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Goldwasser E. The action of erythropoietin as the inducer of erythroid differentiation. Prog Clin Biol Res. Steinberg MH. Erythropoietin for anemia of renal failure in sickle cell disease. N Engl J Med. Discontinue ESAs following completion of a course of chemotherapy.

How should I take Epogen?

Epogen for 3 months. Patients with anemia associated with CKD or cancer chemotherapy: No overall differences in safety and efficacy relative to younger adults. Information for Patients: Patients should be counseled that antibacterial drugs including Sulfamethoxazole and Trimethoprim tablets should only be used to treat bacterial infections.

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Steinberg H. Erythropoietin and visual hallucinations. N Engl J Med. Laver J, Moore MAS. Clinical use of recombinant human hematopoietic growth factors. J Natl Cancer Inst. Xifaxan if diarrhea persists more than 24-48 hours or worsens. Stockenhuber F, Kurz RW, Geissler K et al. Recombinant human erythropoietin activates a broad spectrum of progenitor cells. Kidney Int.

What are possible side effects of Mircera?

Stone WJ, Graber SE, Krantz SB et al. Treatment of the anemia of predialysis patients with recombinant human erythropoietin: a randomized, placebo-controlled trial. Am J Med Sci. 1988; 171-9. Further dosage increases are not likely to improve patient response and may increase risks of therapy; use lowest dosage sufficient to reduce need for RBC transfusions and discontinue drug if responsiveness does not improve. 1 400 See Boxed Warning. Gelmon K, Montaner JS, Fanning M et al. Nature, time course and dose dependence of zidovudine-related side effects: results from the multicenter Canadian azidothymidine trial. AIDS.



Mircera is administered to a nursing woman

Wognum AW, Lansdorp PM, Eaves AC et al. An enzyme-linked immunosorbent assay for erythropoietin using monoclonal antibodies, tetrameric immune complexes, and substrate amplification. Blood. Methods for Antimicrobial Susceptibility Testing of Anaerobic Bacteria; Approved Standard Eighth Edition. CLSI document M11-A8. Wayne, PA: Clinical and Laboratory Standards Institute, 2012. Hepatic metabolism contributes only minimally to elimination of the intact hormone. Grutzmacher P, Radtke HW, Stahl RAK et al. Renal artery stenosis and erythropoietin. Abstracts on recombinant erythropoietin from the American Society of Nephrology 21st annual meeting, San Antonio, TX, December 11-14, 1988. Surgical patients: No overall differences in safety and efficacy relative to younger adults. Graber SE, Krantz SB. Erythropoietin: biology and clinical use. Cowart VS. Erythropoietin: a dangerous new form of blood doping? For the treatment of documented Pneumocystis jiroveci pneumonia and for prophylaxis against P. jiroveci pneumonia in individuals who are immunosuppressed and considered to be at an increased risk of developing P. jiroveci pneumonia. May be beneficial in the treatment of anemia of prematurity. 2 18 36 37 187 331 336 338 350 453 465 519 562 563 564 Optimal patient selection criteria not established.



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Marinella, Mark A. 1999. Trimethoprim-induced hyperkalemia: An analysis of reported cases. Gerontol. Kurtz A, Eckardt KU, Neumann R et al. Site of erythropoietin formation. Contrib Nephrol. Meyer MP, Meyer JH, Commerford A et al. Recombinant human erythropoietin in the treatment of the anemia of prematurity: results of a double-blind, placebo-controlled study. Pediatrics. RxList is part of the WebMD Health Network. The opinions expressed in the WebMD User Reviews are solely those of the User, who may or may not have medical or scientific training, and do not represent the opinions of WebMD. These member reviews have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other purpose except for compliance with our Terms and Conditions. Macdougall IC, Roberts DE, Neubert P et al. Pharmacokinetics of recombinant human erythropoietin in patients on continuous ambulatory peritoneal dialysis. Lancet. Included as part of the PRECAUTIONS section. Peak blood levels for the individual components occur 1 to 4 hours after oral administration. The mean serum half-lives of Sulfamethoxazole and Trimethoprim are 10 and 8 to 10 hours, respectively. However, patients with severely impaired renal function exhibit an increase in the half-lives of both components, requiring dosage regimen adjustment see section. Detectable amounts of Sulfamethoxazole and Trimethoprim are present in the blood 24 hours after drug administration. Rechenstrasse 37, 9014 St. Gallen, Switzerland. Sawyer ST, Krantz SB, Goldwasser E. Binding and receptor-mediated endocytosis of erythropoietin in Friend virus- infected erythroid cells. J Biol Chem. etodolac



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Quantitative methods that require measurement of zone diameters can also provide reproducible estimates of the susceptibility of bacteria to antimicrobial compounds. The zone size provides an estimate of the susceptibility of bacteria to antimicrobial compounds. Schwartz AB, Mintz GS, Kim KE et al. Recombinant human erythropoietin rHuEPO increases MAP, TPRI and systolic and diastolic dysfunction with increased impedance to LV ejection due to increased HCT and RBC mass in pts with CRF. Abstracts on recombinant erythropoietin from the American Society of Nephrology 21st annual meeting, San Antonio, TX, December 11-14, 1988. Levine EA, Gould SA, Rosen RL et al. Perioperative recombinant human erythropoietin. Surgery. Williams MH, Wesseldine S, Somma T et al. The effect of induced erythrocythemia upon 5-mile treadmill run time. Med Sci Sports Exerc. Walker RE, Parker RI, Kovacs JA et al. Anemia and erythropoiesis in patients with the acquired immunodeficiency syndrome AIDS and Kaposi sarcoma treated with zidovudine. Ann Intern Med. Yoshida Y, Ohmori S, Tohyama K et al. Erythropoietic changes in chronic hemodialysis patients undergoing recombinant human erythropoietin therapy. Acta Haematol JPN. Phrommintikul A, Haas SJ, Elsik M et al. Mortality and target haemoglobin concentrations in anaemic patients with chronic kidney disease treated with erythropoietin: a meta-analysis. Lancet. Goldberg MA, Brugnara C, Dover GJ et al. Treatment of sickle cell anemia with hydroxyurea and erythropoietin. N Engl J Med. Samtleben W, Baldamus CA, Bommer J et al. Indications and contraindications for recombinant human erythropoietin treatment: results in hemodialysis patients. Contrib Nephrol. inderal how to purchase visa inderal



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Granolleras C, Branger B, Beau MC et al. Experience with daily self-administered subcutaneous erythropoietin. Contrib Nephrol. Fischer C, Scigalla P, Park W et al. Influence of rhEPO therapy on the protein metabolism of hemodialysis patients with terminal renal insufficiency. Contrib Nephrol. PRCA and severe anemia with or without other cytopenias reported in association with neutralizing antibodies to endogenous erythropoietin. Safety and effectiveness in pediatric patients has not been established. ESA to target a higher 13. DeMarchi S, Cecchin E, Villalta D et al. Relief of pruritus and decreases in plasma histamine concentrations during erythropoietin therapy in patients with uremia. N Engl J Med. Grimm G, Stockenhuber F, Schneeweiss B et al. Improvement of brain function in hemodialysis patients treated with erythropoietin. Kidney Int. Lamperi S, Carozzi S, Icardi A et al. Pathogenesis of uremic anemia and new therapeutic prospectives. Contrib Nephrol. Approximately 70% of sulfamethoxazole and 44% of trimethoprim are bound to plasma proteins. The presence of 10 mg percent sulfamethoxazole in plasma decreases the protein binding of trimethoprim by an insignificant degree; trimethoprim does not influence the protein binding of sulfamethoxazole. buy indinavir online visa europe



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The systemic exposure of rifaximin was markedly elevated in patients with hepatic impairment compared to healthy subjects. Use this medication regularly to get the most benefit from it. To help you remember, it may help to mark your calendar with a reminder. Miller BA, Cheung JY, Tillotson DL et al. Erythropoietin stimulates a rise in intracellular-free calcium concentration in single BFU-E derived erythroblasts at specific stages of differentiation. Blood. Epogen may harm your unborn baby. Not intended for patients with CKD who require acute correction of severe anemia; do not use as a substitute for emergency transfusion. Segal GM, Eschbach JW, Egrie JC et al. The anemia of end-stage renal disease: hematopoietic progenitor cell response. Kidney Int.



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ESA APPRISE Assisting Providers and Cancer Patients with Risk Information for the Safe Use of ESAs Oncology program. 1 619 621 See Restricted Distribution Program in Oncology under Dosage and Administration. Macdougall IC, Tucker B, Thompson J et al. A randomized controlled study of iron supplementation in patients treated with epoetin alfa. Kidney Int. Trimethoprim is metabolized in vitro to 11 different metabolites, of which, five are glutathione adducts and six are oxidative metabolites, including the major metabolites, 1- and 3-oxides and the 3- and 4-hydroxy derivatives. It is not known whether cinacalcet passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are taking this medicine. Nonnast-Daniel B, Schäffer J, Frei U. Hemodynamics in hemodialysis patients treated with recombinant human erythropoietin. Contrib Nephrol. The inhibitory effect of rifaximin on P-glycoprotein transport was observed in an in vitro study. The effect of rifaximin on P-gp transporter was not evaluated in vivo. Importance of regular monitoring of BP and hemoglobin concentration and of keeping appointments for determination of hemoglobin concentrations. sulfasalazine purchase shop otc



ESA for treatment of the anemia of CKD

Pavlovic-Kentera V, Ruvidic R, Milenkovic P et al. Erythropoietin in patients with anaemia in rheumatoid arthritis. Scand J Haematol. Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. Systemic absorption of Xifaxan 200 mg three times daily was evaluated in 13 subjects challenged with shigellosis on Days 1 and 3 of a three-day course of treatment. Rifaximin plasma concentrations and exposures were low and variable. There was no evidence of accumulation of rifaximin following repeated administration for 3 days 9 doses. Store in the refrigerator. not freeze. This may also be stored at room temperature for up to 30 days. Protect it from light. Store the medication in the original carton until ready for use. Let the medication come to room temperature before using. After each dose, throw away any unused medication right away. Keep all away from children and pets. Hypersensitivity reactions, including exfoliative dermatitis, rash, angioneurotic edema swelling of face and tongue and difficulty swallowing urticaria, flushing, pruritus and anaphylaxis have been reported. These events occurred as early as within 15 minutes of drug administration. Paganini E, Thomas T, Fouad F et al. The correction of anemia in hemodialysis patients using recombinant human erythropoietin r-HuEPO: hemodynamic effects. Protect Epogen from light. Infusions of Levophed are usually administered intravenously during cardiac resuscitation to restore and maintain an adequate blood pressure after an effective heartbeat and ventilation have been established by other means. Mircera with the incidence of antibodies to other ESAs may be misleading. McMahon FG, Vargas R, Ryan M et al. Pharmacokinetics and effects of recombinant human erythropoietin after intravenous and subcutaneous injections in healthy volunteers. Blood. Adamson JW. Erythropoietin: in vitro and in vivo studies of the regulation of erythropoiesis. Schweiz Med Wochenschr. What are the ingredients in Mircera? Pagel H, Jelkmann W, Weiss C. Erythropoietin and blood pressure. Horm Metab Res. vcet.info betapace



Indications and usage of epoetin-alfa

Mircera passes into your breast milk. Schuster SJ, Caro J, Erslev AJ. Erythropoietin: current concepts and future prospects. Hematol Pathol. CKD will require supplemental iron during the course of ESA therapy. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to use, whenever solution and container permit. AUC increase with dose. Beer J. Treatment of anaemia in chronic renal failure. Nurs Times. AU: This drug should be used only if clearly needed. Made from Recombinant DNA! Trimethoprim has been noted to impair phenylalanine metabolism but this is of no significance in phenylketonuric patients on appropriate dietary restriction. RBC transfusions during weeks 5-12. This medication is given as an injection under the skin or into a vein as directed by your doctor, usually 1 to 3 times a week. Patients getting this medication before surgery may have a special dosing schedule. Hemodialysis patients should receive this medication by injection into a vein. perindopril



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Delano BG, Lundin AP, Galonsky R et al. Dialyzer urea and creatinine clearances not significantly changed in r-HuEPO treated maintenance hemodialysis MD patients. Platanias LC, Miller CB, Mick R et al. Treatment of chemotherapy-induced anemia with recombinant human erythropoietin in cancer patients. J Clin Oncol. Nonoguchi H, Abe K, Komatsu F. Recombinant human erythropoietin for autologous blood donation. Lancet. National Kidney Foundation Study Group: NKF-DOQI clinical practice guidelines for the treatment of anemia of chronic renal failure. Am J Kidney Dis. What is the treatment for rectal bleeding blood in the stool? Recommendations for prophylaxis against Pneumocystis carinii pneumonia for adults and adolescents infected with human immunodeficiency virus. MMWR. Iseki K, Hori K, Onoyama K et al. Comparison of hemodynamic effects of blood transfusion and erythropoietin in chronic hemodialysis patients. Abstracts on recombinant erythropoietin from the American Society of Nephrology 21st annual meeting, San Antonio, TX, December 11-14, 1988. The Rome II criteria further categorizes IBS patients into 3 subtypes: diarrhea-predominant IBS IBS-D constipation-predominant IBS IBS-C or alternating IBS bowel habits alternating between diarrhea and constipation. Patients with both IBS-D and alternating IBS were included in Trials 1 and 2. Xifaxan is recommended for use in patients with IBS-D. Maier RF, Obladen M, Scigalla P et al. The effect of epoetin beta recombinant human erythropoietin on the need for transfusion in very-low-birth-weight infants. N Engl J Med. Watson AJ, Spivak JL. Recombinant human erythropoietin therapy in end stage renal failure. J Clin Pharmacol. Freedman BI, Barbour GL. Correction of the anemia of end- stage renal disease with recombinant human erythropoietin. N Engl J Med. Revlimid lenalidomide US prescribing information. Kanstrup IL, Ekblom B. Blood volume and hemoglobin concentration as determinants of maximal aerobic power. Med Sci Sports Exerc. Levophed should also not be given to patients with mesenteric or peripheral vascular thrombosis because of the risk of increasing ischemia and extending the area of infarction unless, in the opinion of the attending physician, the administration of Levophed is necessary as a life-saving procedure. Inject this medication into a vein or under the as directed by your doctor, usually every 2 to 4 weeks. patients should receive this medication by injection into a vein.



Prescribing information for epoetin-alfa

Epoetin alfa may sometimes cause or worsen high blood pressure, especially in patients with long-term kidney failure. This effect may be caused by the number of red blood cells increasing too quickly, usually within the first 3 months of starting treatment. If you have high blood pressure, it should be well controlled before beginning treatment with this medication. Your blood pressure should be checked often. Ask your doctor if you should learn how to check your own blood pressure. If high blood pressure develops or worsens, follow your doctor's instructions about diet changes and starting or adjusting your high blood pressure medication. Lowering high blood pressure helps prevent strokes, heart attacks, and further kidney problems. In an unrelated open-label, pharmacokinetic study of oral Xifaxan 200 mg taken every 8 hours for 3 days, 15 adult subjects were challenged with Shigella flexneri 2a, of whom 13 developed diarrhea or dysentery and were treated with Xifaxan. Although this open-label challenge trial was not adequate to assess the effectiveness of Xifaxan in the treatment of shigellosis, the following observations were noted: eight subjects received rescue treatment with ciprofloxacin either because of lack of response to Xifaxan treatment within 24 hours 2 or because they developed severe dysentery 5 or because of recurrence of Shigella flexneri in the stool 1; five of the 13 subjects received ciprofloxacin although they did not have evidence of severe disease or relapse. In vitro susceptibility testing was performed according to the Clinical and Laboratory Standards Institute CLSI. Has been used for the treatment and prevention of the normocytic, normochromic anemia associated with malignancy; 4 10 122 187 247 296 348 349 404 405 411 412 413 461 464 510 518 524 525 529 530 601 however, ESAs have been shown to decrease survival in certain cancer patients who are not receiving chemotherapy or radiation therapy. Instructions for Use” that come with Epogen. Not indicated in patients who are willing to donate autologous blood prior to elective surgery. Patient Instructions for Use”. Amgen. Epogen epoetin alfa product monograph. Thousand Oaks, CA; 1989 Sept. Rosenlöf K, Fyhrquist F, Pekonen F. Receptors for recombinant erythropoietin in human bone marrow cells. Scand J Clin Lab Invest. cheap isotrexin order payment otc



General information about epoetin-alfa

Jacobs J. Death due to iron parenterally. What is Epoetin Alfa Hexal? Corbo DC, Suddith RL, Sharma B et al. Stability, potency, and preservative effectiveness of epoetin alfa after addition of a bacteriostatic diluent. Am J Hosp Pharm. Rudoy RC, Nelson JD, Haltalin KC. Antimicrobial Agents Chemother. Hematologic: Agranulocytosis, aplastic anemia, thrombocytopenia, leukopenia, neutropenia, hemolytic anemia, megaloblastic anemia, hypoprothrombinemia, methemoglobinemia, eosinophilia. Severe skin reactions, generalized bone marrow suppression see and sections a specific decrease in platelets with or without purpura and hyperkalemia are the most frequently reported severe adverse reactions in elderly patients. In those concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. Increased digoxin blood levels can occur with concomitant Sulfamethoxazole and Trimethoprim therapy, especially in elderly patients. Serum digoxin levels should be monitored. Hematological changes indicative of folic acid deficiency may occur in elderly patients. These effects are reversible by folinic acid therapy. Appropriate dosage adjustments should be made for patients with impaired kidney function and duration of use should be as short as possible to minimize risks of undesired reactions see section. The trimethoprim component of Sulfamethoxazole and Trimethoprim may cause hyperkalemia when administered to patients with underlying disorders of potassium metabolism, with renal insufficiency or when given concomitantly with drugs known to induce hyperkalemia, such as angiotensin converting enzyme inhibitors. Close monitoring of serum potassium is warranted in these patients. Discontinuation of Sulfamethoxazole and Trimethoprim treatment is recommended to help lower potassium serum levels. It is unknown what increases this risk. Kurtz A, Eckardt KU, Tannahill L et al. Regulation of erythropoietin production. Contrib Nephrol. Macdougall IC, Coles GA, Williams JD. The pharmacokinetics of recombinant erythropoietin in CAPD patients. Abstracts on recombinant erythropoietin from the American Society of Nephrology 21st annual meeting, San Antonio, TX, December 11- 14, 1988. ESAs, including epoetin alfa, can only be prescribed and dispensed to cancer patients by authorized clinicians and institutions enrolled in the ESA APPRISE Oncology program. 1 619 See Restricted Distribution Program in Oncology under Dosage and Administration and also see REMS. Treatment with epoetin alfa may increase the growth of several types of cancer and reduce survival, and, therefore, its use should be restricted to the conditions discussed previously. Cotes PM. Immunoreactive erythropoietin in serum. I. Evidence for validity of the assay method and the physiological relevance of estimates. Br J Haematol. Besarab A, Goodkin DA, Nissenson AR et al. The normal hematocrit study--follow-up. N Engl J Med. National Collegiate Athletic Association. Fischl M, Galpin JE, Levine JD et al. Recombinant human erythropoietin for patients with AIDS treated with zidovudine. N Engl J Med. aromasin online no prescription



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Casati S, Passerini P, Campise MR et al. Benefits and risks of protracted treatment with human recombinant erythropoietin in patients having haemodialysis. BMJ. S23, Clinical and Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087, USA, 2013. James RD, Wilkinson PM, Belli F et al. Recombinant human erythropoietin in patients with ovarian carcinoma and anaemia secondary to cisplatin and carboplatin chemotherapy: preliminary results. Acta Haematol. Christensen RD. Recombinant erythropoietic growth factors as an alternative to erythrocyte transfusion for patients with “anemia of prematurity. Graf H, Lacombe JL, Braun J et al. Novel erythropoiesis stimulating protein NESP effectively maintains hemoglobin Hgb when administered at a reduced dose frequency compared with recombinant human erythropoietin r-HuEPO in ESRD patients. Paper presented at 33rd American Society of Nephrology annual meeting. Toronto, Canada: 2000 Oct. Abstract. Schmidt B, Ward RA. The impact of erythropoietin on hemodialyzer design and performance. Artif Organs. Do not start, stop, or change the dosage of any medication before checking with them first. Kokot F, Wiecek A, Grzeszczak W et al. Influence of erythropoietin treatment on endocrine abnormalities in haemodialyzed patients. Contrib Nephrol. Fandrey J, Seydel FP, Siegers CP et al. Role of cytochrome P450 in the control of the production of erythropoietin. Life Sci. HE, adjusted for body surface area. Epoetin Alfa Hexal is used as safely as possible. Based on this plan, safety information has been included in the summary of product characteristics and the package leaflet for Epoetin Alfa Hexal, including the appropriate precautions to be followed by healthcare professionals and patients. Duration of Therapy: The infusion should be continued until adequate blood pressure and tissue perfusion are maintained without therapy. Infusions of Levophed should be reduced gradually, avoiding abrupt withdrawal. In some of the reported cases of vascular collapse due to acute myocardial infarction, treatment was required for up to six days. The European Commission granted a marketing authorisation valid throughout the European Union for Epoetin Alfa Hexal on 28 August 2007. Meytes D, Bogin E, Ma A et al. Effect of parathyroid hormone on erythropoiesis. J Clin Invest. vivitrol



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List of epoetin-alfa side effects


What are the possible side effects of epoetin-alfa

Cotes PM, Pippard MJ, Reid CDL et al. Continuing correction of anaemia by treatment with recombinant erythropoietin in patients maintained by haemodialysis. Exp Hematol. Bommer J, Ritz E, Weinreich T et al. Subcutaneous erythropoietin. Lancet. OMONTYS will harm your unborn baby. Lundin AP, Delano BG, Quinn-Cefaro R. Perspectives on the improvement of quality of life with epoetin alfa therapy. Pharmacotherapy.

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Halpérin DS, Wacker P, Lacourt G et al. Effects of recombinant human erythropoietin in infants with the anemia of prematurity: a pilot study. J Pediatr. What brand names are available for sargramostim? Clostridium difficile-associated diarrhea CDAD has been reported with use of nearly all antibacterial agents, including Xifaxan, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon which may lead to overgrowth of C. difficile. Amgen Inc. Darbepoetin alfa: Summary of clinical publications. Thousand Oaks, CA; undated.

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The adverse reactions leading to discontinuation were taste loss, dysentery, weight decrease, anorexia, nausea and nasal passage irritation. ESAs to patients with cancer; participants must re-enroll every 3 years. 1 619 For additional information or to enroll in the ESA APPRISE Oncology program, contact 866-284-8089 or visit www. RBCs to near the same level found in healthy people. Does epoetin alfa injection have side effects? Increased incidence of thromboembolic events also observed in patients undergoing orthopedic surgical procedures without prophylactic anticoagulation and receiving epoetin alfa to reduce allogeneic RBC transfusion requirements. 1 400 589 590 Antithrombotic prophylaxis strongly recommended when ESAs are used in such patients.

Side Effects - Drugs

NDC 55513-144-10 of epoetin alfa. Zehnter E, Pollok M, Longere F et al. Urea kinetics UK in patients on RDT treated with recombinant erythropoietin EPO. Not indicated for reduction of allogeneic RBC transfusions in patients undergoing cardiac or vascular surgery. 1 400 597 601 See Increased Mortality and Cardiovascular and Thromboembolic Events under Cautions. Miles SA, Mitsuyasu RT, Moreno J et al. Combined therapy with recombinant granulocyte colony-stimulating factor and erythropoietin decreases hematologic toxicity from zidovudine. Blood. Shimizu T, Miyake T, Pilch AM et al. Biochemical properties of human urinary megakaryocyte colony-stimulating factor and erythropoietin: the role of sulfhydryl groups and disulfide bonds. Exp Cel Biol.

Regularly monitor CBC, including reticulocyte count, blood cell differential, platelet count, and determination of erythrocyte indices Wintrobe indices. General principles of treatment include the institution of gastric lavage or emesis, forcing oral fluids and the administration of intravenous fluids if urine output is low and renal function is normal. Acidification of the urine will increase renal elimination of trimethoprim. The patient should be monitored with blood counts and appropriate blood chemistries, including electrolytes. If a significant blood dyscrasia or jaundice occurs, specific therapy should be instituted for these complications. Peritoneal dialysis is not effective and hemodialysis is only moderately effective in eliminating Sulfamethoxazole and Trimethoprim.

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