Epoetin Alfa

Pediatric Medication
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This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Epogen; Procrit; Retacrit

Brand Names: Canada

Eprex

Warning
  • This drug may raise the chance of heart attack, stroke, heart failure, blood clots, and death. Talk with the doctor.
  • People with some types of cancer have died sooner when using this drug. This drug also raised the chance of tumor growth and the tumor happening again in these people. Talk with the doctor.
  • The doctor will need to watch your child’s blood cell counts and follow your child closely to change the dose to match the body’s needs. Talk with the doctor.
  • If your child will be having surgery, talk with the doctor. Your child may need to take another drug to keep from getting blood clots while getting this drug.

What is this drug used for?

  • It is used to treat anemia.
  • It is used to help lower the need for blood transfusions for certain surgeries.
  • It may be given to your child for other reasons. Talk with the doctor.

What do I need to tell the doctor BEFORE my child takes this drug?

All products:

  • If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.
  • If your child has high blood pressure.
  • If your child has active bleeding.
  • If your child has low vitamin or mineral levels.
  • If your child has a kind of anemia called Pure Red Cell Aplasia (PRCA).

Multi-dose container:

  • If your child is a premature baby or is a newborn. Do not give this drug to a premature baby or a newborn.
  • If your child is pregnant or may be pregnant. Do not give this form of this drug to your child during pregnancy.
  • If your child is breast-feeding a baby. Be sure your child does not breast-feed a baby while taking this drug and for at least 2 weeks after the last dose.

This is not a list of all drugs or health problems that interact with this drug.

Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe to give this drug with all of your child’s other drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.

What are some things I need to know or do while my child takes this drug?

All products:

  • Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
  • High blood pressure has happened with this drug. Have your child’s blood pressure checked as you have been told by the doctor.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • If your child has phenylketonuria (PKU), talk with your child’s doctor. Some products have phenylalanine.
  • Do not give your child more than what the doctor told you. This may raise the chance of severe side effects. Call the doctor right away if you give your child more of this drug than what the doctor told you.
  • This drug raises the amount of red blood cells in the blood. Sometimes, this type of drug has been abused and misused. Doing so can lead to severe health problems like stroke, heart attack, and blood clots. If you have questions, talk with the doctor.

Multi-dose container:

  • This drug has benzyl alcohol in it. If possible, avoid products with benzyl alcohol in newborns or infants. Serious side effects can happen in these children with some doses of benzyl alcohol, including if given with other drugs that have benzyl alcohol. If you have questions, talk with the doctor.

Single-dose container:

  • Talk with the doctor if your child is pregnant, becomes pregnant, or is breast-feeding a baby. You will need to talk about the benefits and risks to your child and the baby.

Epoetin alfa (Epogen, Procrit):

  • This drug is made from human plasma (part of the blood) and may have viruses that may cause disease. This drug is screened, tested, and treated to lower the chance that it carries an infection. Talk with the doctor.

What are some side effects that I need to call my child’s doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
  • Signs of high blood sugar like confusion, feeling sleepy, unusual thirst or hunger, passing urine more often, flushing, fast breathing, or breath that smells like fruit.
  • Signs of low potassium levels like muscle pain or weakness, muscle cramps, or a heartbeat that does not feel normal.
  • A fast heartbeat.
  • Shortness of breath, a big weight gain, or swelling in the arms or legs.
  • Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
  • Feeling confused.
  • Cool or pale arm or leg.
  • Trouble walking.
  • Dizziness or passing out.
  • Sweating a lot.
  • Seizures.
  • Feeling very tired or weak.
  • Pale skin.
  • Depression.
  • Call the doctor right away if your child has signs of a blood clot like chest pain or pressure; coughing up blood; shortness of breath; swelling, warmth, numbness, change of color, or pain in a leg or arm; or trouble speaking or swallowing.
  • A severe skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause severe health problems that may not go away, and sometimes death. Get medical help right away if your child has signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in the mouth, throat, nose, or eyes.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:

  • Irritation where the shot is given.
  • Upset stomach or throwing up.
  • Fever or chills.
  • Headache.
  • Bone, joint, or muscle pain.
  • Cough.
  • Muscle spasm.
  • Mouth irritation or mouth sores.
  • Weight loss.
  • Trouble sleeping.
  • Signs of a common cold.

These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.

You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.

  • It is given as a shot into the fatty part of the skin.
  • It may be given into a vein by a doctor or other health care provider.
  • Keep giving this drug to your child as you have been told by your child’s doctor or other health care provider, even if your child feels well.
  • If you will be giving your child the shot, your child’s doctor or nurse will teach you how to give the shot.
  • Do not shake.
  • Do not use if it has been shaken.
  • Wash hands before and after use.
  • Do not use if the solution is cloudy, leaking, or has particles.
  • Do not use if solution changes color.
  • Do not give into skin that is irritated, tender, bruised, red, scaly, hard, scarred, or has stretch marks.
  • Throw away needles in a needle/sharp disposal box. Do not reuse needles or other items. When the box is full, follow all local rules for getting rid of it. Talk with a doctor or pharmacist if you have any questions.

What do I do if my child misses a dose?

  • Call your child’s doctor to find out what to do.

How do I store and/or throw out this drug?

All products:

  • Store in a refrigerator. Do not freeze.
  • Do not use if it has been frozen.
  • Protect from light.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Single-use vial:

  • Throw away any part not used after use.

Multi-dose container:

  • Throw away any part not used 3 weeks after first use.

Prefilled syringes:

  • If you cannot store in a refrigerator, you may store at room temperature for up to 7 days.
  • Throw away any part not used after use.

General drug facts

  • If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2024-05-24

Copyright

© 2024 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

Last Updated

Monday, December 12, 2022