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Epoetin Alfa

About Epoetin Alfa

Epoetin Alfa belongs to the class of medication called 'blood-forming agent'  primarily used to treat anaemia (low red blood cell count) in persons with chronic kidney disease (CKD), patients affected with HIV, and those receiving chemotherapy for cancer (except for bone marrow or blood cells' cancer). Anaemia occurs when the body has a lower amount of red blood cells or haemoglobin. In chronic kidney disease, the kidney gets damaged and doesn't filter the blood, leading to anaemia.

Epoetin Alfa contains a human-made protein known as 'Epoetin alfa' which works by providing signals to the bone marrow to make more red blood cells (RBCs). Epoetin Alfa helps to reverse anaemia and reduce the need for blood transfusion. Epoetin Alfa is a biologic response modifier and erythropoiesis-stimulating protein. In chronic kidney disease, when the kidney fails to produce sufficient 'erythropoietin protein' which aids in the formation of red blood cells, Epoetin Alfa stimulates the production of this protein in the bone marrow. 

Epoetin Alfa will be administered by a healthcare professional; do not self-administer. The most common side effects of Epoetin Alfa are shortness of breath,  cough, low blood pressure during dialysis, headache, body aches, diarrhoea, injection site pain and abdominal pain. Most of these side effects of Epoetin Alfa do not require medical attention and gradually resolve over time. However, if the side effects are persistent, reach out to your doctor.

If you have uncontrolled/untreated high blood pressure or red cell aplasia (a type of anaemia) due to epoetin alfa or darbepoetin alfa, please inform your doctor before taking Epoetin Alfa to avoid any complications. Inform your doctor immediately, if you feel weak, lightheaded, tired, or short of breath, or if your skin looks pale as it may be a sign that the body has stopped responding to Epoetin Alfa. It is not known whether Epoetin Alfa will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant and breastfeeding before starting treatment with this medicine. Epoetin Alfa is a cold chain medicine, and so it has to be stored in the refrigerator between 2-8 degrees Celsius else its efficiency might be lost. Do not store in the freezer or the fridge.

Uses of Epoetin Alfa

Treatment of Anemia in cancer, Anemia in chronic kidney disease, Anemia in HIV.

Medicinal Benefits

Epoetin Alfa is a human-made form of naturally occurring erythropoiesis-stimulating protein or erythropoietin (a hormone produced by the kidney's specialized cells and is responsible for protecting red blood cells against destruction and also stimulates the cells of bone marrow to produce more amount of red blood cells). Deficiency of erythropoietin happens when a person is suffering from chronic kidney diseases, which in turn causes low red blood cells count causing anemia.  This medicine is primarily indicated for treating anemia (low red blood cell count) in persons with long-term serious (chronic) kidney disease, persons receiving chemotherapy for some types of cancer except for bone marrow or blood cells cancer, and persons taking zidovudine to treat HIV(human immunodeficiency virus). Epoetin Alfa is also used to reduce the need for red blood cell transfusions in adults having certain types of surgery. Epoetin Alfa contains a protein 'Epoetin alfa' which works by providing signals to the bone marrow to make more red blood cells. 

Directions for Use

Epoetin Alfa will be administered by a healthcare professional; do not self-administer.

Storage

Store in a cool and dry place away from sunlight

Side Effects of Epoetin Alfa

  • Shortness of breath Cough
  • Hypertension (high blood pressure)
  • High blood sugar
  • Headache
  • Body aches
  • Diarrhoea
  • Injection site pain 
  • Abdominal pain (stomach pain) 

Drug Warnings

Epoetin Alfa can enhance the risk of blood clots and serious heart problems including heart attack so tell your doctor immediately if you notice shortness of breath, sudden numbness or weakness, chest pain, or trouble speaking or understanding. This medicine may speed up tumor growth, or shorten remission or survival time in some people with certain types of cancer. Inform your doctor before taking Epoetin Alfa if you have heart disease, high blood pressure, kidney disease, stroke, heart attack, blood clot, seizure, or latex allergy. Do not take Epoetin Alfa if you are pregnant or breastfeeding unless prescribed by the doctor. Epoetin Alfa should not be given to children below 1 month of age, as safety and effectiveness have not been established. Do not use Epoetin Alfa from a multi-dose vial when giving medicine to a baby. The multi-dose vial contains an ingredient (benzyl alcohol) that can cause serious side effects or death in very young infants or premature babies. Epoetin Alfa may affect a person's ability to drive as it may cause convulsions during the initial days of treatment, so a person taking Epoetin Alfa should avoid driving or operating any machine. Avoid consuming alcohol along with Epoetin Alfa as it could lead to increased dizziness and sleepiness. 

Drug Interactions

Drug-Drug Interactions: Epoetin Alfa may have interaction with other chemotherapy drugs (thalidomide, carfilzomib, lenalidomide, pomalidomide),  immunosuppressant medication (cyclosporine),  antihypertensive medicines (captopril, benazepril, enalapril, lisinopril, moexipril). 

Drug-Food Interactions: Avoid alcohol consumption while taking Epoetin Alfa as it might cause increased dizziness and sleepiness.

Drug-Disease Interactions: Epoetin Alfa may have interactions with disease conditions such as seizures, hemodialysis, hypertension, porphyria (liver disorders) and thrombotic events.

Drug-Drug Interactions Checker List:

  • THALIDOMIDE
  • LENALIDOMIDE
  • CYCLOSPORINE
  • CAPTOPRIL
  • ENALAPRIL
  • LISINOPRIL
  • CARFILZOMIB
  • POMALIDOMIDE
  • MOEXIPRIL
  • Safety Advice

    • Safety Warning

      Alcohol

      unsafe

      Avoid consumption of alcohol while taking Epoetin Alfa as it may increase dizziness and sleepiness.

    • Safety Warning

      Pregnancy

      caution

      Avoid taking Epoetin Alfa if you are pregnant unless prescribed by a doctor as Epoetin Alfa is a pregnancy category B drug. Please consult your doctor if you have any concerns regarding this, your doctor will prescribe only if the benefits outweigh the risks. If prescribed use only single-dose vials (the benzyl alcohol-free formulation) in pregnant women.

    • Safety Warning

      Breast Feeding

      caution

      Consult your doctor before taking Epoetin Alfa; your doctor will decide whether Epoetin Alfa can be taken by breastfeeding mothers or not.

    • Safety Warning

      Driving

      caution

      Epoetin Alfa causes convulsions (seizures), especially during the initial months of treatment. So, it is better not to drive or operate machinery unless you are alert.

    • Safety Warning

      Liver

      caution

      Dose adjustment may be needed in patients with liver impairment. Please consult your doctor if you have a liver impairment or any concerns regarding this.

    • Safety Warning

      Kidney

      caution

      Dose adjustment may be needed in patients with kidney impairment. Please consult your doctor if you have kidney impairment or any concerns regarding this.

    • Safety Warning

      Children

      caution

      Epoetin Alfa should not be given to neonates as the safety and efficacy have not been established.

    Habit Forming

    No

    Diet & Lifestyle Advise

    • Limit the consumption of fluids, salt, potassium, phosphorous, and other electrolytes.
    • Eat a low-protein diet, and get enough calories from the foods if you are losing weight.
    • Eat foods that are high in vitamin B12, iron, and folic acid can fulfill the deficiencies of happed in kidney disease.
    • Include a little number of healthy fats in your diet that gives you enough energy to be active during the day; however, try to limit fats that make you fat. Try to include olive oil, peanut oil, and corn oil in your diet.
    • Rest well, and get plenty of sleep.
    • Avoid smoking and alcohol consumption.
    • Using essential oils for massages can help increase circulation.

    Special Advise

    • Certain diagnostic tests like Complete blood count (CBC) can help check the count of red blood cells.
    • Have regular hemoglobin tests to check whether there is an improvement in the level of red blood cells after taking Epoetin Alfa or not.
    • You should not use Epoetin Alfa if you have uncontrolled high blood pressure (hypertension), or if you have ever had pure red cell aplasia (PRCA, a type of anemia) caused by using Epoetin Alfa. 
    • Call your doctor at once if you experience any sign of a blood clot, sudden numbness or weakness, blur vision, speech problem, chest pain, trouble breathing, pain or cold feeling in leg or arm. 
    • Discard any leftover medicine in a multi-dose vial of Epoetin Alfa 21 days after the first use.

    Patients Concern

    Disease/Condition Glossary

    Anaemia: It occurs when the body has a lower amount of red blood cells or haemoglobin than normal haemoglobin (iron-rich protein responsible for allowing red blood cells to carry more oxygen from the lungs to the rest of the body).  In chronic kidney disease, the kidney gets damaged and doesn't filter the blood, leading to anaemia. Symptoms of anaemia in chronic kidney disease include fatigue or tiredness, shortness of breath, ashen skin, weakness, body aches, chest pain, dizziness, fainting, fast or irregular heartbeat, headache, sleep problems, and trouble concentrating. 

    FAQs

    Epoetin Alfa is used to treat anaemia (low red blood cell count) in people with chronic kidney disease (CKD), patients affected with HIV, and those receiving chemotherapy for cancer (except for bone marrow or blood cells cancer).

    Epoetin Alfa contains a protein "Epoetin alfa", which works by providing signals to the bone marrow to make more red blood cells. As in chronic kidney disease, the kidney gets damaged and doesn't filter the blood in the way it should be leading to anemia.

    A person who is allergic to any chemical compound present in Epoetin Alfa or have uncontrolled/untreated high blood pressure, or ever had pure red cell aplasia (a type of anaemia) caused by using darbepoetin alfa, or epoetin alfa is not allowed to take a name.

    It is advised to tell your doctor about your medical conditions like heart disease, high blood pressure, kidney disease, a stroke, heart attack, or blood clot, a seizure, a latex allergy to avoid any type of medical condition.

    It is suggested to store the Epoetin Alfa in the refrigerator between 2 and 8 ℃ and protect it from light. However, a person should not freeze it.

    The common side-effects of Epoetin Alfa are headache and pain, redness at the injection site. These side-effects are usually mild and temporary. However, inform your doctor immediately if any of these side-effects persist or get worse.

    Epoetin Alfa will be administered subcutaneously (under the skin) or intravenously (through the vein) by the doctor or nurse based on individual considerations.

    Since Epoetin Alfa will be administered by the doctor it is unlikely to exceed the recommended dose. However, seek medical attention if you experience symptoms of overdose such as a fast or racing heartbeat.

    Yes, Epoetin Alfa will be given to children by the doctor if needed. However, it should not be given to children under 1 month of age, as its safety and effectiveness have not been established for this age group. Consult the doctor if you have any concerns.

    Yes, Epoetin Alfa may cause hypertension (high blood pressure). The doctor will control high blood pressure before and during treatment. However, it is not recommended for people with uncontrolled hypertension. Let the doctor know if you have hypertension before starting treatment with Epoetin Alfa.

    Available Medicines for

    Epoetin Alfa

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