Any Drs or Pharmacists out there? Need advice about medication.....

[NewYearDifferentName]

Background : 82 year old dad, diagnosed around a year ago with disseminating myeloid syndrome after a period of ill health and investigations for cancer and other conditions. He had one blood transfusion in the summer (2 units) which had minimal effect after the first week or so. After that the hospital decided not to do regular transfusions.

He also takes folic acid 5mg/day, vitamin D (blue capsule) x3 daily, simvastatin, ibuprofen for arthritis, omeprazole to protect his stomach. He had a heart attack in October 2012 and had 1 stent fitted, for this he had a year of clopidigril which he finished in October.

Today my mum informed me that he's been prescribed an injection called Aranesp as his blood count is dropping again. She was supposed to give the first dose today but couldn't open the package so rang me and asked me to give it to him tomorrow when I'm there (was children's nurse until 2011 when I left nursing).

I looks up this drug as its new to me and am really worried. I do intend to ring the consultant tomorrow (they have permission to speak to me about his health so that's not an issue) but wanted to get some opinions from here if I can....

Reading the online information from the company that make it, it appears to be given to patients with anaemia arising from either chronic kidney failure or oncology/chemotherapy related anaemia where the chemo will continue for at least 2 months after the start of the aranesp. He isn't in either of these categories. In contraindications they mention heart disease and previous heart attack.

The info also says treatment with this drug can lead to stroke, further heart attack and seizures as well as high blood pressure.

I am really worried that this drug isn't suitable for my dad and so don't want to start it before speaking to the consultant - it wasn't him who prescribed this drug but one of the more junior members of his team, I don't know if she was aware of his heart attack only 15 months ago (we weren't in the UK when it happened but Portugal and he's only had 1 follow up appointment here)

Can anyone help??

Sorry, realised I didn't put that, when he was diagnosed with the DMS he was told that in up to 10% of patients it can develop into leukaemia but he doesn't have that.

not a pharmacist.
It strikes me that your plan to speak to the cons before starting it is very wise.
it could be that they have prescribed it in full knowledge of his medical history, off label.

but it could easily be a cock up.

ring the secretary tomorrow and ask them to get the cons to phone you. if it's used off label this should have been discussed with him if he has capacity or his NOK/other involved competent person. imho

Also, what new year hasn't said is the info says it can lead to death. I know he's 82, but still......

Thanks pphwff, indeed I forgot to say that, the first line of patient information on the website provided by the manufacturer for this drug is that it can lead to death. As mikkii says, yes he's 82 and he's frail but he's still our dad and, other than being pig headed about some things and not listening to us about a few other things, he's certainly not on his last legs yet!!

I would definitely check with the consultant. Fwiw I often have weekly injections of Aranesp to increase my heamoglobin because of anaemia (have had a kidney transplant).

Clucky

Do you experience any side effects from taking aranesp?

Not that I have noticed Newyear and they tend to raise my hb pretty quickly too. They did raise my bp a bit but not so that I needed medication for it. I do usually need iron infusions as well as the Aranesp because the Aranesp increases hb but not the iron stores. I hope your dad is ok and you get to catch up with the consultant tomorrow. A little tip if your dad does need them, I give my own and find that pressing the plunger fairly slowly makes it sting less going in :)

Thanks again Clucky