Epogen

Generic name: Epoetin alfa

What is Epogen?

Epogen is a manmade form of the protein human erythropoietin that works by stimulating the bone marrow to make more red blood cells, which should increase in count after 2 to 6 weeks of treatment. It is used to treat anemia caused by chronic kidney failure, chemotherapy used to treat cancer, or zidovudine-induced anemia. It may also be given prior to certain types of operations where there in an increased chance of blood loss and/or need for blood transfusions.

What is the most important information I should know about Epogen?

Although Epogen does not improve symptoms of anemia, quality of life, fatigue, or patient well-being for patients with cancer or with HIV, it does increase hemoglobin levels and improves exercise tolerance and physical functioning in chronic kidney failure patients on dialysis. Since it can increase the chance of blood clot formation, blood thinners may be necessary if you are scheduled for surgery as directed by your doctor.

Having levels hemoglobin that are too low or too high can be dangerous. Epogen is only used to maintain a hemoglobin level between 10 and 12 g/dL. Levels >12 g/dL may increase the risk of death and cardiovascular related events.

Epogen may increase the growth of cancerous cells, and cancer patients receiving the drug should be put on the lowest possible dose to prevent the need for blood transfusions.

Who should not take Epogen?

Do not use this medication if you have uncontrolled or untreated high blood pressure or antibodies to erythropoietin.

What should I tell my doctor before I take the first dose of Epogen?

Tell your doctor about all your health conditions and all the medicines you take, including prescription and over-the-counter medicines, vitamins, supplements, and herbals. Be sure to tell your doctor if you have heart disease, high blood pressure, any history of seizures or strokes, or other blood disorders such as sickle cell anemia and blood clotting disorders. Talk to your doctor if you are pregnant or plan to become pregnant

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Chronic Renal Failure

Adults: The recommended range for the starting dose is 50 to 100 Units per kilogram (kg) 3 times a week.

Children: The recommended starting dose is 50 Units/kg 3 times a week. The dose should be reduced as the hemoglobin approaches 12 grams (g) per deciliter (dL) or increases by >1 g/dL in any 2-week period.

If you are on hemodialysis, the IV route is recommended.

Zidovudine-Treated HIV-Infected Patients

Adults: For patients with serum erythropoietin levels ≤500 mUnits/mL who are receiving a dose of zidovudine ≤4200 milligrams (mg) per week, the recommended starting dose of is 100 Units/kg as an IV or subcutaneous injection 3 times a week for 8 weeks.

Cancer Patients on Chemotherapy

Adults: The initial recommended dose is 150 Units/kg subcutaneously 3 times a week or 40,000 Units subcutaneously weekly.

Children: The initial recommended dose is 600 Units/kg weekly administered intravenously.

Surgery Patients

Adults: Prior to starting treatment, obtain hemoglobin levels to establish they are between >10 and ≤13 g/dL. The recommended dose is 300 Units/kg/day subcutaneously for 10 days before surgery, on the day of surgery, and for 4 days after surgery. An alternate dosing schedule is 600 Units/kg subcutaneously in once-weekly doses (21, 14, and 7 days before surgery) plus a fourth dose on the day of surgery.

You should receive adequate iron supplementation as directed by your doctor and should start no later than the beginning of treatment and continue throughout the course of therapy.

How should I take Epogen?

Your doctor will instruct you in the proper way to administer Epogen. You can also refer to the detailed instructions that accompanied your prescription.

Remove the vial of Epogen^™ from the refrigerator and allow it to reach room temperature before using. Do not leave the vial in direct sunlight. Each vial is designed to be used only once, unless you are using a multidose vial. Do not shake. Assemble the other supplies you will need for your injection (vial; syringe; alcohol antiseptic wipes and a container for disposing the needle).

Check the date on the vial to be sure that the drug has not expired. Wash your hands thoroughly with soap and water before preparing the medication.

What should I avoid while taking Epogen?

Avoid improper disposal of syringes.

What are the possible side effects of Epogen?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: increased blood pressure, vomiting, headache, swelling in your legs and arms, body aches, shortness of breath, diarrhea, fever, nausea, cough, chest pain, injection-site reactions

Can I receive Epogen if I am pregnant or breastfeeding?

Epogen^™ has not been studied in pregnant women and its effects on developing babies are not known. It is also not known if Epogen can pass into human breast milk. Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.

What should I do if I miss a dose of Epogen?

If you forget to take a dose, take it as soon as you remember, and resume your regularly scheduled injections. However, if you skip the dose entirely, do not double the next day's dose

How should I store Epogen?

This medication should be stored in the refrigerator, but never in the freezer. Do not use a vial that has been frozen. Do not leave the vial in direct sunlight.