Epogen (Epoetin-Alfa)

Description

Epogen (Epoetin Alfa) is a synthetic form of erythropoietin, a hormone that is naturally produced in the kidneys. As a result, it stimulates the bone marrow to increase the production of red blood cells. Classified as an erythropoiesis-stimulating agent (ESA), epoetin alfa is used primarily to treat anemia typically caused by chronic kidney disease or chemotherapy. This medication helps to reduce the need for blood transfusions in patients living with certain types of anemia.

Directions

Epogen is typically administered via injection, either subcutaneously or intravenously. Patients or their caregivers should receive thorough training on injection techniques to administer doses at home. The standard dosage depends on the patient's medical condition, body weight, and response to treatment. For chronic renal failure patients, the initial recommended dose may vary based on whether they are on dialysis.

Ingredients

The active ingredient in Epogen injections is Epoetin Alfa. The formulation also includes several inactive ingredients that help stabilize the medication and ensure its delivery into the body. These inactive ingredients may include:

• Albumin (Human)
• Sodium Citrate
• Sodium Chloride
• Citric Acid

Contraindications

Do not use this medication under these conditions:

• If you have unregulated high blood pressure
• If you develop pure red cell aplasia (PRCA) following the use of Epoetin Alfa or similar erythropoietin-based treatments
• If you have a known allergy to Epogen or any component in it
• If you are considering the administration of multi-dose formats containing benzyl alcohol to newborns, small children, those expecting a baby, or breastfeeding mothers

Cautions

• Before starting Epogen, ensure that your healthcare provider is informed about the following details:
• The complete list of medications you are taking
• Any existing health conditions you may have
• Any allergies that are known to affect you
• Whether you are pregnant, planning to become pregnant, or considering it
• If you are currently breastfeeding
• Treatment with Epogen can increase the risk of serious heart-related events, such as heart attacks, strokes, and blood clotting (thromboembolism). These risks are particularly notable when the medication is used to achieve a hemoglobin level above 11 g/dL. People with existing heart conditions or a history of stroke need to be especially cautious.
• For individuals with cancer, there's an increased risk of death and potential for the cancer to progress or recur when using Epogen. This underscores the importance of careful monitoring and consultation with your healthcare provider.
• High blood pressure should be effectively controlled both before starting and during treatment with Epogen. Uncontrolled hypertension can be exacerbated by this medication.
• Patients with chronic kidney disease (CKD) who are treated with Epogen have a heightened risk of experiencing seizures. Regular monitoring for seizure activity or signs is important for these patients.
• Developing severe anemia and a low reticulocyte count while on Epogen is a red flag. In such cases, the treatment should be stopped, and testing for PRCA, a rare blood condition, should be conducted.
• Any serious allergic reaction to Epogen requires immediate discontinuation of the medication and appropriate medical intervention.
• If severe skin reactions occur, it is advised to stop using Epogen and seek medical advice.

Side Effects

Epogen has several side effects. For those with CKD, side effects can include high blood pressure, muscle spasm, and fever. Patients with HIV on Zidovudine may experience symptoms like fever and cough. In cancer patients on chemotherapy, common effects are nausea, vomiting, and bone pain. For surgery patients, side effects often include nausea, headache, and a blood clot condition called deep vein thrombosis.

Epogen is also linked to serious side effects. In CKD patients, there's a higher risk of adverse cardiovascular events and stroke. Cancer patients may see a reduced overall survival rate and an increased risk of tumor progression. Surgery patients are at an increased risk of deep venous thrombosis. The lowest effective dose is recommended to decrease these risks, and immediate medical attention should be sought if severe side effects arise.

References:

1. Epogen (Epoetin-Alfa) Product Monograph. Thousand Oaks, CA: Amgen, Inc.; 2018.
2. Epogen (Epoetin-Alfa) Drug Label Information. Thousand Oaks, CA: Amgen, Inc.; 2018.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....