Epoetin (erythropoietin)
Brand names Eprex, Recormon
Used in the following combined preparations None
GENERAL INFORMATION
Epoetin is a form of erythropoietin, a naturally occurring hormone produced by the kidneys. Available in two forms (alpha and beta), epoetin stimulates the body to produce red blood cells. The drug is manufactured by a special technique that uses bacteria to make human erythropoietin.
Epoetin is used to treat anaemia in people with chronic kidney failure, including patients on dialysis. People with kidney failure produce very little erythropoietin themselves, so the number of red blood cells is very low. This was previously treatable only by giving regular blood transfusions. When epoetin is injected regularly, more red cells are made by the bone marrow, and this relieves the anaemia, making blood transfusions unnecessary. Since it is a natural hormone, epoetin has few side effects, but treatment must be carefully monitored, otherwise patients may produce too many red blood cells, causing high blood pressure, or the blood may start clotting too easily.
The drug has also been given to patients with cancer and AIDS who have anaemia due to these diseases or their treatment; however, this is a trial use and is not yet widely available. Epoetin has also been tried by athletes who wish to improve their performance; but this is not a recognized use and is regarded as an illegal use of drugs by the sports authorities.
INFORMATION FOR USERS
This drug is given only under medical supervision and is not for self-administration.
How taken
Injection.
Frequency and timing of doses
2-3 x weekly.
Dosage range
Dosage is calculated on an individual basis according to body weight. The dosage also varies depending on the form of epoetin used.
Onset of effect
Active inside the body within 4 hours, but effects may not be noted for 2-3 months.
Duration of action
Some effects may persist for several days. Diet advice
None. However, if you have kidney failure, you may have to follow a special diet.
Storage
Store at 2-8°C, out of the reach of children. Do not freeze or shake. Protect from light.
Missed dose
Do not make up any missed doses.
Stopping the drug
Discuss with your doctor.
Exceeding the dose
A single excessive dose is unlikely to be a cause for concern. Too high a dose over a long period can increase the likelihood of adverse effects.
POSSIBLE ADVERSE EFFECTS
The most common effects are increased blood pressure and problems at the site of the injection; all unusual symptoms should be discussed with your doctor immediately.
INTERACTIONS
Iron supplements may increase the effect of epoetin if you have a low level of iron in your blood.
ACE inhibitor drugs may increase the level of potassium in the blood.
QUICK REFERENCE
Drug group Kidney hormone
Overdose danger rating Low
Dependence rating Low
Prescription needed Yes
Available as generic No
SPECIAL PRECAUTIONS
Be sure to tell your doctor if:
You have high blood pressure.
You have previously suffered allergic reactions to any drugs.
You have peripheral vascular disease.
You have had epileptic fits.
You are taking other medications.
Pregnancy
Not usually prescribed. Safety in pregnancy not established. Discuss with your doctor.
Breast-feeding
Safety not established. Discuss with your doctor.
Infants and children
Reduced dose necessary.
Over 60
No known problems.
Driving and hazardous work
Not applicable.
Alcohol
Follow your doctor’s advice regarding alcohol.
PROLONGED USE
The long-term effects of the drug are still under investigation, but problems are unlikely if treatment is carefully monitored.
Monitoring Regular blood tests to monitor blood composition and blood pressure monitoring are required.
