Epoetin

Sounds like ‘EE-po-EE-tin.

Epoetin is used to treat anaemia (low numbers of red blood cells). Find out how to take it safely and the possible side effects. Epoetin is also called EPO, Binocrit® or NeoRecormon®.

What is epoetin?

The medication epoetin is a man-made version of human erythropoietin. Erythropoietin is produced naturally in the body, mostly by the kidneys. Erythropoietin travels from your kidneys to your bone marrow and tells it to make red blood cells. Red blood cells are responsible for carrying oxygen around the body.

What is epoetin used to treat?

Some people cannot make enough erythropoietin, and this can cause too few red blood cells (anaemia). Anaemia is common in people with kidney failure or those having chemotherapy for cancer treatment. Epoetin is used to treat anaemia (low red blood cells) caused by severe kidney disease or chemotherapy treatments. It acts like the natural substance in your body to stimulate red blood cell production.

Note: Epoetin is not suitable for the treatment of anaemia from other causes such as iron or folate deficiency or stomach bleeding.

In New Zealand, 2 different brands of epoetin are available: 

  • Binocrit® – this is epoetin alfa.
  • NeoRecormon® – this is epoetin beta.

These brands are slightly different from each other and they are not interchangeable. Therefore, it is important that you stay on the same brand. If your injection looks different from usual, check with your pharmacist.

Dose of epoetin

The dose of the epoetin injection is different for different people, and it depends on what it’s being used for. How long you require epoetin injection depends on how well the treatment is working for you.

Your doctor will measure your haemoglobin level, and this will show how many red blood cells you have. This will then help your doctor work out the best dose of epoetin for you. Your doctor may adjust the dose of epoetin, depending on your haemoglobin levels. The dose is usually given 1 to 3 times a week.

You may not notice the effects of epoetin straight away. It may take 2 weeks or up to 3 months to feel better. You should continue to use epoetin unless you are advised by your doctor to stop. Speak to your doctor or nurse before stopping.

How is epoetin administered?

Epoetin is usually given as an injection just under your skin (this is called a subcutaneous injection). Some people can give themselves the injection. Otherwise it can be given by another person, eg, a family/whānau member or friend after proper training, or by your doctor or nurse. If you are unsure about how to inject epoetin, ask your doctor, nurse, or pharmacist to show you.

Note: If you are undergoing haemodialysis, epoetin may be given after your dialysis sessions.

Preparation

Epoetin is usually stored in the fridge. To ease discomfort during injection, it is best to bring the temperature of the syringe up to room temperature before administration. You can take the injection out of the fridge 15 to 30 minutes before you use it, or gently warm it in the palms of your hands for about 1 minute. Do not warm epoetin in any other way, eg, don't warm it in the microwave or in hot water.

Injection site

Choose an injection site, such as on the front of your thighs or your abdomen (belly) at least 5 cm from your belly button. The injection site should be different from your last injection site to prevent any bruising or thickening of the skin. Do not inject into a red or swollen area. Avoid putting the needle in too deep, as this will inject it into the muscle and it only needs to go under the skin.

Missed doses

If you miss a dose, inject it as soon as you remember and then continue to take it as you would normally. If it is almost time for your next dose when you remember, skip the dose you missed and administer your next dose when you are meant to.

Iron supplements

For the epoetin injection to work well, you will need an adequate amount of iron in your body. Maintain a well balanced diet including foods containing iron, such as meats, green vegetables, cereals and eggs. But, if you have been given dietary restrictions, please follow the advice of your dietician. Some people may need to take iron supplements while receiving epoetin injections. Read more about iron and iron supplements.

Syringe disposal

Avoid recapping the syringe to prevent needle stick injuries. Dispose of syringes in a sharps bin, You can speak to your doctor, nurse or pharmacist about sharp bins. 

What are the side effects of epoetin?

Like all medicines, epoetin can cause side effects, although not everyone gets them.

High blood pressure

Epoetin may cause high blood pressure (hypertension). Tell your doctor or nurse if you have ever had any problems with your blood pressure. You should also tell them if you take any medication for high blood pressure. Your nurse will check your blood pressure regularly during your treatment and you may be asked to monitor your blood pressure at home if you can.

Contact your doctor straight away if you:

  • have a severe headache
  • feel drowsy or confused
  • have problems with your eyesight
  • have fits (seizures)
  • start being sick (vomiting).

These are signs that your blood pressure may be very high.

Other side effects

Side effects What should I do?
  • Reaction at the injection site such as bruising, redness, tenderness.
  • Change the site for each subcutaneous injection (see tips above).
  • Tell your doctor if this does not settle.
  • Nausea
  • Indigestion
  • Tummy upset
  • Mild headache
  • Tiredness
  • Let your doctor know if these bother you.
  • Pain, redness or swelling in a leg or arm
  • Breathlessness
  • Chest pain
  • Tell your doctor immediately or ring Healthline 0800 611 116.
  • Signs of allergic reaction such as muscle or joint pain, fever, rash, intense itching, swelling of the face or hands, sore throat, headache, or difficulty swallowing.
  • Tell your doctor immediately or ring Healthline 0800 611 116. 
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.

Interactions with other medicines

Epoetin should not be taken with some other medicines and herbal supplements. Tell your doctor or pharmacist about all medicines you are taking including over-the-counter medicines, herbal and complementary medicines or recreational drugs. Your doctor or pharmacist will be able to check for any interactions.

Learn more about epoetin

The following links have more information on epoetin.

  • Binocrit  Medsafe Consumer Information Sheet
  • NeoRecormon  Medsafe Consumer Information Sheet

References

Credits: Health Navigator Pharmacists. Reviewed By: Maya Patel, MPharm PGDipClinPharm, Auckland Last reviewed: 18 Nov 2021