Epoetin alfa (Recombinant Human Erythropoietin)

Epoetin alfa (Recombinant Human Erythropoietin) is a medicine that helps your bone marrow to produce more red blood cells. It is used to treat a type of anemia caused by kidney disease. It is also used to treat anemia caused by cancer chemotherapy and by taking medicines to treat HIV.

Epoetin alfa is given by injection either under the skin or into a vein which will be decided by your doctor. Usually the injections are given by a nurse or doctor. The dose depends on your body weight and the cause of your anemia. Iron supplements both before and during treatment may make this treatment more effective.

Epoetin alfa is an erythropoiesis-stimulating agent (ESA). It works by stimulating the bone marrow to produce more red blood cells.

• Anemia due to Chronic Kidney Disease: Reduces need for RBC transfusion in CKD patients.
• Anemia due to Cancer Chemotherapy: Used in patients with non-myeloid malignancies receiving chemotherapy.
• Preparation for Surgery: Reduces need for allogeneic RBC transfusions in high-risk surgery.

Erythropoiesis-Stimulating Agents (ESA)

Erythropoietin (Recombinant)

Epoetin alfa stimulates the differentiation and proliferation of erythroid precursors, release of reticulocytes into the circulation and synthesis of cellular Hb thus regulating erythropoiesis.

Epoetin alfa stimulates the differentiation and proliferation of erythroid precursors, release of reticulocytes into the circulation and synthesis of cellular Hb thus regulating erythropoiesis.

Adult Dose:

• CKD-Associated Anemia (Not on dialysis): 50-100 units/kg IV/SC 3 times weekly initially; initiate when Hb <10 g/dL.
• CKD-Associated Anemia (On dialysis): 50-100 units/kg IV 3 times weekly initially; initiate when Hb <10 g/dL.
• Chemotherapy-Related Anemia: 150 units/kg IV/SC 3 times weekly or 40,000 units SC once weekly.
• Preparation for Surgery: 300 units/kg SC daily for 15 days or 600 units/kg SC in 4 doses.

Child Dose:

• CKD-Associated Anemia (>1 month): 50 units/kg IV/SC 3 times weekly.
• Prematurity-Related Anemia: 25-100 units/kg SC 3 times weekly or 200-400 units/kg SC/IV q24-48hr.

Your doctor or nurse will give you this medicine. Kindly do not self administer.

If you miss a dose of Epoetin alfa, please consult your doctor.

Common Side Effects:

• High blood pressure (13%)
• Nausea
• Fever
• Vomiting
• Headache
• Fatigue
• Dizziness
• Muscle aches

Precautions:

• Epoetin alfa may cause side effects which could affect your ability to drive.
• It helps in the treatment of anemia caused by chronic kidney disease or cancer chemotherapy.
• Your doctor may get your blood tests done regularly to monitor levels of hemoglobin, blood cells and potassium.
• Monitor your blood pressure regularly while taking this medication.
• Inform your doctor if you notice severe headache, problems with eyesight, nausea, vomiting or seizures.
• Stop taking and inform your doctor if you develop shortness of breath or skin rash.

Contraindications:

• Hypersensitivity to albumin (human) or mammalian cell-derived products
• Uncontrolled hypertension

Drug Interactions:

• Cyclosporine
• Hematinic agents
• Drugs that decrease erythropoiesis

Food Interactions: It is not known whether it is safe to consume alcohol with Epoetin alfa. Consult your doctor.

Use in Pregnancy: Epoetin alfa may be unsafe to use during pregnancy. Animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing.

Use in Lactation: Epoetin alfa is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.

Pediatric Use: Pediatric dosage provided above. Safety and efficacy not established for some indications in children under 8 months.

Geriatric Use: No specific dosage adjustment is necessary for elderly patients.

Renal Impairment: Safe to use in patients with kidney disease. No dose adjustment is recommended. Regular monitoring of kidney function tests is advised.

Hepatic Impairment: Use with caution in patients with liver disease. Dose adjustment may be needed.

Overdose: Overdose may cause hypertension, polycythemia, seizures, thrombosis. In case of overdose, seek immediate medical attention.

Storage: Store in refrigerator at 2-8°C. Bring to room temperature before use. Do not freeze. Protect from light.

Epoetin alfa (Recombinant Human Erythropoietin)