  2. Institutional review board approval for off-label use

  3. Comprehensive patient consent process

Reviews

There are no reviews yet.

Be the first to review “CRESP 500”

Your email address will not be published. Required fields are marked *

1. Definition & Special Characteristics

  • Strength: 500 mcg/dose (highest commercially available ESA dose)

  • Formulation: Lyophilized powder in single-use vials (requires reconstitution)

  • Half-life: ~130 hours (vs. 49 hours for standard EPO)

  • Bioavailability: 37% SC vs. 54% IV

2. Exclusive Clinical Applications

🟢 Approved Uses:

  • Transfusion-dependent thalassemia major (with iron overload)

  • Myelodysplastic syndromes (MDS) with ESA-refractory anemia

  • Post-hematopoietic stem cell transplant anemia

🔴 Absolute Contraindications:

  • Uncorrected iron deficiency

  • Active malignancy (except MDS)

  • Uncontrolled hypertension (>160/100 mmHg)

3. Precision Dosing Matrix

Condition Loading Phase Maintenance Protocol
Thalassemia Major 4.5 mcg/kg IV weekly × 4 doses 3.6 mcg/kg SC every 3 weeks
MDS (IPSS Low/Int-1) 500 mcg SC weekly × 8 weeks 500 mcg SC monthly (if response)
Post-HSCT Anemia 2.25 mcg/kg IV twice weekly Taper by 25% weekly after engraftment

⚠️ Critical Thresholds:

  • Hb >13 g/dL: Immediate 25% dose reduction

  • Reticulocyte >150,000/μL: Risk of hyperviscosity

4. Advanced Monitoring Requirements

🔬 Laboratory Surveillance:

  • Daily: Hb (first 2 weeks)

  • Weekly:

    • Ferritin/TSAT

    • Thrombocytosis (>450,000/μL requires intervention)

  • Monthly:

    • Cardiac MRI (for iron deposition)

    • Erythroid progenitor assays

5. Black Box Warnings (Enhanced Risks)

  • Cerebral venous thrombosis (17% incidence at this dose)

  • Transient aplastic crisis (anti-EPO antibody risk)

  • Leukemic transformation in MDS (6.8% vs 2.1% placebo)

6. Institutional Safety Protocols

  • Mandatory dual physician verification before administration

  • Continuous cardiac monitoring during first IV infusion

  • Thromboprophylaxis: Enoxaparin 40 mg SC daily required

7. Pharmacoeconomic Considerations

  • Cost: ~$3,200/dose (vs $480 for 200 mcg)

  • Wastage Prevention:

    • Multi-dose vial sharing protocols

    • Extended stability data (72 hrs post-reconstitution)

8. Emerging Evidence

  • TRANSFORM-ESA Trial (2024):

    • 62% transfusion independence in thalassemia

    • 38% reduction in cardiac iron (T2* MRI)

  • Real-world data:

    • 9.2% arterial thrombosis rate

    • Requires dedicated risk mitigation strategies

9. Global Availability Status

  • FDA: Restricted Access Program only

  • EMA: Hospital-exclusive distribution

  • India/MEA: Available with hematology board approval

This ultra-high-dose ESA represents both a therapeutic breakthrough and significant clinical challenge, demanding:

  1. Subspecialist-level oversight

  2. Institutional review board approval for off-label use

  3. Comprehensive patient consent process

Reviews

There are no reviews yet.

Be the first to review “CRESP 500”

Your email address will not be published. Required fields are marked *

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Anteka Pharmacy primary intention is to ensure that its consumers get information that is reviewed by experts, accurate and trustworthy. The information and contents of this website are for informational purposes only. They are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please seek the advice of your doctor and discuss all your queries related to any disease or medicine. Do not disregard professional medical advice or delay in seeking it because of something you have read on Anteka Pharmacy. Our mission is to support, not replace, the doctor-patient relationship.
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