Epoetin alfa

Intravenous
Subcutaneous
Class
Erythropoiesis-stimulating agents
Subclass
Recombinant human erythropoietin
Substance name
Epoetin alfa, epoetin alfa‑epbx, epoetin alfa‑cgkn
Brand names
Retacrit®
Common formulations
Solution for injection
Dosage and administration
Adults patients
Treatment of anemia of CKD
50-100 unit(s)/kg IV 3× per week
Other off-label uses
Treatment of zidovudine-related anemia
Indications for use
Labeled indications
Adults
Treatment of anemia of CKD
Treatment of chemotherapy-related anemia
Children
Treatment of anemia of CKD
Treatment of chemotherapy-related anemia
Off-label indications
Children
Treatment of zidovudine-related anemia
Safety risks
Boxed warnings
HF
Use extreme caution with CKD.
Contraindications
Undergoing cardiac or vascular surgery
A known hypersensitivity to Epoetin alfa
Chronic kidney failure
Pre-existing hypertension
Warnings and precautions
Seizures
Use caution with a history of seizure disorder or with CKD.
Specific populations
Renal impairment
eGFR 0-90 mL/min/1.73 m²
Use acceptable. No dose adjustment required.
Renal replacement therapy
Any modality
Use acceptable. No dose adjustment required.
Hepatic impairment
Any severity
Use acceptable. No dose adjustment required.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: B3
Use only if benefits outweigh potential risks. Evidence of fetal harm in animals. Multidose vials of epoetin alfa are contraindicated during pregnancy due to the use of benzyl alcohol as a preservative.
When epoetin alfa therapy is needed during pregnancy, use a single-dose vial, which is benzyl alcohol-free.
Benzoyl alcohol is associated with serious adverse events and death when given IV to neonates and infants; similar risks may occur from exposure in utero.
Do not mix with bacteriostatic saline because of its benzoyl alcohol content.
Breastfeeding
Acceptable for use during breastfeeding.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
No overt adverse effects reported in breastfed infants.
No overt adverse effects on lactation reported.
Adverse reactions
Very common > 10%
Hypertension, arthralgia, cough, fever, headache, injection site reactions, itching, nausea, skin rash, vomiting
Common 1-10%
↓ WBC count, depression, ↑ blood glucose, ↑ serum potassium, pulmonary embolism, bone pain, chills, dizziness, dysphagia, insomnia, myalgia, weight loss, stomatitis, urticaria
Uncommon < 1%
Skin erythema
Unknown frequency
Anemia, angioedema, bronchospasm, encephalopathy, erythema multiforme, heart failure, myocardial infarction, phlebitis, pure red cell aplasia, seizure, Stevens-Johnson syndrome, stroke, thromboembolism, thrombosis, toxic epidermal necrolysis, vitamin B6 deficiency
Interactions
Drug(s)
Check Interactions
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