Epoetin Alfa

Breastfeeding
  • TRADE NAMES: Binocrit; Epogen (Amgen); Epoxitin; Eprex (Janssen-Cilag); Erypo; Procrit (Ortho)
  • INDICATIONS: Anemia
  • SYNONYM: erythropoietin; EPO
  • CLASS: Erythropoiesis-stimulating agent (ESA), Erythropoietin
  • HALF-LIFE: 4–13 hours (in patients with chronic renal failure)
CLINICALLY IMPORTANT, POTENTIALLY HAZARDOUS INTERACTIONS WITH:

None known

PREGNANCY CATEGORY: C

Under investigation for treating COVID-19

See adverse reactions attributed to class:

Erythropoiesis-stimulating agent (ESA)

ERYTHROPOIESIS-STIMULATING AGENTS (ESAs) INCREASE THE RISK OF DEATH, MYOCARDIAL INFARCTION, STROKE, VENOUS THROMBOEMBOLISM, THROMBOSIS OF VASCULAR ACCESS AND TUMOR PROGRESSION OR RECURRENCE

See full prescribing information for complete boxed warning.

Angioedema <5%

(package insert)

Dermatitis 

(1993): Hardwick N+, Contact Dermatitis 28, 123

Erythroderma 

(2005): Wolf IH+, J Cutan Pathol 32(5), 371

Erythropoiesis 

(2012): Pandey V+, J Pediatr Hematol Oncol 34(7), 534 ('blueberry muffin' lesions)

Exanthems 

(1990): Schroder-Kolb B, Derm Beruf Umwelt (German) 38(1), 12 (papular)

Hypersensitivity <1%

(package insert)

(2020): Rueangsri R+, Asian Pac J Allergy Immunol Jun, Online ahead of print [REVIEW]

Photosensitivity 

(1992): Harvey E+, J Pediatr 121, 749

Pruritus (itching) 12–21%

(1990): Schroder-Kolb B, Derm Beruf Umwelt (German) 38(1), 12 (papular)

(1989): Faulds D+, Drugs 38, 863 [REVIEW]

Rash 2–19%

(2005): Norgard N+, Am J Health Syst Pharm 62(23), 2524

Alopecia / hair loss 

(2001): Reddy V+, Nephrol Dial Transplant 16(7), 1525

Alopecia totalis 

(2001): Reddy V+, Nephrol Dial Transplant 16(7), 1525

Hypertrichosis 

(1991): Kleiner MJ+, Am J Kidney Dis 18(5), 619

Arrhythmias 

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)

Chest pain 

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)

Hypertension 3–28%

(2013): Fishbane S+, N Engl J Med 368(4), 30711%

Hypotension 

(2013): Fishbane S+, N Engl J Med 368(4), 30715%

Fever (pyrexia) 10–42%

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)

(2013): Fishbane S+, N Engl J Med 368(4), 30714%

Hallucinations, visual 

(1998): Delanty N+, Psychosomatics 39(1), 83

(1991): Steinberg H, N Engl J Med 325(4), 285

Headache 5–18%

(2013): Fishbane S+, N Engl J Med 368(4), 30716%

Paresthesias 11%

(package insert)

Syncope / fainting 

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)

Vertigo / dizziness 

(2013): Fishbane S+, N Engl J Med 368(4), 30711%

Hyperkalemia 

(2013): Fishbane S+, N Engl J Med 368(4), 30712%

Constipation 

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)

(2013): Fishbane S+, N Engl J Med 368(4), 30711%

Diarrhea 

(2013): Fishbane S+, N Engl J Med 368(4), 30716%

Nausea 35–56%

(2013): Fishbane S+, N Engl J Med 368(4), 30720%

Vomiting  

(2013): Fishbane S+, N Engl J Med 368(4), 30713%

Urinary obstruction 

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)

Febrile neutropenia 

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)

Neutropenia (neutrophils decreased) 

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)

Pancytopenia (includes bicytopenia) 

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)

Thrombocytopenia 

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)

(2012): Komrokji RS+, Blood 120(17), 3419 (with lenalidomide)

Thrombotic complications 

(2016): Cariou A+, J Am Coll Cardiol 68(1), 4012%

Injection-site pain 

(1998): Veys N+, Clin Nephrol 49, 41

Injection-site reaction 7%

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)

Arthralgia 10–16%

(2013): Fishbane S+, N Engl J Med 368(4), 30710%

Back pain 

(2013): Fishbane S+, N Engl J Med 368(4), 30711%

Muscle spasm 

(2013): Fishbane S+, N Engl J Med 368(4), 30717%

Pain in extremities 

(2013): Fishbane S+, N Engl J Med 368(4), 30713%

Cough 4–26%

(2013): Fishbane S+, N Engl J Med 368(4), 30717%

Dyspnea / shortness of breath 

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)

(2013): Fishbane S+, N Engl J Med 368(4), 30719%

Adverse effects 

(2012): Bennett CL+, Semin Thromb Hemost 38(8), 783 [REVIEW]

Death 

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)

Infection 

(2014): Tobiasson M+, Blood Cancer J Mar, Epub (with azacitidine)



Adverse reactions attributed to entire drug class Erythropoiesis-stimulating agent (ESA)

Hypertension 

(2016): Robles NR, Clin Drug Investig 36(6), 421 [REVIEW]

Seizures 

(2016): Robles NR, Clin Drug Investig 36(6), 421 [REVIEW]

Page last updated 08/02/2021

Drug Eruption Mobile Site

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Incidence info

  • <1%
  • 1-5%
  • 5-10%
  • 10-15%
  • 15-20%
  • 20-30%
  • >30%

Seriousness info

  • Hospitalization possible
  • Life threatening
  • Fatal

Warnings in other populations info

  • Breast feeding
  • Geriatric
  • Pediatric
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