What Is Erythropoietin Alpha?

Jacquelyn Gilchrist

Erythropoietin alpha, also called epoetin alfa, is a medication called a erythropoiesis-stimulating agent (ESA). It works by stimulating a patient's bone marrow to produce more red blood cells. A doctor may prescribe it to treat anemia in patients who suffer from kidney failure or those undergoing chemotherapy. Patients may also receive this medication before or after some surgeries to lessen the effects of blood loss.

Red blood cells are produced in bone marrow.
Red blood cells are produced in bone marrow.

In the United States, patients may only receive erythropoietin alpha from a doctor who has completed the ESA APPRISE Oncology Program, which is a training program. Patients will also be required to read and sign a waiver. This is due to the risk of serious complications, such as a recurrence of cancer or death from cancer in patients taking it to treat anemia caused by chemotherapy. Those with kidney failure may suffer from a blood clot in the vascular access, which is the point of transfer of blood going to and from the dialysis machine. Other patients may also develop dangerous blood clots in the brain, lungs, or legs.

Erythropoietin alpha may be used to treat anemia in dialysis patients.
Erythropoietin alpha may be used to treat anemia in dialysis patients.

Erythropoietin alpha is only available as an injection to be administered intravenously into a vein or subcutaneously, which means under the skin. Those being treated for kidney failure will receive it intravenously. The doctor will typically begin the patient on the lowest possible dosage, to be increased gradually if needed. He will inject erythropoietin alpha one to three times per week for most patients. Those taking it for a surgery may receive daily injections for 10 days prior to the procedure, on the day of the procedure, and possibly for four days following it.

Patients may experience some side effects while taking erythropoietin alpha, which should be reported to the prescribing physician if they become severe. Stomach pain, constipation, and diarrhea may occur, along with indigestion, nausea, and vomiting. Insomnia, headaches, and joint or muscle pain have also been reported. Some patients may notice pain, redness, or swelling at the injection site.

More serious side effects require a doctor's urgent care. Patients who have developed blood clots may experience shortness of breath, coughing with blood, and sudden trouble speaking or understanding speech. Blood clots can also cause pain, tenderness, or swelling in the legs, along with sudden weakness in an arm or leg. Dizziness, loss of coordination, and sudden vision problems, along with seizures or problems walking may also indicate a blood clot.

Other serious side effects that may be caused by erythropoietin alpha may include problems breathing or swallowing, a lack of energy, and feeling unusually cold. Some patients may experience hoarseness, wheezing, and signs of a possible infection, such as a fever or chills. Hives and a rash that spreads over the whole body have also been reported.

Before using erythropoietin alpha, patients must disclose their other medical conditions, medications, and supplements. As of 2011, it is unknown whether it may pass into breast milk, but it can harm an unborn baby. Erythropoietin alpha may be contraindicated for use by those who have blood clotting problems, an infection, or those with a history of heart attack or stroke.

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