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Epoetin Alfa

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Epoetin Alfa, Erythropoietin Alfa, Procrit, Epogen, Retacrit

  • See Also
  1. Erythropoietin
  • Indications
  1. See Erythropoietin
  2. Anemia of Chronic Renal Failure (Hemoglobin <10 g/dl)
  3. Anemia of Myelosuppressive Cancer Chemotherapy (not intended for cure, Hemoglobin <10 g/dl)
  4. Perioperative non-cardiovascular surgery patients to avoid or reduce Blood Transfusion
    1. See resources below for protocol
  • Contraindications
  1. See Erythropoietin
  • Mechanism
  1. See Erythropoietin
  • Precautions
  1. Not a substitute for Blood Products in acute severe, symptomatic Anemia
  2. Avoid Hemoglobin targets above 11 g/dl (higher risk of cardiovascular and thrombotic events)
    1. Use the lowest effective dose
  3. Iron Supplementation if needed
    1. Check for Iron Deficiency before administration
  • Medications
  1. Available in single dose 1 ml, preservative-free vials ranging from 2000 to 40,000 units
  2. Multiple dose vials contain Benzyl Alcohol and are containdicated in pregnancy, Lactation and infants
  • Dosing
  • Adults
  1. Anemia of Chronic Renal Failure
    1. Start 50 to 100 units/kg IV/SQ three times per week
    2. Indicated for Hemoglobin <10 g/dl
    3. Stop if Hemoglobin >10 g/dl (or >11 g/dl if on Hemodialysis)
  2. Anemia of Myelosuppressive Cancer Chemotherapy (not intended for cure)
    1. Start 150 to 300 units/kg SQ three times per week OR
    2. Start 40,000 units SQ once per week
    3. Indicated for Hemoglobin <10 g/dl AND >=2 months planned of myelosuppression
  • Dosing
  • Children
  1. Anemia of Chronic Renal Failure on Hemodialysis (age 1 month to 16 years)
    1. Start 50 units/kg IV or SQ three times weekly
    2. Indicated for Hemoglobin <10 g/dl
    3. Stop if Hemoglobin >12 g/dl
  2. Anemia of Myelosuppressive Cancer Chemotherapy (age >=5 years)
    1. Give 600 units/kg IV each week until Chemotherapy completed
  • Adverse Effects
  1. See Erythropoietin
  • Safety
  1. Unknown safety in pregnancy
  2. Unknown safety in Lactation
  • Resources
  1. Epoetin Alfa (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=1f2d0b28-9cc5-4523-80b8-637fdaf3f7a5