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Epoetin review
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Epoetin alfa is a synthetic drug used for the treatment of anemia. This is a synthetically produced erythropoietin, which aids the body in increasing the number of red blood cells in the system. Epoetin alfa belongs to a certain class of drugs known as colony-stimulating drugs as they have the ability to stimulate cells in the bone marrow to produce colonies of identical cells.
Epoetin alfa is genetically engineered from the ovarian cells of Chinese hamsters and is synthesized through recombinant DNA technology in a strain of bacteria. Epoetin does not cure the underlying cause of anemia, but rather aids in treating anemia by increasing the number of erythropoietin in the system. Epoetin alfa is analogous to other colony-stimulating drugs such as filgrastim and sargramostim.
Epoetin alfa is administered to treat patients diagnosed with anemia in association with kidney failure, who will be receiving renal dialysis. Epoetin alfa is also administered to HIV-infected patients who will be receiving zidovudine and cancer patients undergoing chemotherapy who have developed anemia. Some studies have shown that epoetin alfa may be used to replace red blood cell transfusion in anemic patients who are undergoing surgery. Epoetin alfa is marketed by two different pharmaceutical companies under brand names Epogen and Procrit.
Epoetin alfa may be administered either through intravenous or subcutaneous injection. The dosage varies on the body weight of the patient and on the targeted hemoglobin levels. The usual dosage is 50-300 units of epoetin alfa per kilogram of weight. Adult cancer patients undergoing chemotherapy may be administered 40,000 – 60,000 units of epoetin alfa weekly via subcutaneous injection.
Very less serious side effects have been reported on the use of epoetin alfa. The most common side effects in patients with kidney failure taking epoetin alfa have been reported to be high blood pressure, headaches, joint pains and blood clotting at the injection site. Less common side effects include pain at the injection sites, skin rashes and flu-like symptoms (fever, muscle pain). Seizures, allergies and thrombotic events like heart attacks and strokes have rarely been reported as side effects.
Fevers, rashes, headaches, and chest pain have been reported to be common side effects of HIV-infected patients receiving zidovudine treatment alongside epoetin alfa. Anemic patients undergoing surgery have been reported to experience side effects like nausea, constipation, fever, skin rashes, and vomiting. Deep vein thrombosis may occur, though very rarely.
Cancer chemotherapy patients have been reported to have experienced side effects such as fever, upper respiratory tract infections, swelling of tissues and shortness of breath. Epoetin alfa treatment may potentially increase the growth of some types of cancer cells; hence the use of the drug should be restricted accordingly.
Epoetin alfa is contraindicated in patients with hypersensitivity to the drug or any of its ingredients. Epoetin alfa poses a risk to patients currently taking medicines for high blood pressure, heparin, probenecid, iron supplements and desmopressin.
A detailed medical history must be reported to the physician prior to the use of epoetin alfa. Any medical history of high blood pressure, heart, kidney, blood vessel and liver problems must be reported to the doctor, as well as allergies to any form of drug.
Epoetin alfa contains benzyl alcohol as a preservative that may cause serious problems to infants if given in large amounts (100 mg/kg daily) during the first months of life. Epoetin alfa also poses a risk to infants with low birth weights. Administration of epoetin alfa to these infants may cause slow heartbeats, low blood pressure, and even death.
Pregnant women should only use epoetin alfa when there is a clear need for it. Although it is not known if epoetin passes into breast milk, nursing mothers should firs consult with their physician if they plan to take epoetin alfa.
Epoetin alfa may cause a potential reduction in the remission time of people diagnosed with head and neck cancer being treated with radiation. It may also shorten the time of survival for patients suffering from lymphoid, cervical, breast, lung, head and neck cancer. Discuss the risks with your physician prior to taking epoetin alfa.
• Molecular formula of epoetin alfa is C815H1317N233O241S5
• Molecular weight is 18396.1 g/mol
Generic name: Darbepoetin alfa
Brand name(s): Aranesp, Erythropoietin precursor
Review published on: 27 July 2009
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