Home Drug Guide Daprodustat

Drug Guide

Generic Name

Daprodustat

Brand Names Jesduvroq

Classification

Therapeutic: Hematologic agent (Anemia in CKD)

Pharmacological: Hematopoietic agent (Hypoxia-inducible factor prolyl hydroxylase inhibitor)

FDA Approved Indications

Treatment of anemia associated with chronic kidney disease (CKD) in adult patients on dialysis

Mechanism of Action

Daprodustat stimulates erythropoiesis by inhibiting hypoxia-inducible factor prolyl hydroxylase, leading to stabilization of hypoxia-inducible factors (HIFs), which increases endogenous erythropoietin production and enhances red blood cell production.

Dosage and Administration

Adult: The recommended starting dose is 4 mg orally once daily. Dose adjustments are based on hemoglobin response.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dose adjustments recommended solely based on age.

Renal Impairment: Adjustments not specified; monitor hemoglobin levels closely.

Hepatic Impairment: No specific adjustments; clinical data limited.

Pharmacokinetics

Absorption: Rapidly absorbed after oral administration.

Distribution: Appears to be extensively distributed; specific volume not specified.

Metabolism: Metabolized primarily via non-enzymatic pathways; minor contribution from CYP enzymes.

Excretion: Mostly excreted in feces; minimal renal excretion.

Half Life: Approximately 12 hours.

Contraindications

Hypersensitivity to daprodustat or excipients.
Uncontrolled hypertension.

Precautions

Monitor hemoglobin levels regularly.
Risk of hypertension, thrombosis, and cardiovascular events.
Avoid in patients with active malignancy or history of malignancy.
Use with caution in patients with liver disease or edema.

Adverse Reactions - Common

Headache (Uncommon)
Nausea (Uncommon)
Hypertension (Common)
Diarrhea (Uncommon)

Adverse Reactions - Serious

Thromboembolic events (Rare)
Hypertensive crises (Rare)
Malignancy (Uncertain, ongoing studies)

Drug-Drug Interactions

Immunosuppressants, other erythropoiesis-stimulating agents, CYP inducers or inhibitors affecting metabolism.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor hemoglobin, hematocrit, blood pressure, and signs of thromboembolic events.

Diagnoses:

Risk for embolism related to erythropoiesis stimulation.
Ineffective tissue perfusion related to thromboembolic events.

Implementation: Administer orally as prescribed; educate patient on adherence and monitoring.

Evaluation: Assess hemoglobin response; ensure blood pressure remains within target range; monitor for adverse reactions.

Patient/Family Teaching

Take medication exactly as prescribed.
Report symptoms of hypertension or blood clots (chest pain, leg swelling, sudden numbness).
Maintain follow-up appointments for blood tests.

Special Considerations

Black Box Warnings:

Risk of thrombosis, including thromboembolic events.
Potential for tumor progression or recurrence in patients with active malignancy.

Genetic Factors: Genetic polymorphisms affecting HIF pathway may influence response.

Lab Test Interference: May affect erythropoietin levels and hematology parameters.

Overdose Management

Signs/Symptoms: Symptoms of excessive erythropoiesis, hypertension, thromboembolic events.

Treatment: Supportive care; monitoring; no specific antidote.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable under recommended storage conditions.