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Aranesp

darbepoetin alfa
Used for Anemia, Kidney Disease
Used for Anemia, Kidney Disease

Aranesp (darbepoetin alfa) is an injectable medication used to treat low red blood cell count (anemia). It's long-acting and doesn't have to be given as often as similar medications. About one-third of people who take Aranesp (darbepoetin alfa) may experience high blood pressure as a side effect. There are other serious risks with this medication, especially if you have certain types of cancer, so make sure your entire healthcare team knows your full medical history.

Reviewed by:
reviewer
Allison Gourley, PharmD
reviewer
Connie Zheng, PharmD
Last reviewed on May 25, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsImagesReferencesPricesMedicare
basics-icon

What is Aranesp (darbepoetin alfa)?

What is Aranesp (darbepoetin alfa) used for?

How Aranesp (darbepoetin alfa) works

Aranesp (darbepoetin alfa) is an erythropoiesis-stimulating agent (ESA). It works similarly to a naturally-occurring hormone in our body (erythropoietin). Erythropoietin sends a signal to our body to make more red blood cells.

Are you looking for information on epoetin alfa instead?

Drug Facts

Common BrandsAranesp
Drug ClassErythropoiesis-stimulating agent (ESA)
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the side effects of Aranesp (darbepoetin alfa)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • High blood pressure (31%)
  • Trouble breathing (17%)
  • Swelling in the hands and legs (17%)
  • Cough (12%)

Other Side Effects

  • Rash
  • Chest pain
  • Dizziness when standing from a sitting lying position

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Seizures
  • Heart attack: chest pain, stomach discomfort, sweating, nausea, dizziness
  • Stroke: sudden numbness or weakness in the arm, leg, or face, confusion, trouble seeing, headache, difficulty walking
  • Dangerously high blood pressure: nausea, vomiting, confusion, dizziness, blurry vision, anxiety
  • Heart failure: tiredness, weakness, trouble breathing, swelling in the ankles and feet, chest pain
  • Serious allergic reaction: swelling of the face or tongue, throat tightening, trouble breathing, welts, skin rash
  • Serious skin reactions: fever, sore throat, tiredness, trouble swallowing, cough, body aches, rash, peeling or blistering skin

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Accumulation of pus

arm, back, or jaw pain

blurred vision

breathing problems (irregular, noisy, or trouble when resting)

chest pain, discomfort, tightness, or heaviness

chills

confusion

cough producing mucus

decrease in the amount of urine

diarrhea

dilated neck veins

dizziness, fainting, or lightheadedness

dry mouth

fast, slow, or irregular heartbeat

fatigue or tiredness (extreme or unusual)

fever

headache

nausea

pain, tenderness, swelling, or warmth over the injection site

pounding in the ears

rapid breathing

rapid or pounding pulse

skin discoloration at the injection site

stomach pain

sunken eyes

sweating

swelling of the ankles, face, fingers, feet, hands, or lower legs

thirst

trouble with breathing

unconsciousness

vomiting

weight gain

wrinkled skin

Less common

Anxiety

difficulty with speaking (slow speech or unable to speak)

double vision

seizures

trouble with thinking

trouble with walking

unable to move the arms, legs, or face muscles (including numbness and tingling)

Rare

Fever

hives, itching, skin rash

pale skin

sore throat

Incidence not known

Blistering, peeling, or loosening of the skin

cough

joint or muscle pain

red, irritated eyes

red skin lesions, often with a purple center

sores, ulcers, or white spots in mouth or on the lips

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Constipation

general feeling of discomfort or illness

lack or loss of strength

loss of appetite

muscle aches, pains, or stiffness

runny nose

shivering

sneezing

trouble with sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Aranesp (darbepoetin alfa)

thumbs-up

Pros

Long-lasting so it doesn't have to be injected as often as some similar medications

Can be injected at home in certain situations and comes as a prefilled "SingleJect" syringe for easier administration

Doesn't contain albumin, so it's less likely to cause an allergic reaction

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Cons

Can raise the risk of blood clots and other heart-related conditions

No lower-cost generic available

Only works if you have enough iron in your blood

No proof that Aranesp (darbepoetin alfa) can improve quality of life, fatigue, or well-being

pharmacist-tips

Pharmacist tips for Aranesp (darbepoetin alfa)

pharmacist

  • Talk to your provider if you have a history of heart or blood clotting problems. ESA medications like Aranesp (darbepoetin alfa) can raise your risk of blood clots and lead to heart attacks or stroke. Report any chest pain, breathing problems, or confusion to your provider right away.

    • Aranesp (darbepoetin alfa) can raise your blood pressure. Monitor your blood pressure as directed and take blood pressure-lowering medications as prescribed.

      • Store Aranesp (darbepoetin alfa) in the refrigerator (not in the freezer). Keep it in its original carton to protect it from light. Don't shake it.

        • Always inspect the medication before you prepare your injection. Make sure it's not cloudy, leaky, or containing any particles (solid chunks). If it has particles, is discolored, or foamy, don't use it. Instead, contact your provider or pharmacy about getting a replacement.

          • Injection instructions will differ from person to person and some people on dialysis might have a port they can administer the medication through. Make sure you understand how to inject the medication properly before starting home injections. It's important to get the correct amount of medication.

            • Throw away your needles, syringes, and leftover medication after each use. The vials and syringes are made for single-use and improper use can lead to serious infections.

              faqs

              Frequently asked questions about Aranesp (darbepoetin alfa)

              Is Aranesp (darbepoetin alfa) the same as Procrit (epoetin alfa)?
              No, Aranesp (darbepoetin alfa) isn't the same as Procrit (epoetin alfa), but they do belong to the same medication class and work well to treat certain anemias. A major difference is that Aranesp (darbepoetin alfa) lasts longer and doesn't need to be injected as often. While Aranesp (darbepoetin alfa) is approved for anemia caused by chemotherapy and chronic kidney disease, Procrit (epoetin alfa) is used in certain other conditions and can help reduce the need for blood transfusions after surgery.
              How long does it take for Aranesp (darbepoetin alfa) to start working?
              After starting Aranesp (darbepoetin alfa), it will take time for you body to make new red blood cells. It can take 2-6 weeks for your hemoglobin to change. Your provider will order blood tests to check your blood cell count weekly, at least at the start of treatment. If your hemoglobin levels are still low after about a month of treatment, your provider might adjust your dose.
              How long do side effects of Aranesp (darbepoetin alfa) last?
              How long the side effects of Aranesp (darbepoetin alfa) last depends on what side effects you're experiencing and whether or not there are ways to manage them. For example, one of the most common side effect of Aranesp (darbepoetin alfa) is high blood pressure that's difficult to control. Your provider will check your blood pressure regularly throughout treatment and might recommend that you start blood pressure medications if needed. Another example is that Aranesp (darbepoetin alfa) can raise your risk for blood clots. This risk will be there as long as you're still receiving Aranesp (darbepoetin alfa) and as long as this medication stays in your body (up to 4 weeks, depending on your dose and medical condition). Your provider will try to minimize your risk for blood clots by making sure your hemoglobin stays within a safe level. Talk with your provider if you've questions about any particular side effect.
              How long can Aranesp (darbepoetin alfa) be out of the refrigerator?
              The manufacturer doesn't give clear guidance for how long Aranesp (darbepoetin alfa) can be left out of the refrigerator. According to the user guide, you should only take out Aranesp (darbepoetin alfa) from the refrigerator when you're ready to use it; don't try to save it to use at a later time. Make sure to only take out the vial or pre-filled syringe that you plan to use, and leave the rest in the refrigerator and protected from light. Talk with your provider or pharmacist if you've question about Aranesp (darbepoetin alfa) storage.
              Where do you inject Aranesp (darbepoetin alfa)?
              Aranesp (darbepoetin alfa) can be injected into the outer area of the upper arms, stomach, front of your middle thigh, and upper outer area of your butt. Don't inject the medication into areas that are tender, red, bruised, hard, or scarred. If you're on dialysis, your provider might instruct you to inject the medication into your special access port.
              Is Aranesp (darbepoetin alfa) chemotherapy?
              No, Aranesp (darbepoetin alfa) isn't chemotherapy. But it's sometimes prescribed for people who are receiving chemotherapy. This is because certain anticancer medications can cause low red blood cell count, so providers prescribe Aranesp (darbepoetin alfa) to help the body make more red blood cells.
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              What are the risks and warnings for Aranesp (darbepoetin alfa)?

              Aranesp (darbepoetin alfa) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Higher risk of death and other serious events

              • Risk factors: History of heart disease | Uncontrolled high blood pressure | High red blood cell level

                Studies found that Aranesp (darbepoetin alfa) can raise the risk of death and serious heart conditions, such as a heart attack or stroke. The risk is higher in people with a history of heart-related conditions and those with higher levels of hemoglobin (a protein found in red blood cells). Make sure you have your labs drawn regularly so your provider can monitor your body's response.

                risk-warning

                Cancer survival and tumor growth

                Aranesp (darbepoetin alfa) can lower the amount of blood transfusions needed, but can also lead to more tumor growth and overall shortened survival. To lower this risk, Aranesp (darbepoetin alfa) should only be used in certain situations and may not be a good option for people with certain curable cancers.

                risk-warning

                High blood pressure

                Aranesp (darbepoetin alfa) can raise blood pressure and shouldn't be used in people who have uncontrolled high blood pressure. Aranesp (darbepoetin alfa) can be used once your blood pressure is controlled and it's important that you continue the medication and dietary changes that lowered your blood pressure. If your blood pressure becomes too high after starting Aranesp (darbepoetin alfa) your provider might pause the medication or lower your dose. They can also add more blood pressure-lowering medications.

                risk-warning

                Seizures in people with CKD

                Aranesp (darbepoetin alfa) can raise the risk of having a seizure in people with CKD. Your provider will monitor this closely during the first few months. Contact your provider if you do have a seizure and report any pre-seizure symptoms such as a migraine or sensitivity to light or sound.

                risk-warning

                No response to Aranesp (darbepoetin alfa)

                • Risk factors: Low iron levels | Bleeding | Infection | Inflammation

                  Sometimes Aranesp (darbepoetin alfa) doesn't work or stops working after a while. If your anemia doesn't respond to the medication, your provider will evaluate potential factors that might be the cause. One possible reason is having low iron levels, so it's important to take iron supplements if prescribed or directed.

                  risk-warning

                  Serious allergic reactions and skin reactions

                  Though rare, Aranesp (darbepoetin alfa) can cause serious allergic reactions or skin reactions (Stevens-Johnson Syndrome). Let your provider know right away if you experience symptoms such as trouble breathing, skin rash, welts, and peeling or blistering skin.

                  dosage

                  Aranesp (darbepoetin alfa) dosage forms

                  Typical dosing for Aranesp (darbepoetin alfa)

                  Your provider will determine your dose based on factors such as your body weight, age, and hemoglobin level.

                  • Anemia due to chemotherapy

                    • The typical starting dose is 2.25 mcg/kg injected under the skin every week, or 500 mcg every 3 weeks until chemotherapy is finished.

                  • Anemia due to CKD

                    • Adults (not receiving dialysis): The typical recommended starting dose is 0.45 mcg/kg body weight injected under the skin or through the veins once every 4 weeks.

                    • Adults (receiving dialysis): The typical recommended starting dose is 0.45 mcg/kg body weight injected under the skin or through the veins once a week, or 0.75 mcg/kg injected once every 2 weeks.

                    • Children: The typical recommended starting dose is 0.45 mcg/kg body weight injected under the skin or through the veins once a week. If not receiving dialysis, the usual starting dose is 0.75 mcg/kg injected once every 2 weeks.

                  interactions

                  Interactions between Aranesp (darbepoetin alfa) and other drugs

                  Aranesp (darbepoetin alfa) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Aranesp (darbepoetin alfa). Please note that only the generic name of each medication is listed below.

                  Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

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                  How much does Aranesp (darbepoetin alfa) cost?

                  To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
                  Aranesp (brand)
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                  contraindications-icon

                  Aranesp (darbepoetin alfa) contraindications

                  Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Aranesp (darbepoetin alfa) will not be safe for you to take.
                  alternatives

                  What are alternatives to Aranesp (darbepoetin alfa)?

                  There are a number of medications that your doctor can prescribe in place of Aranesp (darbepoetin alfa). Compare a few possible alternatives below.
                  Aranesp (darbepoetin alfa)
                  Used for:
                  $769.02 Lowest GoodRx priceView Prices
                  Epogen (epoetin alfa)
                  Used for:

                  • Treatment of anemia due to chemotherapy, chronic kidney disease, and zidovudine use in HIV-infected patients

                  • Reduction of allogeneic red blood cell transfusions in patients having elective, noncardiac, nonvascular surgery

                  $1059.30 Lowest GoodRx priceView Prices
                  Mircera
                  Used for:
                  $220.30 Lowest GoodRx priceView Prices
                  images

                  Aranesp (darbepoetin alfa) images

                  colorless - Aranesp 25mcg / mL Solution for Injection
                  This medicine is Colorless Carton.colorless - Aranesp 25mcg / mL Solution for Injection

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                  References

                  Best studies we found

                  American Cancer Society. (2023). Low red blood cell counts (anemia).

                  Amgen Inc. (2012). Instructions for use.

                  Amgen Inc. (2018). Aranesp- darbepoetin alfa injection, solution; darbepoetin alfa solution [package insert]. DailyMed. 

                  View All References (3)

                  Mangla, A., et al. (2022). Pure red cell aplasia. StatPearls.

                  National Cancer Institute. (n.d.). Hemoglobin.

                  Schoener, B., et al. (2023). Erythropoietin stimulating agents. StatPearls.

                  GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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