Eprex

How does it work?

This medicine contains the active ingredient epoetinum alfa (also known as epoetin alfa), which is a synthetic version of the naturally-occurring hormone erythropoietin. Erythropoietin is produced by healthy kidneys. It stimulates the bone marrow to produce red blood cells, which carry oxygen around the body. Epoetinum alfa is used to treat anaemia, in people with chronic kidney failure who are undergoing dialysis, and in people with impaired kidney function who do not yet need dialysis. These people produce very little erythropoietin as a result of their kidney disease, so the number of red blood cells in their blood is low (anaemia). When epoetinum alfa is injected, it stimulates the bone marrow to produce more red blood cells, and this corrects the anaemia. Epoetinum alfa is also used for treating anaemia in adults who are receiving chemotherapy to treat solid tumours, malignant lymphoma or bone cancer (multiple myeloma). The increased red blood cell production stimulated by epoetinum alfa reduces the chances of these people needing a blood transfusion. Doctors may also prescribe epoetinum alfa for mildly anaemic people who are going to donate blood prior to surgery so that their own blood can be given to them during or after surgery. Because the epoetinum increases blood cell production, it means that a larger volume of blood can be taken from these people, and stored for transfusion during or after the surgery. In addition, epoetinum alfa can be used to stimulate blood cell production in people who are due to have major bone (orthopaedic) surgery, and who have a potentially high risk from blood transfusion complications. In this case the epoetinum is used as an alternative to having a blood transfusion. Your doctor may also prescribe you iron supplements while you are receiving this medicine.

What is it used for?

Alternative to blood transfusion for people due to undergo major bone (orthopaedic) surgery where there is a potentially high risk from blood transfusion complications

Anaemia due to kidney disease

Increasing the volume of blood that can be donated by anaemic patients due to have surgery, so they can receive transfusions of their own blood during or after the surgery

Treating anaemia and reducing the need for blood transfusions in people receiving chemotherapy for solid tumours, malignant lymphoma or bone cancer (multiple myeloma)

Warning!

Your blood pressure should be monitored throughout treatment with this medicine. If your doctor feels it necessary, you may be given additional medicines to lower your blood pressure. If your blood pressure cannot be controlled, treatment with this medicine should be discontinued.

The number of platelets in your blood should be regularly monitored during the first eight weeks of treatment with this medicine.

People with kidney failure should have the levels of salts (electrolytes, eg potassium) and haemoglobin in their blood monitored during treatment with this medicine.

People with cancer should have the amount of haemoglobin in their blood monitored while receiving treatment with this medicine.

If you are receiving dialysis treatment, your dialysis regimen may need adjusting while receiving this medicine. Your doctor will decide this.

All other causes of anaemia, eg iron, vitamin B12 or folate deficiency, should be considered by your doctor and treated if necessary, before you start treatment with this medicine.

People receiving this medicine prior to bone surgery should also receive medication to prevent blood clots, since there is a risk of this occuring following surgery, particularly in people with cardiovascular disease.

All people who receive epoetinum alfa to stimulate blood cell production prior to bone surgery, or prior to donating blood for retransfusion during surgery, should also receive iron supplements. These should ideally be started before the epoetinum treatment, so that the body has adequate iron stores for producing new red blood cells.

Very rarely, this medicine may stop working in people with chronic kidney failure due to the body producing antibodies against the medicine. This causes the production of red blood cells to stop, a condition known as pure red cell aplasia. For this reason, people with kidney failure must only receive this medicine by injection into a vein (intravenously). In the very rare case that pure red cell aplasia develops, this medicine should be stopped and patients should not be switched to any other erythropoietin.

Tell your doctor if you experience sudden stabbing migraine-like headaches while receiving this medicine, as this may be a possible warning sign that your blood pressure is too high.

Use with caution in

Chronic liver failure

Epilepsy

Heart disease caused by inadequate blood flow to the heart

High levels of potassium in the blood (hyperkalaemia)

High platelet count

Malignant or cancerous disease

Predisposition to the formation of blood clots (thrombosis)

Untreated or poorly controlled high blood pressure

Not to be used in

Disease of the arteries in the extremities (applicable to people due to have major bone surgery only)

Disease of the blood vessels in and around the brain (applicable to people due to have major bone surgery only)

People who have recently had a heart attack

People who have recently had a stroke

People who should not receive blood-thinning medicines to prevent blood clots

Severe heart disease

Uncontrolled high blood pressure

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any possible risk to the foetus. Seek medical advice from your doctor.

There is no information available regarding the safety of this medicine during breastfeeding. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Skin rashes

Cold or flu-like symptoms

Dangerously high blood pressure (hypertensive crisis)

Rise in blood pressure

Blood clots in the blood vessels (thrombosis)

Increased numbers of platelets in the blood (thrombocytosis)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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