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Epoetin Alfa Brand Names
Epogen | Procrit | Retacrit
What is Epoetin Alfa
Epoetin alfa (r-HuEPO) is a recombinant form of the renal hormone erythropoietin (EPO) and belongs to a class of drugs known as erythropoiesis-stimulating agents (ESAs).
Native EPO is a glycosylated protein with a molecular weight of about 36,000 daltons. Epoetin alfa is produced via recombinant technology in a Chinese hamster ovarian cell system.
It is immunologically and biologically indistinguishable from native EPO, and its structure is very similar to the native protein with a molecular weight of 30,400 daltons.
The composition and number of carbohydrate chains on epoetin alfa are comparable to those found on the native protein.
Epoetin alfa is FDA-approved for the treatment of anemia due to chronic kidney disease, zidovudine therapy in HIV patients, and chemotherapy in patients with non-myeloid malignancies and to reduce the need for allogeneic blood transfusions in surgical patients.
ESAs have been shown to increase the risk of death, myocardial infarction, stroke, venous thromboembolism, thrombosis of vascular access, and tumor progression or recurrence.
Clinicians are advised to use the lowest dose that will gradually increase the hemoglobin concentration to the lowest hemoglobin sufficient to avoid the need for red blood cell transfusions.
Indications
- anemia
- anemia of prematurity
- hypoxic-ischemic encephalopathy
Side Effects
- anaphylactoid reactions
- anemia
- angioedema
- antibody formation
- arthralgia
- bone pain
- bronchospasm
- chills
- cough
- depression
- dizziness
- dysphagia
- edema
- encephalopathy
- erythema
- erythema multiforme
- fever
- headache
- heart failure
- hyperglycemia
- hypertension
- hypokalemia
- infection
- injection site reaction
- insomnia
- leukopenia
- myalgia
- myocardial infarction
- nausea
- phlebitis
- porphyria
- pruritus
- pulmonary embolism
- rash
- red cell aplasia
- seizures
- Stevens-Johnson syndrome
- stomatitis
- stroke
- thromboembolism
- thrombosis
- toxic epidermal necrolysis
- urticaria
- vitamin B6 deficiency
- vomiting
- weight loss
Monitoring Parameters
- CBC
- ferritin
- hemoglobin/hematocrit
- serum electrolytes
- serum iron
- serum uric acid
- transferrin
Contraindications
- angina
- anticoagulant therapy
- benzyl alcohol hypersensitivity
- breast-feeding
- cardiac disease
- coronary artery bypass graft surgery (CABG)
- dialysis
- folate deficiency
- geriatric
- heart failure
- hematological disease
- hemoglobin concentration greater than 11 g/dl
- hypertension
- infants
- infection
- iron-deficiency anemia
- mortality
- myocardial infarction
- neonates
- neoplastic disease
- phenylketonuria
- pregnancy
- red cell aplasia
- renal failure
- renal impairment
- seizure disorder
- seizures
- stroke
- surgery
- thromboembolism
- viral infection
- vitamin B12 deficiency
Interactions
- Androgens
- Danazol
- Esterified Estrogens; Methyltestosterone
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ferric carboxymaltose
- Ferumoxytol
- Fluoxymesterone
- Iron
- Iron – Injectable Only
- Iron Dextran
- Iron Salts
- Iron Sucrose, Sucroferric Oxyhydroxide
- Lenalidomide
- Methyltestosterone
- Nandrolone Decanoate
- Oxandrolone
- Oxymetholone
- Polysaccharide-Iron Complex
- Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
- Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
- Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
- Testolactone
- Testosterone
- Thalidomide
