Procrit (epoetin alfa) is an injection used to treat anemia, or low red blood cell count, caused by chronic kidney disease (CKD), taking zidovudine for HIV, or cancer chemotherapy. It's also used to reduce the need for blood transfusions in people undergoing certain surgeries. The medication given as a shot under the skin or into a vein, often in a clinic, dialysis center, or sometimes at home. Depending on your condition, you might take it once a day, once a week, or 3 times a week. Common side effects include high blood pressure, fever, and muscle or joint pain.
Treat anemia due to chronic kidney disease (CKD), taking zidovudine for HIV, or cancer chemotherapy
Reduce the need for blood transfusions before certain surgeries
Procrit (epoetin alfa) is an erythropoiesis-stimulating agent (ESA). It works like a natural hormone in your body called erythropoietin, which tells your bone marrow to make more red blood cells. This helps treat anemia and improves the amount of oxygen your blood can carry.
Source: DailyMed
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
headache
increased blood pressure
swelling of the face, fingers, ankles, feet, or lower legs
Less common
blurred vision
change in skin color
change in vision
dizziness or lightheadedness
double vision
fainting
fast heartbeat
migraine headache
pain or discomfort in the arms, jaw, back, or neck
pain, tenderness, or swelling of the foot or leg
pain in the chest, groin, or legs, especially calves of the legs
pale skin
partial or complete loss of vision in the eye
seizures
severe headache of sudden onset
skin rash or hives
slurred speech
sudden and severe inability to speak
sudden loss of coordination
sweating
temporary blindness
tenderness, pain, swelling, warmth, or skin discoloration at the injection site
unusual bleeding or bruising
unusual tiredness or weakness
vision problems
vomiting
weakness in the arm or leg on one side of the body, sudden and severe
Incidence not known
Blistering, peeling, or loosening of the skin
chills
joint or muscle pain
red, irritated eyes
red skin lesions, often with a purple center
sores, ulcers, or white spots in the 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:
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.
Can reduce the need for blood transfusions
If appropriate, can be injected at home
Approved for both children and adults
Dose can be adjusted to fit your individual needs
Raises the risk of blood clots, heart attack, and stroke
Only works if iron levels are high enough
Need regular blood tests to check hemoglobin levels
Can take 2 to 6 weeks for it to work
Don't miss regular blood tests to check your hemoglobin levels while taking Procrit (epoetin alfa). These tests help your care team adjust your dose if needed.
Procrit (epoetin alfa) can be injected into a vein or under your skin. Make sure you understand how to properly inject the medication before starting home injections.
Procrit (epoetin alfa) can raise your risk of serious blood clots, heart attacks, and strokes. Tell your care team right away if you have chest pain, trouble breathing, or swelling.
Procrit (epoetin alfa) can raise your blood pressure. Be sure to check your blood pressure regularly and take any blood pressure medication you've been prescribed.
If you're pregnant, breastfeeding, or giving this to a baby, use single-dose vials of Procrit (epoetin alfa) to avoid a preservative that could be harmful.
Store Procrit (epoetin alfa) in the refrigerator. Throw away the single-dose vial after each use, even if there’s medication left. Throw away multi-dose vials no later than 21 days after you first use them.
After using Procrit (epoetin alfa), throw the needle in a sharps container. This helps prevent injuries and keeps others safe.
Procrit (epoetin 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 factors: High hemoglobin levels
Studies found that Procrit (epoetin alfa) can raise the risk of death and serious events like blood clots, heart attack or stroke. The risk is higher if your hemoglobin level gets too high. Be sure to get your labs done regularly so your care team can monitor how your body is responding. Get emergency help right away if you notice symptoms like leg pain, chest pain, trouble breathing, sudden confusion, sudden vision changes, or weakness on one side of your body.
Procrit (epoetin alfa) might help reduce the need for blood transfusions needed, but it can also cause tumors to grow faster and lower overall survival in some people with cancer. Because of this, your prescriber will carefully consider the risks and benefits before recommending this medication and will monitor your blood levels closely to help keep you safe.
Risk factors: Uncontrolled high blood pressure
Procrit (epoetin alfa) can raise your blood pressure and shouldn't be used in people with uncontrolled high blood pressure. Before starting this medication, your blood pressure should be under control, and your care team will check it regularly during treatment. Keep taking any blood pressure medications and follow any diet changes your prescriber recommends. If your blood pressure becomes hard to manage, they might need to lower your dose, stop Procrit (epoetin alfa).
Risk factors: Chronic kidney disease (CKD)
Procrit (epoetin alfa) can raise the risk of having a seizure in people with chronic kidney disease (CKD). Your prescriber will monitor you closely during the first few months of treatment, especially for early signs like unusual feelings, confusion, or irritability. Let your care team know right away if you have a new seizure, notice warning signs before a seizure, or if seizures happen more often.
Risk factors: Low iron levels | Bleeding | Infection | Inflammation
Sometimes Procrit (epoetin alfa) doesn't work or stops working over time. If your anemia doesn't improve, your prescriber will look into possible causes like low iron, infection, inflammation, or bleeding. If you're told to take iron supplements, it's important to take them as directed to help the medication work better.
Risk factors: Chronic kidney disease (CKD) receiving Procrit (epoetin alfa) under the skin | Hepatitis C
In rare cases, Procrit (epoetin alfa) can cause a serious condition called pure red cell aplasia (PRCA), which means your body stops making red blood cells. This happens when your body makes antibodies that block erythropoietin, the hormone that helps produce red blood cells. If you develop severe anemia, your prescriber will stop Procrit (epoetin alfa) and run tests to check for these antibodies. If PRCA is confirmed, you’ll need to stop the medication for good and shouldn’t switch to another erythropoiesis-stimulating agent (ESA).
Serious allergic reactions can happen with Procrit (epoetin alfa), including anaphylaxis, swelling of the face or throat, trouble breathing, skin rash, or hives. If you have any of these reactions, stop taking the medication right away and get emergency care.
Serious skin reactions like blistering or peeling have been reported in people taking Procrit (epoetin alfa). These can include rare but dangerous conditions such as Stevens-Johnson Syndrome (SJS) or toxic epidermal necrolysis (TEN). Let your care team know immediately if you notice any skin blisters, peeling, skin sores, or painful rash.
Risk factors: Newborns | Infants with low birth weight | Pregnancy | Breastfeeding
Benzyl alcohol is a preservative found in the multi-dose vial of Procrit (epoetin alfa). It can cause a rare but serious condition called "gasping syndrome". This condition is more likely to happen in newborns and infants with low birth weight. If you're pregnant or breastfeeding, talk with your prescriber before getting Procrit (epoetin alfa), since your baby could be exposed to benzyl alcohol through the womb or breast milk. Your prescriber can recommend the single-dose vial that's safer for both you and your baby.
Procrit (epoetin alfa) carries a small risk of spreading certain viruses because it's made from human blood. To help keep it safe, blood donors are carefully screened, the blood is tested for infections, and it goes through special steps to remove or kill viruses. Even with all these safety steps, there’s still a very small chance of disease transmission. If you’re worried or have questions, talk to your care team.
The dose depends on your condition, weight, and age. Your prescriber will also adjust your dose based on your hemoglobin levels.
Chronic Kidney Disease
Adults: The typical starting dose is 50 to 100 Units/kg injected into the vein or under the skin 3 times a week.
Children (1 month and older): The typical starting dose is 50 Units/kg injected into the vein or under the skin 3 times a week.
Taking zidovudine for HIV:
The typical starting dose is 100 Units/kg injected into the vein or under the skin 3 times a week.
Receiving chemotherapy:
Adults: The typical dose is 150 Units/kg injected under the skin 3 times a week until chemotherapy ends, OR 40,000 Units injected under the skin weekly until chemotherapy ends.
Children (5 to 18 years old): The typical dose is 600 Units/kg injected into a vein weekly until chemotherapy ends.
Certain surgeries:
A typical dose is 300 Units/kg injected daily for 15 days OR 600 Units/kg injected under the skin 21, 14, and 7 days before surgery, and on the day of surgery.
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.
Uncontrolled high blood pressure
Pure red cell aplasia (PRCA) that begins after treatment with Procrit (epoetin alfa) or other erythropoiesis-stimulating agents (ESAs)
Use of the multiple-dose vials in neonates, infants, pregnant women, and breastfeeding women
Treat anemia due to chronic kidney disease (CKD), taking zidovudine for HIV, or cancer chemotherapy
Reduce the need for blood transfusions before certain surgeries
Treat anemia due to chronic kidney disease (CKD), taking zidovudine for HIV, or cancer chemotherapy
Reduce the need for blood transfusions before certain surgeries
Anemia due to chemotherapy
Anemia due to chronic kidney disease (dialysis and non-dialysis)
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