Hemin Dosage

Medically reviewed by Drugs.com. Last updated on Aug 11, 2023.

Usual Adult Dose for Porphyria

1 to 4 mg/kg/day IV over at least 30 minutes

Maximum dose: 6 mg/kg per 24 hours

Duration: For 3 to 14 days based on clinical signs

Comments:

• In severe cases, dose may be repeated every 12 hours.

Use: This drug is indicated for the amelioration of recurrent attacks of acute intermittent porphyria temporally related to the menstrual cycle in susceptible women after initial carbohydrate therapy is known or suspected to be inadequate

Usual Pediatric Dose for Porphyria

16 years and older:
1 to 4 mg/kg/day IV over at least 30 minutes

Maximum dose: 6 mg/kg per 24 hours

Duration: For 3 to 14 days based on clinical signs

Comments:

• In severe cases, dose may be repeated every 12 hours

Use: This drug is indicated for the amelioration of recurrent attacks of acute intermittent porphyria temporally related to the menstrual cycle in susceptible women after initial carbohydrate therapy is known or suspected to be inadequate

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

CONTRAINDICATIONS:

• Hypersensitivity to the active component or any of the ingredients

Safety and efficacy have not been established in patients younger than 16 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Before administering this drug, a period of alternate therapy (i.e., 400 g glucose per day for 1 to 2 days) should be considered.
• When this drug is reconstituted, it is not transparent, and any undissolved particulate matter is difficult to see when inspected visually. Therefore, terminal filtration through a sterile 0.45 micron or smaller filter is recommended.

Storage requirements:

• Store lyophilized powder at 20C to 25C (68F to 77F).

Reconstitution technique:

• Reconstitute this drug by aseptically adding 48 mL of sterile water for injection, to the dispensing vial.
• Immediately after adding the diluent, shake well for 2 to 3 minutes.
• Because this drug contains no preservative and undergoes rapid chemical decomposition in solution, it should not be reconstituted until immediately before use.
• After the first withdrawal from the vial, any solution remaining should be discarded.

IV compatibility:

• This drug is compatible with sterile water for injection.
• No drug or chemical agent should be added to this drug admixture unless its effect on the chemical and physical stability has first been determined.

General:

• Therapy with this drug should be considered after an appropriate period of carbohydrate loading (i.e., 400 g of glucose per day for 1 to 2 days).
• This drug should only be used by physicians experienced in the management of porphyria in hospitals where the recommended clinical and laboratory diagnostic and monitoring techniques are available.
• Before initiating therapy, the presence of acute porphyria should be diagnosed using the following criteria: The presence of clinical symptoms and a positive Watson-Schwartz or Hoesch test (a negative Watson-Schwartz or Hoesch test indicates a porphyric attack is highly unlikely). When in doubt, quantitative measures of delta-aminolevulinic acid and porphobilinogen in serum or urine may aid in diagnosis.
• Therapy with this drug is intended to prevent an attack from reaching the critical stage of neuronal degeneration. This drug is not effective in repairing neuronal damage.
• For moderate-to-severe attacks, immediate treatment with this drug is recommended. Symptoms of severe attacks are severe or prolonged pain, persistent vomiting, hyponatremia, convulsion, psychosis, and neuropathy.
• Therapy with this drug is not curative. After discontinuation of therapy, symptoms generally return, although in some cases, remission is prolonged. Some neurological symptoms have improved weeks to months after therapy, although little or no response was noted at the time of treatment.

Monitoring:
Metabolic: Iron and serum ferritin
Urinary concentrations of the following compounds:

• Delta-aminolevulinic acid (ALA)
• Uroporphyrinogen (UPG)
• Porphobilinogen (PBG)
• Coproporphyrin

Patient advice:

• Read the US FDA-approved patient labeling (Patient Information).
• Patients should not take estrogens (e.g., oral contraceptives), barbiturates, or steroids, as they can trigger an attack or make the attack worse.
• Female patients should notify the prescriber if they are pregnant or planning to become pregnant.

See also:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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