Nephrology Medications

Each is listed with the kidney uses its FDA label gives it:

• Anemia of chronic kidney disease: Epogen (epoetin alfa), also sold as Procrit, given by subcutaneous injection or intravenously, for patients on dialysis or not, to lower the need for red blood cell transfusions. For iron deficiency anemia with CKD: Venofer (iron sucrose), with or without dialysis; Injectafer (ferric carboxymaltose), for patients not on dialysis; Feraheme (ferumoxytol); and Ferrlecit (sodium ferric gluconate complex in sucrose), for patients on hemodialysis who also receive epoetin. All four are given intravenously; iron infusion at home describes each one.
• Autosomal dominant polycystic kidney disease (ADPKD): Jynarque (tolvaptan), a tablet, for adults at risk of rapidly progressing ADPKD, to slow the loss of kidney function. Jynarque is available only through a REMS safety program; MedRx Infusion is certified to dispense it. The same medicine, as Samsca, is approved for serious hyponatremia (low blood sodium) with normal or high body fluid, and is started in a hospital.
• Lupus nephritis: Benlysta (belimumab), given intravenously or by subcutaneous injection, for patients 5 years and older with active lupus nephritis who are receiving standard therapy.
• Atypical hemolytic uremic syndrome (aHUS): Soliris (eculizumab) and Ultomiris (ravulizumab-cwvz), both intravenous; neither is for HUS caused by Shiga toxin-producing E. coli (STEC-HUS). Each is available only through a REMS safety program, and MedRx Infusion is certified to dispense both.
• Immunoglobulin A nephropathy (IgAN): Ultomiris, for adults with primary IgAN at risk of disease progression, to reduce proteinuria (protein in the urine). This use has accelerated approval, an early approval that depends on the results of a further study.
• Infections: IV antibiotics and anti-infectives, among them agents approved for complicated urinary tract infections and pyelonephritis (kidney infection). See IV antibiotics at home.
• Nutrition during dialysis: intradialytic parenteral nutrition (IDPN), which is given during dialysis. See nutritional therapy.

Epogen can be given under the skin at home by the patient or a caregiver after training, and a nurse can teach the technique; for patients on hemodialysis, the label recommends giving it intravenously, usually through the dialysis line. Benlysta's subcutaneous injection can also be self-given after training.

Jynarque is taken at home: MedRx ships it to the patient's door, and the prescriber orders regular liver blood tests.

For an infusion the prescriber approves for home, such as Venofer, Injectafer or an IV antibiotic, MedRx sends a skilled, trusted and licensed nurse from an accredited nursing agency.

Ferrlecit and IDPN are given during dialysis sessions. Feraheme's label requires staff and treatment for serious allergic reactions to be ready, and at least 30 minutes of observation. The prescriber, with the dialysis team for Ferrlecit, determines where these are given.

1. The nephrologist's office faxes the referral or calls (844) 671-2600, sending the Nephrology referral form (PDF), or for IV iron the Iron infusion referral form (PDF), with recent notes and laboratory results. Other forms are on Quick Referral.
2. MedRx's intake team confirms benefits and requests the prior authorization the plan requires.
3. Medications such as Epogen and Jynarque, with supplies, are delivered to the patient's door at no charge. Next-day delivery is available; timing varies by location.
4. A skilled, trusted and licensed nurse from an accredited nursing agency gives any infusion approved for home.
5. Patients can call a MedRx pharmacist 24 hours a day, 7 days a week.

Plans commonly require prior authorization for epoetin, IV iron and the biologics on this page. MedRx checks coverage with the nephrologist's office before the first delivery, and helps patients apply for copay assistance, grants and manufacturer programs such as Amgen SupportPlus for Epogen and Otsuka Patient Support for Jynarque.

• Anemia of chronic kidney disease: Venofer, Injectafer, Ferumoxytol, Ferrlecit and Epogen.
• Kidney conditions: Tolvaptan, Benlysta, Ultomiris and Soliris.
• Infusions at home: IV antibiotics.
• Nutrition: intradialytic and parenteral nutrition.

Each has its own page: what it is approved for, how it is given, and how to start. See every medication we fill.