Epoetin alfa is used to treat anaemia (low red blood cell count) caused by:
- chronic kidney disease (gradual loss of kidney function over a period of months or years)
- zidovudine (medicine for HIV infection) in HIV-infected patients
- chemotherapy in patients with cancer
This medicine may also be used to reduce the need for a blood transfusion in patients undergoing surgery and who are at risk of blood loss.
Use this medicine exactly as directed by your doctor or according to the instructions on the label. Do not administer more or less than instructed by your doctor.
Epoetin alfa is to be injected subcutaneously (into the fatty layer under the skin, usually in front of the middle thighs, upper arm, upper area of the buttocks, or abdomen).
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of your treatment depending on your condition.
Your doctor or nurse will administer the injection for you. If you or a caregiver had been given the proper training on the preparation and injection techniques of Epoetin alfa, you or your caregiver may do the administration.
How to use this medicine:
- Wash your hands with soap and water then dry them.
- Take the vial out of the box and hold it at the bottom with one hand. Flip off the protective cap and wipe the top of the vial with an alcohol swab. Put the vial on a clean and flat surface.
- Open the sterile needle package. Place the needle on the top of the syringe, push it down and rotate it clockwise until it is tight.
- Remove the needle cover and put the needle into the vial. Make sure the needle does not touch the outside of the vial. Pull the plunger up and draw all the liquid into the syringe.
- Get rid of the air bubbles in the syringe by holding it upright (in one hand between two fingers with your thumb at the bottom of the plunger) and tapping the syringe gently using your fingers from your other hand.
- Push up on the plunger until you see a drop of liquid on the tip of the needle.
- Wipe the injection site with alcohol swabs and let it dry.
- Gently pinch the skin at the injection site with one hand and pick up the syringe with other hand. Hold the syringe like a pencil and insert the needle into the pinched skin at a 45-degree or 90-degree angle using a quick dart-like motion.
- Gently press the plunger all the way down until the syringe is empty.
- Slowly let go of the skin and gently pull the needle out of the skin.
- Place a cotton ball or gauze over the injection site and press for about 5 seconds. Do not recap the needle.
- Dispose your used needles and syringes according to your doctor or pharmacist’s instructions. Do not throw away in household trash.
Remember to rotate the injection sites. Do not inject into the same area all the time. New injection sites should be at least 1.5 inches away from the previous injection site. Do not inject near the navel (belly button).
Do not inject into an area that is inflamed, bruised, has scars, stretch marks or irritated skin.
Epoetin alfa must be used regularly for it to be effective. Continue using this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Administer the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
Alert your doctor if you have the following conditions:
- uncontrolled high blood pressure
- pure red cell aplasia (a condition in which the bone marrow stops making red blood cells, causing anaemia) that begins after treatment with Epoetin alfa or similar medicines
- undergoing surgery (e.g. hip or knee surgery) and having severe heart and blood vessel disease; recent heart attack or stroke; and cannot take blood-thinning medicines
as Epoetin alfa may not be suitable for you.
Inform your doctor if you have the following conditions:
- diseases of the heart or blood vessels
- cancer
- chronic kidney disease (gradual loss of kidney function over a period of months or years)
- history of high blood pressure
- history of fits or seizures
- severe anaemia or blood loss
- liver failure
- history or risk of formation of blood clots in the blood vessels (e.g. obesity)
- porphyria (an inherited disorder that may cause skin or nerve problems)
Let your doctor know if you are pregnant or breastfeeding.
Keep your appointments with your doctor. Your doctor needs to monitor your condition (e.g. blood pressure, signs of seizures) and check your response to this medicine regularly. Your doctor may also need to do routine blood tests such as haemoglobin (protein in red blood cells) levels and platelet counts while you are being treated with this medicine. Your iron (a mineral in the body essential for blood production) status should also be evaluated before and during treatment with Epoetin alfa.
Epoetin alfa may cause any of the following side effects: headache, cough, diarrhoea, nausea, vomiting, joint pain, bone pain, muscle pain, limb pain, fever, chills, flu-like illness, skin rash itching and swelling in the ankles, feet, or hands.
You may also experience redness, itching, pain, swelling, bruising, or a small amount of blood loss at the injection site.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs and symptoms of an allergic reaction e.g. rashes, breathlessness, swollen face
- signs and symptoms of formation of blood clots in the blood vessels e.g. leg pain, paleness or coolness of a leg
- signs and symptoms of high blood pressure e.g. sudden headache, vomiting, confusion, trouble speaking, unsteady gait
- signs and symptoms of pure red cell aplasia e.g. pale skin, tiredness, shortness of breath, dizziness
- fits or seizures
- severe rash with blisters, sores or peeling
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines used in organ transplant or certain immune disorders e.g. ciclosporin
- medicines for cancer e.g. lenalidomide
- nandrolone (medicine that acts like the male hormone testosterone)
- desmopressin (medicine for excessive urination)
- probenecid (medicine for gout)
This list does not include all medicines that may interact with Epoetin alfa.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Store in the refrigerator, between 2-8°C. Do not allow to freeze. If frozen, this medicine will become ineffective and should not be used. Do not shake. Protect from light.
Do not use this medicine if it becomes cloudy or if it has changed in colour. Medicines must not be used past the expiry date.
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