Epoetin alfa injection products are used to treat anemia (a lower than normal number of red blood cells) in people with chronic kidney failure (condition in which the kidneys slowly and permanently stop working over a period of time). Epoetin alfa injection products are also used to treat anemia caused by chemotherapy in people with certain types of cancer or caused by zidovudine (AZT, Retrovir, in Trizivir, in Combivir), a medication used to treat human immunodeficiency virus (HIV). Epoetin alfa injection products are also used before and after certain types of surgery to decrease the chance that blood transfusions (transfer of one person’s blood to another person’s body) will be needed because of blood loss during surgery.
Epoetin alfa injection products should not be used to decrease the risk that transfusions will be needed in people who are having surgery on their hearts or blood vessels. These injection products also should not be used to treat people who are able and willing to donate blood before surgery so that this blood can be replaced in their bodies during or after surgery. Epoetin alfa injection products cannot be used in place of a red blood cell transfusion to treat severe anemia and have not been shown to improve tiredness or poor well-being that may be caused by anemia. Epoetin alfa products are in a class of medications called erythropoiesis-stimulating agents (ESAs). They work by causing the bone marrow (soft tissue inside the bones where blood is made) to make more red blood cells.
Side Effects Of Epoetin Alfa Injection
Epoetin alfa injection products may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- joint or muscle aches, pain, or soreness
- weight loss
- sores in the mouth
- difficulty falling asleep or staying asleep
- muscle spasms
- runny nose, sneezing, and congestion
- fever, cough, or chills
- redness, swelling, pain, or itching at the injection spot
Some side effects can be serious. If you experience any of the following symptoms or those listed in the WARNING section, call your doctor immediately or get emergency medical treatment:
- swelling of the face, throat, tongue, lips, or eyes
- skin blisters or peeling skin
- difficulty breathing or swallowing
- unusual tiredness
- lack of energy
Epoetin alfa injection products may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
Warnings & Precautions
Before using an epoetin alfa injection product:
- tell your doctor and pharmacist if you are allergic to epoetin alfa, epoetin alfa-epbx, darbepoetin alfa (Aranesp), any other medications, or any of the ingredients in epoetin alfa injection products. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have had high blood pressure and if you have ever had pure red cell aplasia (PRCA; a type of severe anemia that may develop after treatment with an ESA such as darbepoetin alfa injection or epoetin alfa injection). Your doctor may tell you not to use an injection product.
- tell your doctor if you have or have ever had seizures. If you are using an epoetin alfa injection product to treat anemia caused by chronic kidney disease, tell your doctor if you have or have ever had cancer.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using the product, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are using an epoetin alfa injection product.
Dosage Of Epoetin Alfa Injection
Epoetin alfa injection products come as a solution (liquid) to inject subcutaneously (just under the skin) or intravenously (into a vein). It is usually injected one to three times weekly. When the products are used to decrease the risk that blood transfusions will be required due to surgery, it is sometimes injected once daily for 10 days before surgery, on the day of surgery, and for 4 days after surgery. Alternatively, epoetin alfa injection products are sometimes injected once weekly, beginning 3 weeks before surgery and on the day of surgery.
Your doctor will start you on a low dose and adjust your dose depending on your lab results and how you are feeling, usually not more than once every month. Your doctor may also tell you to stop using an epoetin alfa injection product for a time. Follow these instructions carefully.
Epoetin alfa injection products will help control your anemia only as long as you continue to use it. It may take 2–6 weeks or longer before you feel the full benefit of an epoetin alfa injection product. Do not stop using an epoetin alfa injection product without talking to your doctor.
Epoetin alfa injection products may be given by a doctor or nurse, or you may be told to inject the medication at home. If you will be injecting the medication at home, follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any part you do not understand. Use an epoetin alfa injection product exactly as directed. To help you remember to use an epoetin alfainjection product, mark a calendar to keep track of when you are to receive a dose. Do not use more or less of it or use it more often than prescribed by your doctor.
If you are using an epoetin alfa injection product at home, a healthcare provider will show you how to inject the medication. Be sure that you understand these directions. Before you use an epoetin alfaproduct for the first time, you and the person who will be giving the injections should read the manufacturer’s information for the patient that comes with it. Ask your healthcare provider if you have any questions about where on your body you should inject the medication, how to give the injection, what type of syringe to use, or how to dispose of used needles and syringes after you inject the medication. Always keep a spare syringe and needle on hand.
Do not shake an epoetin alfa injection product. If you shake the medication, it may look foamy and should not be used.
You can inject an epoetin alfa injection product just under the skin anywhere on the outer area of your upper arms, middle of the front thighs, stomach (except for a 2-inch [5-centimeter] area around the navel [belly button]), or outer area of the buttocks. Do not inject an epoetin alfa injection product into a spot that is tender, red, bruised, hard, or has scars or stretch marks. Choose a new spot each time you inject the medication, as directed by your doctor.
If you are being treated with dialysis (treatment to remove waste from the blood when the kidneys are not working), your doctor may tell you to inject the medication into your venous access port. Ask your doctor if you have any questions about how to inject your medication.
Always look at the solution before you inject it. Be sure that the vial is labeled with the correct name and strength of medication and an expiration date that has not passed. Also check that the solution is clear and colorless and does not contain lumps, flakes, or particles. If there are any problems with your medication, call your pharmacist and do not inject it.
Keep all appointments with your doctor. Your doctor will monitor your blood pressure often during your treatment with epoetin alfa injection products.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are using an epoetin alfa injection product.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
All information has been provided courtesy of MedLinePlus from the National Library of Medicine and from the FDA.