CinnaPoietin (Erythropoietin β)

Cinnapoietin is a clear, colourless solution for injection under the skin or into a vein. It contains a hormone called epoetin beta, which stimulates the production of red blood cells. Epoetin beta is produced by a specialized genetic technology and works in exactly the same way as the natural hormone erythropoietin.

• It is used in the treatment of anemia associated with chronic kidney disease in patients on dialysis and symptomatic patients not yet undergoing dialysis.

• It is used to increase the yield of autologous blood from patients in a pre-donation program initiated to avoid the use of homologous blood.

• It is used in the prevention of anemia of prematurity in infants with a birth weight of 750 g to 1500 g and gestational age of less than 34 weeks.

• It is used in the treatment of anemia and reduction of transfusion requirements in patients with non-myeloid malignancies, where anemia develops as a result of concomitantly administered chemotherapy.

Do not use Cinnapoietin:

• If you are allergic to epoetin beta or any of the other ingredients of this medicine.

• If you have high blood pressure that cannot be controlled.

• If you are donating your blood before surgery, and.

• You had a stroke or heart attack in the month before your treatment.

• You have unstable angina pectoris (new or increasing chest pain). You are at risk of blood clots in the veins – for example, if you have had clots before.

• If it is your baby that needs treatment with Cinnapoietin, your baby will be carefully monitored for any potential effects on the eye.

• If your anemia does not improve with epoetin treatment.

• If you are low in B vitamins (folic acid or vitamin B12).

• If you have high levels of aluminium in your blood.

• If your blood platelet count is high.

• If you have chronic liver disease.

• If you have epilepsy.

• If you have developed anti-erythropoietin antibodies and pure red cell aplasia (reduced or stopped production of red blood cells) during prior exposure to any erythropoietic substance. In this case, you should not be switched to Cinnapoietin.

• If you are pregnant or planning to become pregnant.

• If you are breastfeeding or planning to breastfeed.

What should I know before using Cinnapoietin?

• Cardiovascular and thrombotic events such as myocardial ischemia and infarction, cerebrovascular hemorrhage and infarction, transient ischaemic attacks, deep venous thrombosis, arterial thrombosis, pulmonary emboli, retinal thrombosis, and hemodialysis graft occlusion have been reported in patients receiving Erythropoiesis Stimulating Agents (ESAs).  To reduce cardiovascular risks, your doctor will use the lowest dose of CinnaPoietin which will gradually increase the hemoglobin concentration.

• CinnaPoietin should only be used in cancer patients with anemia where the anemia has arisen as a result of concomitantly administered chemotherapy.

• CinnaPoietin could act as a growth factor for any type of malignancy.

• Pure Red Cell Aplasia (PRCA) caused by neutralizing anti-erythropoietin antibodies has been reported in association with ESA therapy. Patients confirmed or suspected to have neutralizing antibodies to erythropoietin should not be switched to CinnaPoietin. If anti-erythropoietin antibody-mediated PRCA develops while on CinnaPoietin, therapy with CinnaPoietin must be discontinued and patients should not be switched to another ESA.

• CinnaPoietin should be used with caution in the presence of refractory anemia with excess blasts in transformation chronic liver failure, and thrombocytosis. 

• ESAs should be used carefully or with caution in patients with epilepsy.

• The indication of nephrosclerotic patients not yet undergoing dialysis should be defined individually as a possible acceleration of progression of renal failure that cannot be ruled out with certainty.

• Anaphylactoid reactions have been observed in isolated cases.

• In dialysis patients, an increase in heparin dose is frequently required during the course of CinnaPoietin therapy as a result of increased hemoglobin. Occlusion of the dialysis system is possible if heparinisation is not optimum.

Use Cinnapoietin exactly as your doctor has told you. Your doctor will use the lowest dose to control the symptoms of your anemia. If you do not respond to Cinnapoietin your doctor will check your dose and will inform you if you need to change doses. Further injections are given by your doctor or, you can also inject Cinnapoietin yourself after receiving training. Cinnapoietin can be injected under the skin in the abdomen, arm, or thigh; or into a vein.

Your doctor will carry out regular blood tests to monitor how your anemia is responding to treatment by measuring your hemoglobin level.

Skin reactions such as rash, injection site reactions, pruritus, or urticaria may happen particularly when starting treatment,    

Flu-like symptoms such as headaches, pain in the limbs, fever, chills, malaise, and/or bone pain have been reported. These reactions were mild to moderate and subsided after a couple of hours or days.

• Store between 2- 8 °C (in the refrigerator) in the carton to protect from light.

• Do not freeze.

• Keep Cinnapoietin out of reach of children.