Epoetin 5000 IU/.5 ml Injection

Erythropoiesis-stimulating agent (injection) for:

• Anaemia of chronic kidney disease (on dialysis or not)
• Anaemia from cancer chemotherapy
• Anaemia in HIV treated with zidovudine; before elective surgery to reduce transfusion (selected patients)
• Anaemia of prematurity (specialist)

Specialist-directed, by SC or IV injection.

• CKD (correction): 50–100 IU/kg three times weekly (or 20,000–40,000 IU weekly SC in some regimens); adjust every 4 weeks to keep haemoglobin about 10–12 g/dL (do not exceed 12; avoid rises over 1–2 g/dL per month).
• Chemotherapy anaemia: 150 IU/kg three times weekly or 40,000 IU weekly SC; stop after chemotherapy ends.
• Check and correct iron (ferritin, transferrin saturation) before and during treatment — iron supplements are usually needed.

• Uncontrolled high blood pressure
• Pure red cell aplasia after previous erythropoietin
• Allergy to the product
• Patients who cannot receive anticoagulant prophylaxis before major surgery

Common: raised blood pressure, headache, flu-like symptoms, joint pain, injection-site reactions, clotting of dialysis access.

Serious: blood clots (stroke, heart attack, DVT) especially if haemoglobin is raised too high or too fast, hypertensive encephalopathy and seizures, pure red cell aplasia (sudden loss of effect), possible tumour progression in some cancers, severe skin reactions.

• Monitor haemoglobin every 1–2 weeks initially and blood pressure regularly.
• Ensure iron, B12 and folate are adequate.
• Use the lowest dose to avoid transfusion.
• Seizure history: caution.

Use in pregnancy only if clearly needed. Probably compatible with breastfeeding.

• ACE inhibitors (may reduce response; risk of high potassium)
• Ciclosporin (levels may change)
• Iron (needed for response)

Excessive haemoglobin rise, high blood pressure, clots. Venesection may be needed.

Store in a refrigerator (2–8°C); do not freeze or shake. Protect from light. May be kept at room temperature (below 25°C) for a limited time as stated on the pack.