In my past two blog postings I have talked about some recent warnings from the Food and Drug Administration (FDA) that concern me as a geriatric care manager, and they should concern caregivers and the elders in their charge as well. This most recent and third warning was about some of the dosing for drugs that are used for people who may be anemic or suffer from chronic kidney disease or be on chemotherapy of some sort. As you may suspect, this is a relatively smaller segment of the adult population, and as you will see here, it gets even smaller as we are mainly talking about people with chronic kidney disease. But one of these medications has been part of one of my client’s standard monthly routine for some time, so it struck closer to home.
You may know these drugs by their brand names if you or a loved one has one of the conditions. The brand names are Procrit, Epotin or Aranesp, and they help the body increase the red blood cell count for people with some types of anemia. These drugs, referred to as erythropoiesis-stimulating agents or ESAs, are also now known to increase patients’ risk of cardiovascular events. As with the other two warnings I have posted, these risks only became known over time as more and more people were given these medications. This is because the actual cardiovascular events they can cause are still fairly rare.
All of these drugs already had had warnings of one sort or another on their packaging, so doctors have been aware of those. The new warnings, in fact, are most particularly a danger for patients whose medications move their hemoglobin levels above a given point. These drugs were intended to replace the need for certain patients to have red blood cell transfusions which also pose their own risks. The new guidelines have been made clear to doctors in new warnings on the package inserts of these drugs, and they specifically make it clear that patients with chronic kidney disease and on dialysis should be treated differently from patients who are not on dialysis.
As with any warning from an agency like the FDA, this may call for a conversation with your provider. If you or an elder or other special needs person for whom you are a caregiver have chronic kidney disease, you should talk with your specialist about steps that may be taken to minimize any unnecessary heart risks.
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families throughout metropolitan Chicago. Please email your questions to Charlotte Bishop.