Eprex (Epoetin Alfa)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Eprex Used For?
Eprex contains epoetin alfa, a protein that stimulates your bone marrow to produce more red blood cells. Red blood cells carry oxygen throughout your body, and when you don’t have enough, you develop anemia with symptoms like tiredness, breathlessness during exercise, and feeling cold.
Primary Uses
Eprex treats anemia caused by kidney disease when your kidneys don’t produce enough erythropoietin hormone. It’s also used for anemia from cancer chemotherapy when blood transfusions aren’t appropriate. Additionally, it helps mildly anemic patients donate their own blood before surgery and serves as an alternative to blood transfusion for major bone surgery patients at high risk for transfusion complications.
How It Works
Eprex is virtually identical to your body’s natural erythropoietin hormone. It stimulates your bone marrow to produce more red blood cells, helping treat your anemia by increasing the oxygen-carrying capacity of your blood.
Good to know: Eprex is not addictive and is available only with a doctor’s prescription.
How to Take Eprex
Your doctor will determine the correct dose of Eprex. The injection is given either into a vein (intravenously) or under the skin (subcutaneously). After proper training, you may be able to inject it under the skin yourself.
Dosage Instructions
For kidney failure anemia: usual starting dose is 50 IU/kg three times per week for adults and 25 IU/kg three times per week for children. For surgery patients: 300 IU/kg for 10 days before surgery, on surgery day, and 4 days after, or 600 IU/kg weekly for 3 weeks before surgery. For cancer patients on chemotherapy: initial dose is 150 IU/kg three times per week, may increase to 300 IU/kg three times weekly after 4 weeks if needed.
What If You Miss a Dose?
Eprex should be used regularly at the same time. If it’s almost time for your next dose, skip the missed dose and take your next dose as scheduled. Never take a double dose to make up for a missed one.
Important: Never take a double dose to make up for a missed dose. Only use Eprex if it has been stored correctly and is for single use only.
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Nausea, vomiting or diarrhea
- Cough or congested airways such as stuffy nose and sore throat
- Flu-like symptoms such as dizziness, drowsiness, fever, chills, headache, muscle and joint pain and weakness
- Redness, burning and pain at the injection site
- Swelling of the lower legs or hands
Seek immediate medical attention if you experience:
- Severe, sudden, stabbing migraine-like headaches
- Seizures, confusion or epileptic fits
- Raised blood pressure
- Clotting of blood in the hemodialysis system or blockage of fistula
- Chest pain, breathlessness, painful swelling in the leg (blood clot symptoms)
- Signs of allergic reaction like skin rashes, hives, shortness of breath, wheezing, difficulty breathing, swelling of face or eyelids
- Sudden tiredness, dizziness or sudden shortness of breath (may indicate pure red cell aplasia)
Important Warnings
There are important safety considerations before using Eprex. A boxed warning provides critical safety information that you should read before using this medicine.
Who Should Not Take Eprex
Do not use if you’re allergic to epoetin alfa or any ingredients, have uncontrolled high blood pressure, been diagnosed with pure red cell aplasia, cannot have transfusions with your own blood, have severe heart disease, disorders with veins or arteries, recently had a heart attack or stroke, or are a surgery patient who shouldn’t receive blood-thinning medicines.
Medical Conditions to Discuss
Tell your doctor if you have high blood pressure, heart disease, blood circulation disorders causing pins and needles or cold hands/feet, blood clotting disorders, seizures or epilepsy, cancer, anemia from other causes, liver disease, gout, porphyria, or latex allergy.
Pregnancy and Breastfeeding
Check with your doctor if you are pregnant or intend to become pregnant. Talk to your doctor if you are breastfeeding or intend to breastfeed. In women with severe kidney failure, Eprex may restart monthly periods, so discuss contraception needs with your doctor.
Cancer Patients Warning: Use of medicines like Eprex that stimulate red blood cell production during chemotherapy has been associated with increased risk of death in some studies. Your doctor should only use Eprex if blood transfusions are not appropriate.
Drug Interactions
Some medicines may interfere with Eprex and affect how it works. Always tell your doctor about all medicines you’re taking.
- Iron supplements may increase your response to Eprex treatment
- Other blood stimulating drugs may increase your response to Eprex treatment
Alcohol & Driving
Be careful before you drive or use any machines or tools until you know how Eprex affects you.
Alcohol
No specific alcohol interactions mentioned in the source material.
Driving and Operating Machinery
Eprex may cause dizziness in some people. Be careful before you drive or use any machines or tools until you know how Eprex affects you.
Storage
Store Eprex between 2°C and 8°C in the refrigerator. Do not freeze and protect from light. Immediately prior to use, Eprex may be stored at room temperature below 25°C for a maximum of seven days. Keep it where young children cannot reach it. Do not store in the bathroom or near a sink, and don’t leave in cars or on windowsills as heat and dampness can destroy the medicine.
Overdose Information
If you think you have used too much Eprex, you may need urgent medical attention. Immediately phone the Poisons Information Centre (13 11 26), contact your doctor, or go to the Emergency Department at your nearest hospital. Do this even if there are no signs of discomfort or poisoning.
Frequently Asked Questions
Your doctor will monitor your response with regular blood tests. For cancer patients, response is typically checked after 4 weeks of treatment.
No, Eprex is not addictive.
Yes, after proper training from your doctor or nurse, you may be able to inject Eprex under the skin yourself. Never attempt self-injection without proper training.
If it’s almost time for your next dose, skip the missed dose and take your next dose as scheduled. Never take a double dose to make up for a missed one.
Store between 2°C and 8°C in the refrigerator. Don’t freeze or expose to light. You can store it at room temperature below 25°C for up to 7 days before use.
If you become increasingly tired, dizzy, or breathless, talk to your doctor immediately. This may indicate pure red cell aplasia, a rare condition where Eprex stops working effectively.
Check with your doctor if you are pregnant or intend to become pregnant. In women with severe kidney failure, Eprex may restart monthly periods, so discuss contraception with your doctor.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.