Epoetin Alfa-Epbx (Injection Route)

Epoetin alfa-epbx injection causes the bone marrow to produce red blood cells. If the body does not produce enough red blood cells, severe anemia can occur. This often occurs in people with chronic kidney failure whose kidneys are not working properly. Epoetin alfa-epbx may be used for patients on kidney dialysis or for those not on dialysis. Anemia can also occur in people who are receiving chemotherapy to treat cancer or in patients with HIV who are receiving zidovudine. Epoetin alfa-epbx is used to treat severe anemia in these patients.

Epoetin alfa-epbx injection is also used to lessen or avoid the need for blood transfusion in patients scheduled for any type of surgery where a lot of blood loss is expected.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

• Solution

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Bleeding or
• Infection or inflammation or
• Iron or vitamin deficiency or
• Metabolic or chronic inflammatory conditions—May cause a delay in response to treatment. These conditions must be corrected first before using this medicine.

• Cancer—May cause some tumors to progress or come back.

• Heart bypass surgery or
• Heart or blood vessel disease or
• Stroke, history of—The chance of side effects may be increased.

• Hypertension (high blood pressure), uncontrolled or
• Pure red cell aplasia (rare bone marrow disease)—Should not be used in patients with these conditions.

• Patients receiving dialysis—May require an increase in the dose of blood thinner (eg, heparin) to prevent the blood from clotting too much.

• Phenylketonuria—Use with caution. This medicine contains phenylalanine which may cause serious unwanted effects in patients with this condition.

• Seizures, history of—Use with caution. May make this condition worse.

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For injection dosage form (solution):
  • For anemia from chemotherapy:
    • Adults—Dose is based on body weight and must be determined by your doctor. The starting dose is 150 units per kilogram (kg) injected under the skin 3 times a week or 40,000 units injected under the skin once a week. Your doctor may adjust the dose as needed.
    • Children 5 years of age and older—Dose is based on body weight and must be determined by your doctor. The starting dose is 600 units per kg injected into a vein once a week. Your doctor may adjust the dose as needed.
    • Children younger than 5 years of age—Use and dose must be determined by your doctor.
  • For anemia from chronic kidney failure on dialysis:
    • Adults—Dose is based on body weight and must be determined by your doctor. The starting dose is 50 to 100 units per kilogram (kg) injected into a vein or under the skin 3 times a week. Your doctor may adjust the dose as needed.
    • Children 1 month to 16 years of age—Dose is based on body weight and must be determined by your doctor. The starting dose is 50 units per kg injected into a vein or under the skin 3 times a week. Your doctor may adjust the dose as needed.
    • Children younger than 1 month of age—Use and dose must be determined by your doctor.
  • For anemia from chronic kidney failure not on dialysis:
    • Adults—Dose is based on body weight and must be determined by your doctor. The starting dose is 50 to 100 units per kilogram (kg) injected into a vein or under the skin 3 times a week. Your doctor may adjust the dose as needed.
    • Children—Use and dose must be determined by your doctor.
  • For anemia from HIV treatment:
    • Adults—Dose is based on body weight and must be determined by your doctor. The starting dose is 100 units per kilogram (kg) injected into a vein or under the skin 3 times a week for 8 weeks. Your doctor may adjust the dose as needed.
    • Children—Use and dose must be determined by your doctor.
  • For anemia from surgery:
    • Adults—Dose is based on body weight and must be determined by your doctor. The starting dose is 300 units per kilogram (kg) injected under the skin for 10 days before the surgery, on the day of the surgery, and for 4 days after surgery.
    • Children—Use and dose must be determined by your doctor.