Erythropoietin
Indications
Erythropoietin (epoetin) is used to treat anaemia (low red blood cells) caused by chronic kidney disease, including people on dialysis. It is also used for anaemia caused by cancer chemotherapy, to reduce the need for blood transfusion in some people having planned surgery, and in some other specialist situations.
How It Works
Erythropoietin is a copy of a natural hormone made by the kidneys. It signals the bone marrow to make more red blood cells, which carry oxygen around the body. Damaged kidneys make too little of this hormone, which is why kidney disease often causes anaemia.
Dosage and Administration
As prescribed. It is given as an injection under the skin or into a vein, usually by a doctor or nurse; some patients are trained to inject it at home. The dose is based on body weight and adjusted according to regular haemoglobin tests, aiming to correct the anaemia without raising haemoglobin too high. Iron tablets or injections are often needed alongside it.
Interactions
Few direct drug interactions are known. Blood pressure medicines may need adjusting because Erythropoietin can raise blood pressure. In people on Ciclosporin, levels of that medicine may need checking. Iron levels must be adequate for it to work well.
Contraindications
- High blood pressure that is not controlled.
- Pure red cell aplasia (the bone marrow stops making red cells) after earlier treatment with any erythropoietin product.
- Allergy to Erythropoietin or any ingredient.
- Before planned surgery, in people who cannot receive medicine to prevent blood clots or who have severe heart or blood vessel disease.
Side Effects
Common: rise in blood pressure, headache, flu-like symptoms, joint or muscle pain, and pain or redness at the injection site. Blood clots in dialysis access lines can occur.
Get urgent medical help for: a sudden severe headache, confusion, fits (seizures), chest pain, breathlessness, pain or swelling in one leg, weakness or numbness of the face, arm or leg, slurred speech, or a severe skin rash with blisters or peeling.
Pregnancy and Lactation
Information is limited. It should be used in pregnancy only if the doctor decides it is needed. It is not expected to harm a breastfed baby, but discuss with the doctor first.
Precautions and Warnings
- Blood pressure and haemoglobin must be checked regularly. Raising haemoglobin too high increases the risk of stroke, heart attack and blood clots.
- In people with cancer, it may affect tumour growth; the doctor will weigh the benefits and risks.
- Tell the doctor about epilepsy or seizures, heart disease, liver disease, sickle cell disease or gout.
- Do not switch between different erythropoietin products without the doctor's instruction.
Overdose
Too much can raise haemoglobin and blood pressure too high and increase the risk of clots. Contact the doctor; the dose may need to be stopped and blood tests checked.
Therapeutic Class
Haematopoietic agent (anti-anaemia; red blood cell stimulant).
Storage
Store in a refrigerator at 2 to 8°C. Do not freeze or shake. Keep in the original carton to protect from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Erythropoietin