Polycythemia medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Debduti Mukhopadhyay, M.B.B.S[2]
Overview
- Phlebotomy is used to decrease blood thickness.
- Medicines that may be used include:
- Hydroxyurea: reduce the number of red blood cells made by the bone marrow. This drug may be used when the numbers of other blood cell types are also high.
- Interferon: lower blood counts.
- Anagrelide: lower platelet counts.
- Ruxolitinib (Jakafi): reduce the number of red blood cells and reduce an enlarged spleen. This drug is prescribed when hydroxyurea and other treatments have failed.
- Aspirin: reduce the risk of blood clots.
- Ultraviolet-B light therapy: reduce the itchiness.
Medical Therapy
- Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
- Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
- Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
- Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
Disease Name
- 1 Stage 1 - Name of stage
- 1.1 Specific Organ system involved 1
- 1.1.1 Adult
- Preferred regimen (1): drug name 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
- Preferred regimen (2): drug name 500 mg PO q8h for 14-21 days
- Preferred regimen (3): drug name 500 mg q12h for 14-21 days
- Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
- Alternative regimen (2): drug name 500 mg PO q12h for 14–21 days
- Alternative regimen (3): drug name 500 mg PO q6h for 14–21 days
- 1.1.2 Pediatric
- 1.1.2.1 (Specific population e.g. children < 8 years of age)
- Preferred regimen (1): drug name 50 mg/kg PO per day q8h (maximum, 500 mg per dose)
- Preferred regimen (2): drug name 30 mg/kg PO per day in 2 divided doses (maximum, 500 mg per dose)
- Alternative regimen (1): drug name10 mg/kg PO q6h (maximum, 500 mg per day)
- Alternative regimen (2): drug name 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
- Alternative regimen (3): drug name 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
- 1.1.2.2 (Specific population e.g. 'children < 8 years of age')
- Preferred regimen (1): drug name 4 mg/kg/day PO q12h(maximum, 100 mg per dose)
- Alternative regimen (1): drug name 10 mg/kg PO q6h (maximum, 500 mg per day)
- Alternative regimen (2): drug name 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
- Alternative regimen (3): drug name 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
- 1.1.2.1 (Specific population e.g. children < 8 years of age)
- 1.1.1 Adult
- 1.2 Specific Organ system involved 2
- 1.1 Specific Organ system involved 1
- 2 Stage 2 - Name of stage
- 2.1 Specific Organ system involved 1
- Note (1):
- Note (2):
- Note (3):
- 2.1.1 Adult
- Parenteral regimen
- Oral regimen
- Preferred regimen (1): drug name 500 mg PO q8h for 14 (14–21) days
- Preferred regimen (2): drug name 100 mg PO q12h for 14 (14–21) days
- Preferred regimen (3): drug name 500 mg PO q12h for 14 (14–21) days
- Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
- Alternative regimen (2): drug name 500 mg PO q12h for 14–21 days
- Alternative regimen (3):drug name 500 mg PO q6h for 14–21 days
- 2.1.2 Pediatric
- Parenteral regimen
- Preferred regimen (1): drug name 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
- Alternative regimen (1): drug name 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
- Alternative regimen (2): drug name 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) '(Contraindications/specific instructions)'
- Oral regimen
- Preferred regimen (1): drug name 50 mg/kg/day PO q8h for 14 (14–21) days (maximum, 500 mg per dose)
- Preferred regimen (2): drug name (for children aged ≥ 8 years) 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
- Preferred regimen (3): drug name 30 mg/kg/day PO q12h for 14 (14–21) days (maximum, 500 mg per dose)
- Alternative regimen (1): drug name 10 mg/kg PO q6h 7–10 days (maximum, 500 mg per day)
- Alternative regimen (2): drug name 7.5 mg/kg PO q12h for 14–21 days (maximum, 500 mg per dose)
- Alternative regimen (3): drug name 12.5 mg/kg PO q6h for 14–21 days (maximum,500 mg per dose)
- Parenteral regimen
- 2.2 'Other Organ system involved 2'
- Note (1):
- Note (2):
- Note (3):
- 2.2.1 Adult
- Parenteral regimen
- Oral regimen
- Preferred regimen (1): drug name 500 mg PO q8h for 14 (14–21) days
- Preferred regimen (2): drug name 100 mg PO q12h for 14 (14–21) days
- Preferred regimen (3): drug name 500 mg PO q12h for 14 (14–21) days
- Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
- Alternative regimen (2): drug name 500 mg PO q12h for 14–21 days
- Alternative regimen (3):drug name 500 mg PO q6h for 14–21 days
- 2.2.2 Pediatric
- Parenteral regimen
- Preferred regimen (1): drug name 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
- Alternative regimen (1): drug name 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
- Alternative regimen (2): drug name 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day)
- Oral regimen
- Preferred regimen (1): drug name 50 mg/kg/day PO q8h for 14 (14–21) days (maximum, 500 mg per dose)
- Preferred regimen (2): drug name 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
- Preferred regimen (3): drug name 30 mg/kg/day PO q12h for 14 (14–21) days (maximum, 500 mg per dose)
- Alternative regimen (1): drug name 10 mg/kg PO q6h 7–10 days (maximum, 500 mg per day)
- Alternative regimen (2): drug name 7.5 mg/kg PO q12h for 14–21 days (maximum, 500 mg per dose)
- Alternative regimen (3): drug name 12.5 mg/kg PO q6h for 14–21 days (maximum,500 mg per dose)
- Parenteral regimen
- 2.1 Specific Organ system involved 1