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Eprex

Eprex

(erythropoietin-human)

Epoetin alfa belongs to the class of medications known as erythropoiesis regulating hormones. It is used to increase the production of red blood cells and decrease the need for transfusions of red blood cells.

Available form

Dosage

Injectable Syringe

5000IU/0.5ML

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Eprex information

Dosage

Side Effects

Available Form

Contraindications

Precautions

Warnings

Epoetin alfa is available only as an injection, which is given subcutaneously (under the skin) or intravenously (into a vein). People who receive the medication under the skin can usually be taught to self-administer the medication. Be sure you understand exactly how it is to be injected, as instructed by your doctor or nurse. People who need to receive the medication into a vein will need to have the medication administered by a doctor or nurse.

For children with chronic renal failure, the starting dose for anemia is 50 units (IU) per kilogram body weight, given 3 times a week.

For adults with chronic renal failure, the starting dose for anemia is 50 to 100 units per kilogram of body weight, injected three times a week.

For anemia in adults with HIV, the usual starting dose is 100 units per kilogram body weight, injected 3 times a week.

For people with anemia due to chemotherapy, the starting dose is 150 units per kilogram of body weight, injected subcutaneously 3 times a week. As an alternative, epoetin alfa may be injected subcutaneously once weekly as a dose of 40,000 units.

When epoetin alfa is used in people scheduled for surgery, higher doses are used.

Your doctor may need to adjust the dose according to your body's response to the medication. Adjustments usually involve blood tests and are not done more often than once every 4 weeks. While you are being treated with epoetin alfa, your doctor may want you to take iron supplements to help the medication work as well as possible.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use Eprex (Erythropoietin-human) exactly as prescribed by your doctor. If you miss a dose, administer it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not administer a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

If you miss an appointment to receive epoetin alfa, contact your doctor as soon as possible to reschedule your appointment.

Epoetin alfa should be refrigerated and protected from light. Do not let it freeze. The prefilled syringe should be allowed to warm to room temperature just before injecting it, and may be stored for up to 7 days at room temperature. Do not shake the medication before use.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Eprex (Erythropoietin-human). If you are concerned about side effects, discuss the risks and benefits of Eprex (Erythropoietin-human) with your doctor.

The following side effects have been reported by at least 1% of people taking Eprex (Erythropoietin-human). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

Diarrhea
general feeling of tiredness or weakness
nausea
pain, stinging, redness, or swelling around the injection site
vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

clotting of the vascular access site (for people on hemodialysis)
edema (swelling of the face, fingers, ankles, feet, or lower legs)
flu-like symptoms (e.g., dizziness, drowsiness, Fever, headache, muscle and joint pain)
increase in Headaches
increased or decreased blood pressure, dizziness, or feeling faint
muscle aches and pain
signs of infection (cough, fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, sore throat, stiff neck, weight loss, or listlessness)

Stop taking the medication and seek immediate medical attention if any of the following occur:

chest pain
seizures
signs of allergic reaction (symptoms may include skin rash or Hives, trouble breathing, sweating, abnormal heart rate, or decreased blood pressure)
signs of Blood Clots (pain or swelling in the legs, worsening shortness of breath, coughing up blood)
signs of a serious skin reaction (such as skin rash; red skin; blistering of the lips, eyes, or mouth; skin peeling; fever; or joint pain)signs of Stroke (confusion, severe headache, sudden weakness, dizziness, trouble speaking, or vision problems)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Eprex (Erythropoietin-human).

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Eprex (Erythropoietin-human).

Blood clots: It has been identified in clinical trials that cancer patients who are treated with epoetin alfa to raise their hemoglobin beyond normal levels are at a higher risk of developing blood clots, which in some cases can cause death. Your doctor will monitor your hemoglobin level closely with blood tests during treatment with Eprex (Erythropoietin-human).

If you experience symptoms such as sharp pain and swelling in the leg, or difficulty breathing, contact your doctor immediately.

Cancer: Epoetin alfa is used to treat anemia caused by chemotherapy treatment of non-myeloid cancers. It is not used to treat anemia that is due to the cancer itself. If you have cancer and your hemoglobin is kept too high, your cancer may grow faster or you may have an increased risk of Heart Attack or stroke. Discuss any concerns you have with your doctor.

Cardiovascular disease: Eprex (Erythropoietin-human) often affects blood pressure and can contribute to symptoms of heart disease. If you have high blood pressure, heart disease such as heart failure, Angina, or a previous heart attack, discuss with your doctor how Eprex (Erythropoietin-human) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Eprex (Erythropoietin-human), and whether any special monitoring is needed. If you are taking blood pressure pills to control blood pressure, it is important to continue taking them regularly while you are on epoetin alfa. Your doctor will monitor your hemoglobin (the protein in red blood cells that carry oxygen) until an appropriate dose of epoetin alfa has been determined.

Gout: Eprex (Erythropoietin-human) may cause symptoms of gout. If you have gout or a history of gout, discuss with your doctor how Eprex (Erythropoietin-human) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Eprex (Erythropoietin-human), and whether any special monitoring is needed.

Kidney disease: Eprex (Erythropoietin-human) may be used by people with chronic kidney disease who are receiving dialysis and those who are not receiving dialysis. The dose may be different for each. Your doctor will monitor you closely for your response to the medication.

Medical conditions: Be sure to tell the doctor if you have any of the following medical problems, as they may affect how well Eprex (Erythropoietin-human) works:

folic acid, iron, or vitamin B12 deficiency
excess aluminum in the blood
infection
inflammation
cancer
bone problems
blood diseases (e.g., Sickle Cell Anemia)

Porphyria: If you have a history of porphyrin metabolism disorder (a metabolic disorder), discuss with your doctor how Eprex (Erythropoietin-human) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Eprex (Erythropoietin-human), and whether any special monitoring is needed.

Pure red cell aplasia: Cases of pure red cell aplasia (PRCA) have been reported among people treated with epoetin alfa. PRCA is a condition in which a person's bone marrow stops producing red blood cells, leading to severe anemia. People who develop PRCA may experience a new or worsening feeling of tiredness or shortness of breath. If you are experiencing such symptoms, call your doctor as soon as possible. Do not stop your medication without contacting your doctor first.

Seizure: Eprex (Erythropoietin-human) may contribute to an increase in seizures although the relationship between epoetin alfa and seizures is not clear. If you experience seizures or have a history of seizures, discuss with your doctor how Eprex (Erythropoietin-human) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Eprex (Erythropoietin-human), and whether any special monitoring is needed.

Stroke: Epoetin alfa can increase the risk of blood clots forming in the blood vessels. If you have a past history of stroke, discuss with your doctor how Eprex (Erythropoietin-human) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Eprex (Erythropoietin-human), and whether any special monitoring is needed.

If you experience signs and symptoms of a stroke, such as blurred vision, difficulty speaking, sudden headache, or loss of coordination, contact your doctor immediately.

Worsening of anemia: Severe and sudden tiredness and shortness of breath could be a sign of severe anemia. People who develop these symptoms should see their doctor as soon as possible.

Pregnancy: Eprex (Erythropoietin-human) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Eprex (Erythropoietin-human), contact your doctor immediately.

Breast-feeding: It is not known if epoetin alfa passes into breast milk. If you are a breast-feeding mother and are taking Eprex (Erythropoietin-human), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Eprex (Erythropoietin-human) have not been established for children less than 1 month of age. Epoetin alfa has been shown to be safe for children over the age of 1 month who need dialysis to treat chronic renal failure.

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