Epoetin Alfa

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Summary

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Key Points

  • Mechanism
    • Synthetic (recombinant) Erythropoietin (EPO)
      • Erythropoietin is a naturally occurring hormone from the kidneys that increases red blood cells by stimulating the bone marrow
    • Clinical Use
      • Anemia
        • Target goal is to increase the hemoglobin to the lowest possible level that does not require a blood transfusion
        • Especially useful in chronic kidney disease, where the kidneys are not producing erythropoietin, and in cancer patients where the chemotherapy is suppressing the bone marrow’s production of RBC
        • May be offered to people who refuse blood products (e.g. Jehovah’s Witness)
    • Side Effects and Adverse Reactions
      • Thrombotic Events
        • Myocardial infarction, stroke, pulmonary embolism, etc.
        • Hemoglobin should not exceed 11 g/dL
          • Black box warning
          • Hemoglobin and hematocrit will be monitored periodically during treatment
        • Monitor patient for signs of chest pain, shortness of breath, and altered mental status
        • Contraindicated in hypertension or patients with a history of heart attack or stroke, as they are at an increased risk of blood clots