A patient on one erythropoiesis-stimulating agent may be switched to another by using the equivalent dose.
Erythropoiesis-stimulating agents:
(1) recombinant erythropoietin (Epoetin Beta)
(2) darbepoetin alfa
(3) continuous erythropoietin receptor stimulating activator (CERA)
The official conversion of Epoetin Beta to Darbepoetin Alfa is 200 Units Epoetin to 1 µg Darbepoetin.
Factors that may alter the conversion factor:
(1) race
(2) hemoglobin
(3) low vs high dose
(4) iron status
Patient Population
Equivalence for 1 µg Darbepoetin
Taiwanese, hemoglobin 8 to10 g/dL
296.4 IU
Taiwanese, hemoglobin 10.1 to 11 g/dL
277.2 IU
low dose epoetin (<= 200 IU per kg per week)
300 IU
high dose epoetin (> 200 IU per kg per week)
350 IU
hospital-based dialysis patients (Sharma et al)
320 IU
Horowitz et al
302 to 380 IU
The patient's hemoglobin should be monitored after the conversion and adjustments made to the dose of the new erythropoiesis stimulant.
For a continuous erythropoietin receptor activator (CERA) the dose is:
(1) 60 IU/week Epoetin beta is equivalent to 1 µg/month CERA
(2) 1 µg/week Darboetin alfa is equivalent to 3.33 µg/month CERA
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Specialty: Pharmacology, clinical
