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BLOOD AND BLOOD FORMING ORGANS › ANTIANEMIC PREPARATIONS › OTHER ANTIANEMIC PREPARATIONS › Other antianemic preparations
vadadustat
B03XA08
Forms & Strengths
- Oral tablets: 150 mg
- Oral tablets: 250 mg
- Oral tablets: 300 mg
Adult Dosing
- Starting dose: 300 mg orally once daily with or without food, regardless of dialysis status
- Maintenance titration: Adjust dose by 50 mg increments or decrements based on hemoglobin response (target range 10-11 g/dL)
- Maximum dose: 600 mg once daily
- Discontinue or interrupt if hemoglobin exceeds 11 g/dL or rises too rapidly (>1 g/dL in any 2-week period)
Pediatric Dosing
- Safety and effectiveness in pediatric patients below the age of 18 years have not been established
Indications
- Treatment of anemia due to chronic kidney disease (CKD) in adult patients on dialysis for at least 3 months
Mechanism of Action
- Inhibitor of hypoxia-inducible factor (HIF) prolyl hydroxylase (PH) enzymes (HIF-PHI)
- Stabilizes HIF-1alpha and HIF-2alpha transcription factors
- Stimulates endogenous erythropoietin production and improves iron mobilization and absorption, promoting erythropoiesis
Contraindications
- Known hypersensitivity to vadadustat or any of its excipients
- Use with strong CYP2C9 inhibitors (e.g., fluconazole)
Adverse Reactions
- Hypertension
- Vascular access thrombosis
- Diarrhea
- Peripheral edema
- Nausea
- Constipation
- Increased risk of major adverse cardiovascular events (MACE), thrombosis, and death when targets are inappropriately set
Drug Interactions
- Strong CYP2C9 inhibitors (e.g., fluconazole): Significantly increase vadadustat exposure; coadministration is contraindicated
- Moderate to strong CYP2C9 inducers (e.g., rifampin): May decrease vadadustat efficacy
- Iron supplements, phosphate binders, or multivalent cation-containing antacids: May bind vadadustat or alter absorption; separate administration times if interaction suspected
Curated Content: Needs Vetting Before Put to Clinical Use