What to Know About Procrit for Anemia

If you or a loved one live with anemia, you’re well aware how bothersome it can be. You may often feel tired or weak, and there may be times when you feel irritable, cold, or dizzy. These types of anemia symptoms are often attributable to one key factor —  not having enough red blood cells in your body.

Red blood cells carry oxygen to tissues and organs throughout your body, so when there’s not enough of them, many parts of your body are affected. Because of this, treatments for anemia are usually aimed at boosting the number of red blood cells in your body.

So, if you or someone you know has anemia, you may be curious about what your treatment options are. One medication used to treat different types of anemia is Procrit (epoetin alfa). But there’s a lot to know about the medication, and it can understandably get confusing.

Here, we'll talk about Procrit — what it is, how it works, and how much it costs.

What is Procrit?

Procrit is an injectable biologic medication that's FDA-approved to treat different types of anemia. Biologics are medications that are made from natural sources, like sugars, proteins, and tissues. Procrit can be injected into a vein or under your skin.

What types of anemia does Procrit treat?

Procrit may be used to treat anemia if it is caused by:

• Chronic kidney disease (CKD) (with or without dialysis)

• Chemotherapy

• Zidovudine, a medication that treats HIV

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In addition to these, Procrit can also help prevent complications from blood loss caused by elective surgeries that aren’t related to your heart or blood vessels

How does it work for anemia?

Procrit is an erythropoietin stimulating agent (ESA). It tells your body to make more red blood cells to treat anemia. It’s used to help avoid the need for red blood cell transfusions (donated blood given into your vein).

ESAs work similarly to a naturally-occurring hormone in our body called erythropoietin (EPO). EPO sends a signal to your body to make more red blood cells. This also helps raise your hemoglobin, which is a protein in red blood cells that helps carry oxygen to tissues and organs throughout your body.

However, Procrit doesn’t work right away. It usually takes 2 to 6 weeks for your body to make new red blood cells. Your healthcare provider will monitor your hemoglobin levels and may change your Procrit dose to make sure you reach your goal.

How is Procrit given when treating anemia?

Procrit is given as a subcutaneous (under the skin) or intravenous (into the vein) injection. It’s available in two forms: a single-dose or multiple-use vial. Your healthcare provider may give it to you, or you could be instructed to use it at home.

The recommended starting dose for CKD is 50 to 100 units per kilogram of body weight, 3 times weekly. After starting Procrit, your healthcare provider will likely monitor your hemoglobin levels weekly until your level is stable. Your provider may also adjust your dose once every 4 weeks if needed.

But as discussed, Procrit treats different types of anemia. Your dose will depend on the type of anemia you have. It can be given daily, 3 times a week, or once a week. You should always take Procrit exactly as your healthcare provider tells you to. 

What are the potential side effects?

Like all medications, Procrit can cause some side effects. Some are common and manageable, but serious side effects are also possible. You should tell your healthcare provider about any side effects that you experience.

Common side effects

Specific side effects vary depending on what you’re using Procrit to treat. But, common side effects of Procrit can include:

• Irritation (like redness, pain, swelling) where the medication was injected

• Joint or muscle pain

• Fever

• Dizziness

• Headache

• Cough

• Nausea and vomiting

• High blood pressure

Serious side effects

Procrit has a few boxed warnings — the most serious type of warning the FDA can give a medication about risks and side effects.

If you have cancer and are receiving Procrit, it may make your tumor grow faster, and you may die sooner. Because of this, oncologists won’t use Procrit in people with cancer when the goal of treatment is to cure the cancer.

For other people who take Procrit, serious heart conditions such as heart failure, heart attack, and stroke are possible. This risk is higher for people with heart-related conditions and higher hemoglobin levels. To lower this risk, your healthcare provider will regularly check your labs and use the lowest Procrit dose necessary.

Blood clots may also happen while taking Procrit. If you need surgery, it's important to talk with your healthcare provider about whether or not you need to take a blood thinner to help prevent blood clots during or after surgery. Call your healthcare provider immediately or go to the emergency room if you have any of the following symptoms of a blood clot: 

• Trouble breathing, chest pain, or sweating

• Trouble speaking, seizures, or weakness

• Pain, swelling, or warmth in your arm or leg

• Your dialysis access stops working

These aren’t the only serious possible side effects. If you’re currently receiving Procrit or have been told you may need it in the future, it’s important to talk with your healthcare provider about all of the risks that are possible. 

How effective is Procrit when treating anemia?

Procrit is quite effective when treating anemia for people with CKD.

One study found that Procrit can help raise hemoglobin levels after 4 weeks in people with CKD who aren’t on dialysis. The same study also showed that people taking Procrit had a significant improvement in energy levels and ability to do work than those taking placebo (an injection with no medication in it).

In another study, Procrit also raised hemoglobin for people with CKD on dialysis. After 2 months, people receiving Procrit experienced significant improvements in exercise tolerance and physical function compared to placebo.

But, as mentioned, Procrit can treat anemia due to other causes. Procrit has also been shown to effectively treat and reduce the symptoms of anemia due to chemotherapy and zidovudine. It can also effectively help prevent complications from blood loss caused by elective surgeries.

How much does Procrit cost?

Procrit is expensive, especially if it’s not covered by insurance. For example, the list price per month for Procrit was over $4,800 in 2020. Since the dose for Procrit varies depending on your body weight and medical condition, specific costs vary for everyone. But there are always ways you can save.

If you have Medicare, Part B may pay the majority of the costs for Procrit. Part B covers medications you receive in a healthcare provider's office or clinic. Most of the time, you can expect to pay 20% of the Medicare-approved amount for the Part B-covered medications after you've paid your Part B deductible. For 2022, your Medicare Part B deductible is $233.

If you have Medicaid, you may find your medication is covered depending on your local program. Procrit may be free or a low cost to you. Keep in mind the federal government sets the guidelines, but each state runs its own Medicaid program. Because of this, your eligibility and potential cost varies from state to state.

If you don't have insurance, if your medicine isn't covered by insurance, or if you have Medicare and can't pay for your Procrit, the Johnson & Johnson Patient Assistance Foundation may be able to help you get Procrit for no cost. For more information, call 1-800-652-6227 or apply online.

Other financial assistance programs are also available. For example, if you have Medicare and meet certain income requirements, you may be able to receive financial assistance from the HealthWell Foundation or the federal government's Extra Help program.

What are some alternatives to Procrit?

You and your healthcare provider will decide what anemia treatment is best for you based on what type of anemia you have. Your healthcare provider will likely consider other health conditions, current lab results, and insurance status.

But if your healthcare provider believes you need an ESA to treat anemia, other options include:

• Epogen (epoetin alfa)

• Retacrit (epoetin alfa)

• Aranesp (darbepoetin alfa)

• Mircera (methoxy polyethylene glycol-epoetin beta)

Retacrit is biosimilar to both Procrit and Epogen. A biosimilar is a biologic medication that is highly similar to an FDA-approved reference biologic medication. Biosimilars have similar safety and effectiveness and tend to be less expensive than their reference biologic.

But, ultimately, the best medication for different types of anemia is different for every person. Your healthcare provider can help choose the best treatment for you.

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Written by:

Nikki Javit, PharmD

Nikki Javit, PharmD, is a clinical pharmacist with certifications in international travel medicine, immunization delivery, and pharmacogenomics. She received her bachelor’s of science in biology from Indiana University Bloomington and her doctor of pharmacy degree from Butler University.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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