vadadustat: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
vadadustat: clinical details
Prescribing considerations
- Confirm symptomatic anaemia associated with dialysis-dependent chronic kidney disease and assess other causes, including bleeding, inflammation, vitamin deficiency and inadequate iron availability.
- Do not use for non-dialysis-dependent chronic kidney disease; cardiovascular safety was not established in this population.
- Review thromboembolism, cardiovascular disease, hypertension, seizure history and severe hepatic impairment.
- The product is under additional monitoring; report suspected adverse reactions through the Yellow Card scheme.
Contraindications and cautions
- Hypersensitivity to vadadustat or any excipient.
- Severe hepatic impairment is not a formal contraindication, but use is not recommended because it has not been adequately studied.
Monitoring
- Haemoglobin response and rate of change.
- Blood pressure, iron status and nutritional factors.
- ALT, AST and bilirubin.
- Clinical evidence of thrombosis, dialysis-access dysfunction, seizures and cardiovascular events.
Clinical pharmacology
Vadadustat is an oral HIF prolyl-hydroxylase inhibitor that increases endogenous erythropoietin, iron mobilisation and erythropoiesis. It is highly protein-bound, mainly metabolised through glucuronidation, and only partly removed by dialysis.
Formulation and product differences
- The selected product is a film-coated oral tablet that should be swallowed whole.
- The selected tablet is yellow and oval; strength selection is managed separately according to the prescribed preparation.
vadadustat preparations and strengths
Tablet
Route: Oral
Strengths: 150 mg, 300 mg
vadadustat interactions
Check the complete medicine list, including supplements and phosphate binders, before and during treatment.
Oral iron and iron-containing phosphate binders
They can markedly reduce vadadustat absorption, so administration must be separated.
Sevelamer, calcium acetate and other multivalent-cation products
They can reduce absorption and require separated administration.
Probenecid and other OAT1/OAT3 inhibitors
They may increase vadadustat exposure.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.