ARANESP (DARBEPOETIN) FOR CKD		version 7/10/2025		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room	Every 4 weeks	S	 treatments	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine		

Provider Communication 	

	
	Interval	Defer Until	Duration	
	☑	Coverage Determination Considerations: Hemoglobin must be less than 10 g/dL (hematocrit less than 30%) and obtained within 14 days.	Once	S	1 treatment	
		For 1st dose only.		

Labs 	

	
	Interval	Defer Until	Duration	
	☑	Hemoglobin & hematocrit	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect		
	☐	CBC with platelet and differential	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect		
	☑	Iron level	Every 90 days	S+90	 treatments	
		STAT, Normal, Clinic Collect		
	☑	Total iron binding capacity	Every 90 days	S+90	 treatments	
		STAT, Normal, Clinic Collect		
	☑	Ferritin level	Every 90 days	S+90	 treatments	
		STAT, Normal, Clinic Collect		
	☐	Creatinine level	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☑	Nursing communication	Every visit	S	Until discont'd	
		Ensure hemoglobin results have been obtained within 2 weeks before each dose. If not, please obtain. 
	Check and document blood pressure before administering dose.		
	☑	Treatment conditions	Every visit	S	 treatments	
		Hold dose if SBP GREATER than 170 mmg Hg or DBP GREATER than 110 mm Hg, and notify ordering provider.
	
	o If hemoglobin LESS than 7, administer scheduled dose and notify ordering provider.
	o If hemoglobin is GREATER than or EQUAL to 7 and LESS than 9, administer scheduled dose and notify ordering provider of result for potential dose adjustment for next scheduled dose. 
	o If hemoglobin is GREATER than or EQUAL to 9 and LESS than 11, administer scheduled dose.  No need to notify ordering provider of result.
	o If hemoglobin is GREATER than or EQUAL to 11 and LESS than 12, administer scheduled dose and notify ordering provider of result for potential dose adjustment for next scheduled dose. 
	o If hemoglobin is GREATER than 12, do NOT administer scheduled dose and contact ordering provider.		

Medications 	

	
	Interval	Defer Until	Duration	
	☑	darbepoetin (ARANESP) injection solution 0.45 mcg/kg	Every 4 weeks	S	 treatments	
		0.45 mcg/kg, subcutaneous, once, Starting when released