What Are Erythropoietin Stimulating Agents?

Jacquelyn Gilchrist

Erythropoietin stimulating agents (ESAs) are a type of medication that helps the body produce more red blood cells in the bone marrow. They are a synthetic form of erythropoietin, which is a hormone naturally made in the body by the kidneys. A doctor may prescribe erythropoietin stimulating agents to patients with anemia that may be caused by chemotherapy treatments for cancer. ESAs may also benefit patients with chronic kidney disease or kidney failure. The two types of ESAs are erythropoietin alpha and erythropoietin beta.

Erythropoietin stimulating agents can help increase a person's red blood cell count.
Erythropoietin stimulating agents can help increase a person's red blood cell count.

Before receiving one of these medications, patients should discuss serious medical risks with their doctors. Erythropoietin stimulating agents have been known to cause dangerous blood clots, which may travel to the lungs or brain. These drugs may also cause too many red blood cells to be produced, which can quickly raise the level of hemoglobin in the body. If this occurs, the patient could suffer from a dangerous heart problem, such as congestive heart failure or a heart attack. Those who have cancer should be aware that ESAs may accelerate the growth of a tumor.

There is no oral form of these medicines available. Patients must receive them with an injection administered under the skin, either in the hospital or at home. Those with kidney disease or kidney failure should receive the medicine intravenously, or directly into a vein. A doctor will typically prescribe a dosage one to three times per week. The patient's red blood cell count may increase within two to six weeks.

Some side effects may occur while taking erythropoietin stimulating agents, which should be reported to the prescribing physician if they become severe. Patients may experience nausea, vomiting, and diarrhea. Muscle aches, headaches, and upper respiratory infections have also been reported. Some patients may notice pain or swelling at the injection site. Others may develop high blood pressure or low blood pressure.

More serious side effects require immediate medical attention, as they may be indicative of a dangerous complication. These can include chest pain, sudden vision problems, or sudden numbness or weakness. An abrupt loss of coordination, trouble walking, or loss of consciousness may also occur. Patients may also experience leg pain, seizures, and coughing up blood. Shortness of breath, slurred speech, and a sudden, severe headache have also been reported.

Before using erythropoietin stimulating agents to raise the red blood cell count, patients should disclose their other medical conditions, medications, and supplements. Women who are breastfeeding, pregnant, or may become pregnant must discuss possible risks with their doctors. These drugs may be contraindicated for use by those who have heart disease, seizures, or high blood pressure.

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