Blood clots in veins, referred to as a deep venous thrombosis, also may occur.
Among patients with cancer receiving chemotherapy, the most common side effects of epoetin alfa are:
- tissue swelling,
- shortness of breath,
- paresthesia (abnormal sensations like burning or prickling that may occur anywhere in the body), and
- upper respiratory infection.
Treatment with epoetin alfa may increase the growth of several types of cancer and reduce survival, and, therefore, its use should be restricted to the conditions discussed previously.
GENERIC AVAILABLE: No
PREPARATIONS: Vials containing liquid for injection: 2000, 3000, 4000, 10000, 20000 and 40000 U/ml as well as 20000 U/2ml
STORAGE: Epoetin alfa should be stored at 2 C - 8 C (36 F - 46 F). It should not be frozen. Multiple-use vials should be used within 21 days of the first use.
DOSING: Epoetin alfa is administered intravenously or subcutaneously (under the skin) at 50-100 units/kg of body weight, three times weekly. The dose is tailored to each patient based on targeted hemoglobin levels. Adult patients with cancer receiving chemotherapy may be treated with 40,000 units weekly or 150 units/kg 3 times weekly.
Zidovudine treated patients should receive 100 units/kg 3 times weekly.
Surgery patients should receive 300 units/kg per day daily for 14 days or 600 units/kg weekly. The smallest effective dose should be used.
In clinical trials, the risk of death or serious heart problems, and stroke occurred more often when epoetin alpha was administered to target a hemoglobin level greater than 11 g/dL. Epoetin alfa vials should not be shaken since the drug may be damaged, and bubbles may form that prevent some of the drug from being drawn up into the syringe during injection. Iron stores should be evaluated before therapy and supplemental iron should be administered if needed.
DRUG INTERACTIONS: No clinical studies have been done to demonstrate epoetin alfa drug interactions.
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