Discontinue treatment if pure red cell aplasia (PRCA) is diagnosed. Do not switch to another ESA if patient has erythropoietin antibodies. Reduce or withhold dose if high BP is difficult to control by drug treatment or dietary measures. Fe deficiency & inflammatory disorders, chronic blood loss, bone marrow fibrosis, severe Al overload due to renal failure treatment, folic acid or vit B
12 deficiencies & haemolysis. May stimulate growth of any type of malignancy. May lead to excessive increase in Hb if misused by non-anaemic patients. Patients w/ haemoglobinopathies, seizures or w/ platelet level >500 x 10
9/L. Monitor Hb every 2 wk until stabilised & periodically thereafter. Evaluate Fe status prior to, & during treatment. Adequately control BP prior to, at initiation of, & during treatment. Consider bone marrow exam for PRCA if patient has sudden drop of Hb associated w/ reticulocytopenia & anti-erythropoietin antibodies. Pregnancy & lactation. Ped patients <18 yr.
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