Epoetin Alfa

Other names: Procrit®

It is UPMC policy to give each patient receiving this drug a copy of the Amgen medication guide for Procrit®.

Download the medication guide here. (PDF)

About This Drug

Epoetin alfa is used to treat anemia. It helps your body make more red blood cells. It can be given in the vein (IV) or by injection under your skin (subcutaneously).

Possible Side Effects (More Common)

  • Rash
  • Swelling (fluid retention) in the arms, legs, ankles, and/or feet
  • Mild nausea and throwing up (vomiting).
  • Loose bowel movements (diarrhea )
  • Redness, pain, warmth, or swelling at the injection site.
  • Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak).
  • Heart problems. If you are treated with epoetin alfa to a hemoglobin level above 11 g/dL, you may get serious heart problems such as a heart attack, stroke, or heart failure, and you may die sooner. UPMC guidelines call for checking your hemoglobin levels to keep them in the appropriate range.
  • Blood clots. You may get blood clots at any time while taking epoetin alfa. If you are receiving epoetin alfa and you are going to have surgery, talk to your doctor about whether or not you need to take a blood thinner to lessen the chance of blood clots during surgery. Clots can form in blood vessels (veins), especially in your leg. This is called DVT, or deep venous thrombosis. A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. Pieces of a blood clot may travel to the lungs and block the blood circulation in the lungs. This is called a pulmonary embolus. A blood clot in your lungs may cause trouble breathing, pain when breathing, and/or chest pain.
  • Increase in blood pressure
  • Upper respiratory problems such as infections.

Possible Side Effects (Less Common)

  • Seizures
  • Antibodies to epoetin alfa. Your body may make antibodies to epoetin alfa. These antibodies can block or lessen your body’s ability to make red blood cells and can cause you to have severe anemia. This is extremely rare.

Allergic Reactions

Allergic reactions including anaphylaxis are rare but may happen in some patients. Signs of allergic reactions to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, do not take another dose of this drug. You should get urgent medical treatment.

Treating Side Effects

  • Ask your doctor or nurse about medicine that is available to help stop or lessen nausea, throwing up (vomiting), loose bowel movements (diarrhea), injection site pain, and rash.
  • Drink 6-8 cups of fluids every day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • If you have a rash, do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry.
  • Let your doctor know if you have a history of seizures.

Important Information

Your tumor may grow faster and you may die sooner if epoetin alfa is used as an experiment to try to raise your hemoglobin beyond the amount needed to avoid red blood cell transfusion, or when it is given to patients who are not getting strong doses of chemotherapy. It is not known whether these risks exist when epoetin alfa is given according to the FDA-approved directions for use. UPMC guidelines call for checking your hemoglobin levels to keep them in the appropriate range.

Other Instructions

  • If you have high blood pressure, it may become worse when you take this drug. Be sure to continue to take your blood pressure medicine and follow any diet your doctor prescribed.
  • You will be enrolled in a special program called REMS ESA APPRISE. Your doctor or nurse will give you more information about this.

Food and Drug Interactions

There are no known interactions of epoetin alfa with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs, and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor’s help.

When to Call the Doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Easy bruising or bleeding
  • Wheezing or trouble breathing
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Loose bowel movements (diarrhea) more than 4 times a day or diarrhea with weakness or feeling lightheaded
  • Blurred vision or other changes in eyesight
  • Pain when passing urine; blood in urine
  • Pain in your lower back or side
  • Feeling confused or agitated
  • Nausea that stops you from eating or drinking
  • Throwing up more than 3 times a day
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause. If you have any of these symptoms for 2 minutes, call 911.
  • Signs of liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak unusual itching, or yellowing of the eyes or skin.

Call your doctor or nurse as soon as possible if any of these symptoms happen:

  • Change in hearing or ringing in the ears
  • Decreased urine
  • Unusual thirst or passing urine often
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Nausea that is not relieved by prescribed medicines
  • Rash that is not relieved by prescribed medicines
  • Heavy menstrual period that lasts longer than normal
  • Numbness, tingling, decreased feeling or weakness in fingers, toes, arms, or legs
  • Trouble walking or changes in the way you walk, feeling clumsy when buttoning clothes, opening jars, or other routine hand motions
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Headache that does not go away
  • Painful, red, or swollen areas on your hands or feet.
  • No bowel movement for 3 days or you feel uncomfortable
  • Extreme weakness that interferes with normal activities

Sexual Problems and Reproductive Concerns

Pregnancy warning: It is not known if this drug may harm an unborn child. For this reason, be sure to talk with your doctor if you are pregnant or planning to become pregnant while getting this drug.

Breast feeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

Revised July 2014