Epogen (Epoetin Alfa)
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Epoetin Alfa Information
(e poe' e tin)Epoetin alfa injection and epoetin alfa-epbx injection are biologic medications (medications made from living organisms). Biosimilar epoetin alfa-epbx injection is highly similar to epoetin alfa injection and works the same way as epoetin alfa injection in the body. Therefore, the term epoetin injection products will be used to represent these medications in this discussion. All patients: Using epoetin alfa injection products increases the risk that blood clots will form in or move to the legs, lungs, or brain. Tell your doctor if you have or have ever had heart disease, a stroke, deep venous thrombosis (DVT; blood clot in your leg), a pulmonary embolus (PE; blood clot in your lungs), or if you are going to have surgery. Before having any surgery, even dental surgery, tell your doctor or dentist that you are being treated with an epoetin alfa injection product, especially if you are having coronary artery bypass graft (CABG) surgery or orthopedic surgery. Your doctor may prescribe an anticoagulant ('blood thinner') to prevent clots from forming during surgery. Call your doctor immediately or get emergency medical help if you experience any of the following symptoms: pain, tenderness, redness, warmth, and/or swelling in the legs; coolness or paleness in an arm or leg; difficulty breathing or shortness of breath; chest pain; sudden trouble speaking or understanding speech; sudden confusion; sudden weakness or numbness of an arm or leg (especially on one side of the body) or of the face; sudden trouble walking, dizziness, or loss of balance or coordination; or fainting. If you are being treated with hemodialysis (treatment to remove waste from the blood when the kidneys are not working), a blood clot may form in your vascular access (place where the hemodialysis tubing connects to your body). Tell your doctor if your vascular access is not working as usual. Your doctor will adjust your dose of an epoetin alfa injection product so that your hemoglobin level (amount of a protein found in red blood cells) is just high enough that you do not need a red blood cell transfusion (transfer of one person's red blood cells to another person's body to treat severe anemia). If you receive enough of an epoetin alfa product to increase your hemoglobin to a normal or near normal level, there is a greater risk that you will have a stroke or develop serious or life threatening heart problems including heart attack or heart failure. Call your doctor immediately or get emergency medical help if you experience any of the following symptoms: chest pain, squeezing pressure, or tightness; shortness of breath; nausea, lightheadedness, sweating, and other early signs of heart attack; discomfort or pain in the arms, shoulder, neck, jaw, or back; or swelling of the hands, feet, or ankles. Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to epoetin alfa injection products. Your doctor may decrease your dose or tell you to stop using an epoetin alfa injection product for a period of time if the tests show that you are at high risk of experiencing serious side effects. Follow your doctor's directions carefully. Talk to your doctor about the risks of using an epoetin alfa injection product. Cancer patients: In clinical studies, people with certain cancers who received epoetin alfa injection died sooner or experienced tumor growth, a return of their cancer, or cancer that spread sooner than people who did not receive the medication. You should only receive epoetin alfa injection products to treat anemia caused by chemotherapy if your chemotherapy is expected to continue for at least 2 months after you start your treatment with epoetin alfa injection and if there is not a high chance that your cancer will be cured. Treatment with epoetin alfa injection products should be stopped when your course of chemotherapy ends. Surgical patients: You may be given an epoetin alfa injection product to decrease the risk that you will develop anemia and require a blood transfusion as a result of blood loss during certain types of surgery. However, receiving an epoetin alfa injection product before and after surgery may increase the risk that you will develop a dangerous blood clot during or after surgery. Your doctor will probably prescribe medication to help prevent blood clots.
Before using an epoetin alfa injection product,
- tell your doctor and pharmacist if you are allergic to epoetin alfa, epoetin alfa-epbx, darbepoetin alfa (Aranesp), any other medications, or any of the ingredients in epoetin alfa injection products. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have had high blood pressure and if you have ever had pure red cell aplasia (PRCA; a type of severe anemia that may develop after treatment with an ESA such as darbepoetin alfa injection or epoetin alfa injection). Your doctor may tell you not to use an epoetin alfa injection product.
- tell your doctor if you have or have ever had seizures. If you are using an epoetin alfa injection product to treat anemia caused by chronic kidney disease, tell your doctor if you have or have ever had cancer.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using an epoetin alfa injection product, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are using an epoetin alfa injection product.
- joint or muscle aches, pain, or soreness
- weight loss
- sores in the mouth
- difficulty falling asleep or staying asleep
- muscle spasms
- runny nose, sneezing, and congestion
- fever, cough, or chills
- redness, swelling, pain, or itching at the injection spot
- swelling of the face, throat, tongue, lips, or eyes
- skin blisters or peeling skin
- difficulty breathing or swallowing
- unusual tiredness
- lack of energy