epoetin alfa

Posted on April 28th, 2009 by

Class: Supportive care

Generic Name: Epoetin alfa (ee-POE-eh-tin AL-feh)
Trade Name: Procrit®

For which conditions is this drug approved? Epoetin alfa is FDA approved for the treatment of anemia in patients with non-hematologic cancers that are being treated with chemotherapy. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.

What is the mechanism of action? Epoetin alfa belongs to a class of agents called biologic response modifiers. Epoetin alfa alleviates anemia that can be caused by chemotherapy by increasing low levels of red blood cells to normal levels. Red blood cells transport necessary oxygen to tissues throughout the body and carry some waste products from cells. Epoetin alfa works by stimulating cells in the bone marrow to produce functioning red blood cells, ultimately providing sustained normal levels of red blood cells in the body.

How is epoetin alfa typically given (administered)? Epoetin alfa is administered as an injection under the skin (subcutaneous).

How are patients typically monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with epoetin alfa.  Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.  Two important blood levels will be checked, hemoglobin and hematocrit. Hemoglobin is an iron-containing molecule inside every red blood cell that is responsible for the delivery of oxygen to tissues that have low levels of oxygen. Hematocrit is the proportion of red blood cells that are in blood. Physicians will continue to schedule blood draws throughout treatment with epoetin alfa, as patient needs may change in response to chemotherapy or specific conditions. Iron levels may be assessed. Blood pressure will also be taken frequently. Patients will also be monitored for blood clots, including redness, pain or swelling of one extremity and not the other, sudden difficulty or pain in breathing, severe headache or blurry vision.

What are the common side effects of treatment with epoetin alfa?

• Diarrhea
• Swelling of the feet or hands (edema)
• Fever
• Shortness of breath
• Headache
• Fatigue
• Upper respiratory infection
• Nausea
• Local pain at injection site
• Change in blood pressure

What can patients do to help alleviate or prevent discomfort and side effects?

• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.

When should patients notify their physician?

• Difficulty or pain in breathing
• Acute back pain
• Chest pain
• Noticeable changes in heart rate or rhythm
• Redness, swelling or pain in one extremity and not the other
• Vision changes
• Extreme headache
• Swelling of the hands or feet
• Weight gain
• Rash
• Increased blood pressure
• Muscle tremors or seizures

What is a package insert?

A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.  A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

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Important Limitations of Use

The information provided above on the drug you have selected is provided for your information only and is not a substitute for consultation with an appropriate medical doctor. We are providing this information solely as a courtesy and, as such, it is in no way a recommendation as to the safety, efficacy or appropriateness of any particular drug, regimen, dosing schedule for any particular cancer, condition or patient nor is it in any way to be considered medical advice. Patients should discuss the appropriateness of a particular drug or chemotherapy regimen with their physician.

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Tags: E, Supportive

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