Medical Information

Daprodustat is an oral hypoxia inducible factor prolyl hydroxylase inhibitor (HIF-PHI) primarily used for the treatment of anemia associated with chronic kidney disease (CKD). It promotes endogenous erythropoietin production by simulating hypoxic physiological responses, which is suitable for anemia management in specific populations. Strict adherence to medication indications and monitoring of cardiovascular risks are required.

1. Indications

(1) Adult chronic kidney disease anemia

Suitable for the treatment of anemia in adult patients with dialysis dependent CKD, with a target hemoglobin value of 10-11g/dL. Use only after ruling out other causes of anemia such as iron deficiency.

(2) Non dialysis dependent CKD

For patients with estimated glomerular filtration rate (eGFR) of 15-59mL/min/1.73m ² and insufficient response to erythropoietin therapy, hemoglobin changes need to be monitored every 4 weeks.

2. Medication precautions

(1) Cardiovascular risk monitoring

Before treatment, a history of thrombosis should be evaluated, and blood pressure and cardiovascular events should be monitored during medication. When the hemoglobin growth rate exceeds 1g/dL/2 weeks, it should be reduced.

(2) Iron metabolism management

Maintain transferrin saturation ≥ 20% and serum ferritin ≥ 100ng/mL. Iron supplementation should be given at least 1 hour after administration.

(3) Medication for special populations

Patients with liver function impairment need to adjust the dosage; Pregnant women are prohibited from using it; Suspend feeding during lactation period; Patients over 65 years old need to monitor hemoglobin more frequently.

3. Principle of dose adjustment

(1) Initial dose

Dialysis patients usually take 4mg once a day, while non dialysis patients adjust according to their weight (above 60kg and 6mg). Medication should be administered on an empty stomach.

(2) Dose titration

Adjust the dosage every 4 weeks, with a maximum increase or decrease of 2mg each time. When hemoglobin is greater than 11g/dL, administration should be suspended.

4. Adverse reaction management

(1) Hypertensive crisis

If there is a sudden increase in blood pressure (>180/110mmHg), the medication should be stopped immediately and antihypertensive treatment should be given.

(2) Thrombotic events

When symptoms of deep vein thrombosis occur, medication should be permanently discontinued and anticoagulant therapy should be initiated.

(3) Abnormal liver function

When ALT/AST>3 times ULN, treatment needs to be interrupted. After returning to baseline, consider reducing dosage and restarting.