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What is Vadadustat: Uses, Dosage, Side Effects and More

Created at:1/13/2025

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Vadadustat is a newer type of medication that helps your body make more red blood cells when you have anemia related to chronic kidney disease. It works differently from traditional treatments by mimicking what happens naturally when your body needs more oxygen-carrying red blood cells.

This oral medication offers an alternative to injectable treatments that many kidney patients have used for years. Understanding how it works and what to expect can help you feel more confident about your treatment plan.

What is Vadadustat?

Vadadustat is an oral medication that belongs to a class of drugs called HIF-PHI (hypoxia-inducible factor prolyl hydroxylase inhibitors). It helps treat anemia in adults with chronic kidney disease who are on dialysis.

Think of it as a medication that tricks your body into thinking it needs more oxygen. When your body senses low oxygen levels, it naturally produces more red blood cells to carry oxygen around your body. Vadadustat activates this same pathway, encouraging your bone marrow to make more red blood cells even when oxygen levels are normal.

This medication represents a significant advancement in anemia treatment because it can be taken by mouth rather than through injections. Your doctor prescribes it as tablets that you take daily, making it more convenient than some traditional treatments.

What is Vadadustat Used For?

Vadadustat is specifically approved to treat anemia in adults with chronic kidney disease who are receiving dialysis. Anemia happens when you don't have enough healthy red blood cells to carry adequate oxygen to your body's tissues.

When your kidneys aren't working properly, they don't produce enough of a hormone called erythropoietin, which tells your bone marrow to make red blood cells. This leads to anemia, which can make you feel tired, weak, and short of breath.

Your doctor might consider vadadustat if you're already on dialysis and struggling with anemia symptoms. It's particularly helpful for people who want an oral treatment option rather than regular injections.

How Does Vadadustat Work?

Vadadustat works by blocking certain enzymes in your body that normally break down proteins involved in red blood cell production. This is considered a moderately strong approach to treating anemia.

When these enzymes are blocked, your body responds as if oxygen levels are low. This triggers a natural cascade that increases production of erythropoietin, the hormone that stimulates red blood cell formation in your bone marrow.

The medication also helps your body absorb iron more efficiently and move it to where it's needed for red blood cell production. This dual action makes it effective for people whose anemia is related to both low erythropoietin levels and iron management issues.

How Should I Take Vadadustat?

Take vadadustat exactly as your doctor prescribes, usually once daily with or without food. You can take it with water, and there's no specific requirement to take it with milk or avoid certain foods.

It's best to take your dose at the same time each day to help you remember and maintain steady levels in your body. You don't need to eat anything special before taking it, though taking it with food may help reduce any stomach upset if you experience it.

Swallow the tablets whole without crushing, chewing, or breaking them. If you have trouble swallowing pills, talk to your doctor about alternatives rather than trying to modify the tablets yourself.

How Long Should I Take Vadadustat For?

You'll likely need to take vadadustat for as long as you have chronic kidney disease and anemia. This is typically a long-term treatment rather than a short course of medication.

Your doctor will monitor your blood levels regularly to see how well the medication is working. They'll check your hemoglobin levels and may adjust your dose based on how your body responds.

Never stop taking vadadustat suddenly without talking to your doctor first. Your anemia symptoms could return if you discontinue the medication abruptly, and your doctor may need to transition you to another treatment.

What Are the Side Effects of Vadadustat?

Like all medications, vadadustat can cause side effects, though not everyone experiences them. Most side effects are manageable and tend to be mild to moderate in severity.

Here are the more common side effects you might experience:

  • Diarrhea or changes in bowel movements
  • Abdominal pain or stomach discomfort
  • High blood pressure or worsening of existing hypertension
  • Cough or respiratory symptoms
  • Headache
  • Fatigue, though this may improve as your anemia gets better

These common side effects usually improve as your body adjusts to the medication. If they persist or become bothersome, your doctor can help you manage them.

Some less common but more serious side effects require immediate medical attention:

  • Blood clots in legs, lungs, or other parts of your body
  • Severe abdominal pain that doesn't go away
  • Sudden shortness of breath or chest pain
  • Severe headaches or vision changes
  • Signs of stroke such as sudden weakness or difficulty speaking

Contact your healthcare provider right away if you experience any of these serious symptoms. While rare, these complications need prompt medical evaluation.

Who Should Not Take Vadadustat?

Vadadustat isn't suitable for everyone, and your doctor will carefully evaluate whether it's right for you. Certain conditions or circumstances make this medication potentially harmful.

You should not take vadadustat if you:

  • Are allergic to vadadustat or any of its ingredients
  • Have chronic kidney disease but are not on dialysis
  • Are pregnant or planning to become pregnant
  • Are breastfeeding
  • Have certain types of cancer, especially blood cancers

Your doctor will also use extra caution if you have a history of blood clots, heart disease, or stroke. These conditions may increase your risk of serious complications while taking vadadustat.

Vadadustat Brand Names

Vadadustat is available under the brand name Vafseo in some countries. The medication may have different brand names depending on where you live and which pharmaceutical company distributes it in your region.

Always use the brand name your doctor prescribes, as different formulations might have slight differences in how they're absorbed or processed by your body. If you need to switch brands, your doctor will guide you through the process safely.

Vadadustat Alternatives

Several other medications can treat anemia in chronic kidney disease patients, each with different advantages and considerations. Your doctor might suggest alternatives based on your specific situation and preferences.

Injectable options include erythropoiesis-stimulating agents (ESAs) like epoetin alfa or darbepoetin alfa. These have been used for many years and require regular injections, usually given at your dialysis center.

Other oral HIF-PHI medications like roxadustat might be available in some regions. Iron supplements, both oral and intravenous, often work alongside anemia medications to provide the building blocks your body needs for red blood cell production.

Your doctor will help you weigh the benefits and drawbacks of each option based on your medical history, lifestyle, and treatment goals.

Is Vadadustat Better Than Epoetin Alfa?

Both vadadustat and epoetin alfa effectively treat anemia in chronic kidney disease, but they work differently and have distinct advantages. The "better" choice depends on your individual circumstances and preferences.

Vadadustat offers the convenience of oral dosing, which many patients prefer over regular injections. It also works through a different mechanism that may provide more stable hemoglobin levels over time.

Epoetin alfa has been used for decades with a well-established safety profile. It's typically given as injections during dialysis sessions, which some patients find more convenient since they're already at the treatment center.

Your doctor will consider factors like your current hemoglobin levels, how well you've responded to previous treatments, and your personal preferences when recommending the best option for you.

Frequently asked questions about Vadadustat (oral route)

Vadadustat requires careful monitoring in people with heart disease, as it may increase the risk of blood clots and cardiovascular events. Your doctor will weigh the benefits against the risks based on your specific heart condition.

If you have heart disease, your healthcare team will likely monitor you more closely with regular blood tests and heart evaluations. They may also adjust your dose or recommend additional medications to reduce cardiovascular risks.

If you accidentally take more vadadustat than prescribed, contact your doctor or poison control center immediately. Taking too much can potentially cause dangerous increases in red blood cell production or other serious complications.

Don't wait to see if you feel symptoms. Even if you feel fine, it's important to get medical advice about potential overdose effects and what monitoring you might need.

If you miss a dose, take it as soon as you remember, unless it's almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular schedule.

Never take two doses at once to make up for a missed dose. This can increase your risk of side effects without providing additional benefits.

Only stop taking vadadustat when your doctor tells you to. Since chronic kidney disease and anemia are long-term conditions, you'll likely need ongoing treatment to maintain healthy red blood cell levels.

Your doctor might discontinue vadadustat if your kidney function improves significantly, if you experience serious side effects, or if you need to switch to a different treatment approach.

Vadadustat can interact with certain medications, so it's crucial to tell your doctor about all prescriptions, over-the-counter drugs, and supplements you take. Some interactions can affect how well vadadustat works or increase your risk of side effects.

Your doctor will review your complete medication list and may need to adjust doses or timing of other medications. Don't start any new medications or supplements without checking with your healthcare provider first.

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