Binocrit

Target a haemoglobin range of 10-12 g/dL; do not exceed 12 g/dL except in narrowly justified clinical settings.‍​‍‍‍​‍‍‍‍‍‍‍‍​‍ Targeting normal or supranormal haemoglobin increases cardiovascular and thromboembolic risk and, in oncology, mortality and tumour progression. Optimise iron, vitamin B12, and folate status before initiation and throughout therapy — most non-responders are functionally iron-deficient. Monitor blood pressure regularly and treat or intensify antihypertensive therapy as needed. Investigate any abrupt loss of efficacy with rapidly falling haemoglobin and reticulocyte count by an anti-EPO antibody assay (suspected PRCA) and discontinue all erythropoietin therapy if confirmed. In oncology, use only when symptomatic anaemia limits quality of life and discontinue when chemotherapy ends. Use cautiously in epilepsy, sickle-cell disease, and chronic liver disease.