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Drug overview for PROCRIT (epoetin alfa):
Generic name: EPOETIN ALFA (e-POE-tin AL-fa)
Drug class: Erythropoiesis-Stimulating Agents
Therapeutic class: Hematological Agents
Epoetin alfa, a biosynthetic form of the glycoprotein hormone erythropoietin, is a hematopoietic agent that principally affects erythropoiesis. Epoetin alfa-epbx is biosimilar to epoetin alfa (Epogen(R); Procrit(R)). The FDA defines a biosimilar as a biological that is highly similar to an FDA-licensed reference biological with the exception of minor differences in clinically inactive components and for which there are no clinically meaningful differences in safety, purity, or potency.
The claim of biosimilarity is based on a totality-of-evidence approach, which includes consideration of data from analytical, animal, and clinical studies. Therefore, biosimilarity of 2 drugs may be established even when there are formulation or minor structural differences or minor differences in rates of adverse effects between the drugs as long as these differences are not clinically meaningful. Biosimilars are approved through an abbreviated licensure pathway that establishes biosimilarity between the proposed biological and the reference biological but does not independently establish safety and effectiveness of the proposed biological.
In order to be considered an interchangeable biosimilar, a biological product must meet additional requirements beyond demonstrating biosimilarity to its reference product; these requirements include demonstrating that the biological product can be expected to produce the same clinical results as the reference product in any given patient and, for a biological product that is administered more than once to an individual, the risk in terms of safety or diminished efficacy of alternating or switching between use of the biological product and the reference product is no greater than the risk of using the reference product without such alternation or switch. Biosimilar products that are interchangeable can be substituted for the reference product without the intervention of the healthcare provider who prescribed the reference product. The currently available epoetin alfa biosimilar does not have interchangeable data at this time. In this monograph, unless otherwise stated, the term ''epoetin alfa products'' refers to epoetin alfa (the reference drug), epoetin alfa-epbx (the biosimilar), or both drugs.
Epoetin alfa and epoetin alfa-epbx have not been shown to improve quality of life, fatigue, or patient well-being.
Generic name: EPOETIN ALFA (e-POE-tin AL-fa)
Drug class: Erythropoiesis-Stimulating Agents
Therapeutic class: Hematological Agents
Epoetin alfa, a biosynthetic form of the glycoprotein hormone erythropoietin, is a hematopoietic agent that principally affects erythropoiesis. Epoetin alfa-epbx is biosimilar to epoetin alfa (Epogen(R); Procrit(R)). The FDA defines a biosimilar as a biological that is highly similar to an FDA-licensed reference biological with the exception of minor differences in clinically inactive components and for which there are no clinically meaningful differences in safety, purity, or potency.
The claim of biosimilarity is based on a totality-of-evidence approach, which includes consideration of data from analytical, animal, and clinical studies. Therefore, biosimilarity of 2 drugs may be established even when there are formulation or minor structural differences or minor differences in rates of adverse effects between the drugs as long as these differences are not clinically meaningful. Biosimilars are approved through an abbreviated licensure pathway that establishes biosimilarity between the proposed biological and the reference biological but does not independently establish safety and effectiveness of the proposed biological.
In order to be considered an interchangeable biosimilar, a biological product must meet additional requirements beyond demonstrating biosimilarity to its reference product; these requirements include demonstrating that the biological product can be expected to produce the same clinical results as the reference product in any given patient and, for a biological product that is administered more than once to an individual, the risk in terms of safety or diminished efficacy of alternating or switching between use of the biological product and the reference product is no greater than the risk of using the reference product without such alternation or switch. Biosimilar products that are interchangeable can be substituted for the reference product without the intervention of the healthcare provider who prescribed the reference product. The currently available epoetin alfa biosimilar does not have interchangeable data at this time. In this monograph, unless otherwise stated, the term ''epoetin alfa products'' refers to epoetin alfa (the reference drug), epoetin alfa-epbx (the biosimilar), or both drugs.
Epoetin alfa and epoetin alfa-epbx have not been shown to improve quality of life, fatigue, or patient well-being.
DRUG IMAGES
PROCRIT 10,000 UNITS/ML VIAL
PROCRIT 3,000 UNITS/ML VIAL
PROCRIT 2,000 UNITS/ML VIAL
PROCRIT 4,000 UNITS/ML VIAL
PROCRIT 40,000 UNITS/ML VIAL
PROCRIT 20,000 UNITS/ML VIAL
The following indications for PROCRIT (epoetin alfa) have been approved by the FDA:
Indications:
Anemia due to chemotherapy and radiotherapy combination
Anemia in chronic kidney disease
Chemotherapy-induced anemia
Reduction of allogeneic blood transfusion in surgery
Zidovudine-induced anemia
Professional Synonyms:
Anemia co-occurrent and due to chronic kidney disease
Anemia due to chronic kidney disease
Anemia due to CKD
Anemia in CKD
AZT-induced anemia
Indications:
Anemia due to chemotherapy and radiotherapy combination
Anemia in chronic kidney disease
Chemotherapy-induced anemia
Reduction of allogeneic blood transfusion in surgery
Zidovudine-induced anemia
Professional Synonyms:
Anemia co-occurrent and due to chronic kidney disease
Anemia due to chronic kidney disease
Anemia due to CKD
Anemia in CKD
AZT-induced anemia
The following dosing information is available for PROCRIT (epoetin alfa):
No enhanced Dosing information available for this drug.
Administer epoetin alfa products by IV or subcutaneous injection. In patients undergoing hemodialysis, the manufacturers recommend that epoetin alfa products be given IV rather than subcutaneously because of reports of pure red cell aplasia (PRCA) associated with the latter route of administration. Do not shake or freeze vials of epoetin alfa product, and discard if subjected to these conditions.
Inspect visually the contents of vials of epoetin alfa product for discoloration and/or particulate matter prior to administration whenever solution and container permit; if either is present, discard the solution. For IV or subcutaneous use, withdraw the appropriate dose of the epoetin alfa product from the vial into the syringe for administration; once the dose has been withdrawn from the vial, administer promptly. Do not mix epoetin alfa products with other drug solutions in general.
However, the manufacturers of Epogen(R) and Procrit(R) state that the preservative-free formulation from single-use vials may be admixed in equal parts (in a 1:1 ratio) in a syringe with bacteriostatic 0.9% sodium chloride injection (preserved with benzyl alcohol) at the time of administration. Discard unused portions of epoetin alfa product from single-dose preservative-free vials.
Any unused portion of epoetin alfa product from multi-dose vials can be stored, protected from light, between 2-8degreesC for 21 days after initial entry. Because of the risks associated with benzyl alcohol, do not use epoetin alfa product that has been admixed with injection solutions containing benzyl alcohol in neonates, infants, and pregnant and nursing women.
Inspect visually the contents of vials of epoetin alfa product for discoloration and/or particulate matter prior to administration whenever solution and container permit; if either is present, discard the solution. For IV or subcutaneous use, withdraw the appropriate dose of the epoetin alfa product from the vial into the syringe for administration; once the dose has been withdrawn from the vial, administer promptly. Do not mix epoetin alfa products with other drug solutions in general.
However, the manufacturers of Epogen(R) and Procrit(R) state that the preservative-free formulation from single-use vials may be admixed in equal parts (in a 1:1 ratio) in a syringe with bacteriostatic 0.9% sodium chloride injection (preserved with benzyl alcohol) at the time of administration. Discard unused portions of epoetin alfa product from single-dose preservative-free vials.
Any unused portion of epoetin alfa product from multi-dose vials can be stored, protected from light, between 2-8degreesC for 21 days after initial entry. Because of the risks associated with benzyl alcohol, do not use epoetin alfa product that has been admixed with injection solutions containing benzyl alcohol in neonates, infants, and pregnant and nursing women.
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| PROCRIT 2,000 UNITS/ML VIAL | Maintenance | Adults inject 100 unit/kg by subcutaneous route 3 times per week |
| PROCRIT 3,000 UNITS/ML VIAL | Maintenance | Adults inject 100 unit/kg by subcutaneous route 3 times per week |
| PROCRIT 10,000 UNITS/ML VIAL | Maintenance | Adults inject 100 unit/kg by subcutaneous route 3 times per week |
| PROCRIT 20,000 UNITS/ML VIAL | Maintenance | Adults inject 100 unit/kg by subcutaneous route 3 times per week |
| PROCRIT 40,000 UNITS/ML VIAL | Maintenance | Adults inject 100 unit/kg by subcutaneous route 3 times per week |
No generic dosing information available.
The following drug interaction information is available for PROCRIT (epoetin alfa):
There are 0 contraindications.
There are 2 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Erythropoietic agents/Lenalidomide SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: The mechanism of this interaction is unknown. CLINICAL EFFECTS: Concurrent use of erythropoietic agents, such as darbepoetin or epoetin, with lenalidomide may increase the risk of thrombosis.(1,2) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of lenalidomide states the risk of venous thromboembolism (VTE) may be increased when patients are taking concomitant therapy with erythropoietin stimulating agents. Use caution with concomitant use after a patient specific risk-benefit assessment has been completed. Observe patients for signs and symptoms of VTE and instruct patients to seek medical care if they develop symptoms such as shortness of breath, chest pain, or arm or leg swelling.(1) The National Comprehensive Cancer Network (NCCN) Guidelines include use of erythropoietic stimulating agents as a high risk factor for venous thromboembolism (VTE). Other risk factors include: active cancer, advanced stage cancer, certain cancer types, regional bulky lymphadenopathy, familial and/or acquired hypercoagulability, medical comorbidities, poor performance status, older age, major surgery, central venous catheter, chemotherapy including lenalidomide plus high-dose dexamethasone, hormone replacement therapy, contraceptives, tamoxifen/raloxifene, diethylstilbestrol, smoking, obesity, or activity level/exercise.(3) The NCCN Guidelines utilize a Risk Assessment Model to determine chemoprophylaxis. In patients with 0-1 risk factors, consider VTE chemoprophylaxis with aspirin 81-325 mg once daily. In patients with >/= 2 risk factors, consider VTE chemoprophylaxis with low-molecular weight heparin (LMWH) with a dose equivalent to enoxaparin 40 mg once daily or full-dose warfarin with a dose to maintain a target international normalized ratio (INR) 2-3.(3) DISCUSSION: The National Comprehensive Cancer Network (NCCN) Guidelines include use of erythropoietin as an individual risk factor for venous thromboembolism (VTE). Patients should be assessed for total risk based on NCCN guidelines and recommended for the appropriate VTE chemoprophylaxis agent based on risk category.(3) A pooled analysis of two placebo-controlled trials in multiple myeloma noted an incidence rate for VTE of 23% in patients receiving lenalidomide, dexamethasone and erythropoietic therapy versus 5% in patients without erythropoietic therapy. A multivariate analysis indicated an independent correlation between thrombosis and patients with concomitant erythropoietin therapy.(4) A pooled analysis of 125 patients from 3 trials with multiple myeloma on lenalidomide therapy noted a 17% incidence of VTE in patients on lenalidomide with concurrent erythropoietin therapy.(5) Several studies have evaluated the optimal VTE prophylaxis agent with lenalidomide-treated patients. Patients receiving lenalidomide/dexamethasone and no chemoprophylaxis had a VTE incidence of 11-75%, 26% with the use of aspirin, 17% with the use of aspirin/LMWH/warfarin combination therapy, and 2-15% with the use of LMWH. (6) |
LENALIDOMIDE, REVLIMID |
| Lovotibeglogene Autotemcel/Erythropoietic agents SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Erythropoietic agents may interfere with hematopoietic stem cell (HSC) mobilization of CD34+ cells.(1) CLINICAL EFFECTS: Use of erythropoietic agents before mobilization may result in unsuccessful stem cell mobilization.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Discontinue erythropoietic agents at least 2 months prior to mobilization.(1) DISCUSSION: Erythropoietic agents may interfere with the manufacturing of lovotibeglogene autotemcel therapy. There are no data regarding use of erythropoietin between apheresis and conditioning or after lovotibeglogene autotemcel therapy.(1) |
LYFGENIA |
There are 1 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| Vadadustat/Erythropoietin Stimulating Agents SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Vadadustat and erythropoietin stimulating agents (ESAs) both stimulate endogenous erythropoietin production, resulting in increased red blood cell production.(1-2) CLINICAL EFFECTS: Concurrent use of vadadustat and erythropoietin stimulating agents may increase the risk of thrombosis. PREDISPOSING FACTORS: Predisposing factors include a history of thromboembolic disorder, thrombophilia, malignancy, hyperlipidemia, hypertension, heart failure, diabetes mellitus, chronic kidney disease, COPD, obesity, tobacco smoking, major surgery with prolonged post-operative immobilization, and being bed-ridden. PATIENT MANAGEMENT: ESAs should be stopped before initiating vadadustat.(1) For patients receiving temporary ESA rescue treatment, vadadustat should be held until hemoglobin levels are greater than or equal to 10 g/dL. The pause in vadadustat treatment should be extended to: - 2 days after last dose of epoetin - 7 days after last dose of darbepoetin alfa - 14 days after last dose of methoxy polyethylene glycol-epoetin beta Vadadustat should be resumed at the prior dose or one dose higher, with subsequent titration according to the dose titration guidelines in the vadadustat package insert.(1-2) Monitor hemoglobin levels every two weeks until stable, then monitor at least monthly.(1-2) Observe patients for signs and symptoms of venous thromboembolism and instruct patients to seek medical care if they develop symptoms such as shortness of breath, chest pain, or arm or leg swelling. DISCUSSION: Vadadustat increases endogenous erythropoietin by decreasing degradation of hypoxia-inducible factor (HIF), which increases transcription of the HIF-responsive genes including EPO. Thromboembolic events were reported as very common (13.7%) in two active-controlled clinical trials in chronic kidney disease.(1-2) Controlled clinical trials of patients showed that ESAs increased the risk of death, myocardial infarction, stroke, congestive heart failure, and other thromboembolic events with a higher target hemoglobin.(3) |
VAFSEO |
The following contraindication information is available for PROCRIT (epoetin alfa):
Drug contraindication overview.
*Uncontrolled hypertension. *Pure red cell aplasia (PRCA) following treatment with epoetin alfa products or other erythropoietin proteins. *History of a serious allergic reaction to epoetin alfa products. *Use of epoetin alfa products from multi-dose vials containing benzyl alcohol in women who are pregnant or breastfeeding, neonates, and infants.
*Uncontrolled hypertension. *Pure red cell aplasia (PRCA) following treatment with epoetin alfa products or other erythropoietin proteins. *History of a serious allergic reaction to epoetin alfa products. *Use of epoetin alfa products from multi-dose vials containing benzyl alcohol in women who are pregnant or breastfeeding, neonates, and infants.
There are 2 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Pure red cell aplasia |
| Severe uncontrolled hypertension |
There are 9 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Acute decompensated heart failure |
| Acute myocardial infarction |
| Cerebrovascular accident |
| Coronary artery disease |
| Deep venous thrombosis |
| Hypertension |
| Pulmonary thromboembolism |
| Thromboembolic disorder |
| Vascular access thrombosis |
There are 6 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Folate deficiency |
| Iron deficiency anemia |
| Lower seizure threshold |
| Porphyria |
| Seizure disorder |
| Vitamin b12 deficiency |
The following adverse reaction information is available for PROCRIT (epoetin alfa):
Adverse reaction overview.
Patients with CKD (>=5%): hypertension, arthralgia, muscle spasm, pyrexia, dizziness, medical device malfunction, vascular occlusion, and upper respiratory tract infection. Patients with HIV infection treated with zidovudine (>=5%): pyrexia, cough, rash, and injection site irritation. Patients with cancer receiving chemotherapy (>=5%): nausea, vomiting, myalgia, arthralgia, stomatitis, cough, weight decrease, leukopenia, bone pain, rash, hyperglycemia, insomnia, headache, depression, dysphagia, hypokalemia, and thrombosis. Surgical patients (>=5%): nausea, vomiting, pruritus, headache, injection site pain, chills, deep vein thrombosis, cough, and hypertension.
Patients with CKD (>=5%): hypertension, arthralgia, muscle spasm, pyrexia, dizziness, medical device malfunction, vascular occlusion, and upper respiratory tract infection. Patients with HIV infection treated with zidovudine (>=5%): pyrexia, cough, rash, and injection site irritation. Patients with cancer receiving chemotherapy (>=5%): nausea, vomiting, myalgia, arthralgia, stomatitis, cough, weight decrease, leukopenia, bone pain, rash, hyperglycemia, insomnia, headache, depression, dysphagia, hypokalemia, and thrombosis. Surgical patients (>=5%): nausea, vomiting, pruritus, headache, injection site pain, chills, deep vein thrombosis, cough, and hypertension.
There are 25 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Edema Hypertension Tachycardia Vascular access thrombosis |
Acute myocardial infarction Cerebrovascular accident Headache disorder Hypokalemia Pulmonary thromboembolism Seizure disorder Thrombotic disorder Transient cerebral ischemia |
| Rare/Very Rare |
|---|
|
Anaphylaxis Angioedema Chest pain Chronic heart failure Deep venous thrombosis Erythema multiforme Porphyria Pure red cell aplasia Shortened time to tumor progression Stevens-johnson syndrome Thromboembolic disorder Toxic epidermal necrolysis Urticaria |
There are 25 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Anorexia Arthralgia Cough Diarrhea Fatigue Fever General weakness Injection site sequelae Insomnia Leukopenia Muscle spasm Nausea Vomiting |
Bone pain Depression Dizziness Dysphagia Hyperglycemia Myalgia Stomatitis Upper respiratory infection |
| Rare/Very Rare |
|---|
|
Chills Flu-like symptoms Hyperhidrosis Skin rash |
The following precautions are available for PROCRIT (epoetin alfa):
The safety and efficacy of epoetin alfa products for the treatment of anemia associated with CKD, regardless of dialysis status, in pediatric patients younger than 1 month of age have not been established. In children at least 1 month of age with CKD, the pattern of most adverse events was similar to that found in adults. There does not appear to be a difference in safety profiles in pediatric patients with CKD requiring dialysis and not requiring dialysis.
The safety and efficacy of epoetin alfa products have not been established in pediatric patients who are younger than 5 years of age with cancer and receiving chemotherapy. In pediatric patients with cancer who are at least 5 years of age, the pattern of most adverse events was similar to that found in adults. The safety and efficacy of epoetin alfa products have not been established in pediatric patients who are younger than 8 months of age with HIV infection receiving zidovudine.
Because of a potential risk of neurologic and other toxicity in neonates and infants exposed to benzyl alcohol, epoetin alfa products from multidose vials (with benzyl alcohol preservative) or from single-dose vials admixed with bacteriostatic saline containing benzyl alcohol should not be used in these populations. When epoetin alfa products are needed for neonates or infants, use of a benzyl alcohol-free formulation is recommended.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
The safety and efficacy of epoetin alfa products have not been established in pediatric patients who are younger than 5 years of age with cancer and receiving chemotherapy. In pediatric patients with cancer who are at least 5 years of age, the pattern of most adverse events was similar to that found in adults. The safety and efficacy of epoetin alfa products have not been established in pediatric patients who are younger than 8 months of age with HIV infection receiving zidovudine.
Because of a potential risk of neurologic and other toxicity in neonates and infants exposed to benzyl alcohol, epoetin alfa products from multidose vials (with benzyl alcohol preservative) or from single-dose vials admixed with bacteriostatic saline containing benzyl alcohol should not be used in these populations. When epoetin alfa products are needed for neonates or infants, use of a benzyl alcohol-free formulation is recommended.
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
Although there are no adequate and controlled studies to date of epoetin alfa product use during pregnancy, the drug has been used in a limited number of pregnant women with anemia alone or anemia associated with severe renal disease and hematologic disorders. Adverse pregnancy outcomes, including prenatal complications (i.e., polyhydramnios, intrauterine growth restriction) have been reported. The manufacturers state that due to the limited number of exposed pregnancies and the presence of multiple confounding factors (e.g., concomitant medications or other maternal conditions), such data cannot be used to reliably estimate the frequency or absence of adverse pregnancy outcomes.
Epoetin alfa products should be used during pregnancy only when the potential benefits justify the possible risks to the fetus. Because of a potential risk of neurologic and other toxicity (e.g., gasping syndrome) in neonates exposed to benzyl alcohol, epoetin alfa product from multidose vials (with benzyl alcohol preservative) or from single-dose vials admixed with bacteriostatic saline containing benzyl alcohol should not be used in pregnant women. When therapy is needed during pregnancy or nursing, use of a benzyl alcohol-free formulation is recommended.
Epoetin alfa products should be used during pregnancy only when the potential benefits justify the possible risks to the fetus. Because of a potential risk of neurologic and other toxicity (e.g., gasping syndrome) in neonates exposed to benzyl alcohol, epoetin alfa product from multidose vials (with benzyl alcohol preservative) or from single-dose vials admixed with bacteriostatic saline containing benzyl alcohol should not be used in pregnant women. When therapy is needed during pregnancy or nursing, use of a benzyl alcohol-free formulation is recommended.
It is not known whether epoetin alfa is distributed into human milk. The effects of the drug on breast-fed infants or on the production of milk are unknown. Because of the potential for adverse reactions to epoetin alfa in breast-fed infants, caution is advised in women who breast-feed while receiving the drug.
Because of a potential risk of neurologic and other toxicity in neonates exposed to benzyl alcohol, epoetin alfa from multidose vials (with benzyl alcohol preservative) or from single-dose vials admixed with bacteriostatic saline containing benzyl alcohol should not be used in nursing women. The manufacturer advises women not to breastfeed for at least 2 weeks after the last dose of epoetin alfa product from a multidose vial. When therapy is needed for women who are nursing, use of a benzyl alcohol-free formulation is recommended.
Because of a potential risk of neurologic and other toxicity in neonates exposed to benzyl alcohol, epoetin alfa from multidose vials (with benzyl alcohol preservative) or from single-dose vials admixed with bacteriostatic saline containing benzyl alcohol should not be used in nursing women. The manufacturer advises women not to breastfeed for at least 2 weeks after the last dose of epoetin alfa product from a multidose vial. When therapy is needed for women who are nursing, use of a benzyl alcohol-free formulation is recommended.
While safety and efficacy of epoetin alfa products have not been established specifically in geriatric patients, a large proportion of patients treated with the drug for anemia associated with CKD have been 65 years of age or older. In geriatric patients with anemia associated with CKD, no overall differences in safety and efficacy have been observed relative to younger adults. In geriatric patients with anemia due to concomitant chemotherapy or in those undergoing elective surgery, no overall differences in safety and efficacy of epoetin alfa products have been observed relative to younger adults; dosing requirements generally were similar between geriatric patients and younger adults for each indication. Data are insufficient in patients 65 years of age and older who have HIV infection and are treated with zidovudine to determine whether they respond differently than younger adults to epoetin alfa products.
The following prioritized warning is available for PROCRIT (epoetin alfa):
WARNING: Discuss the risks and benefits of epoetin alfa with your doctor, as this medication may rarely cause very serious (possibly fatal) side effects, including blood clots, heart attack, stroke, or heart failure. It is very important to keep all lab appointments since your doctor will need to carefully check your red blood cell count and hemoglobin level. The lowest effective dose of this medication should be used.
When used to treat anemia related to cancer, this medication may also increase the risk of death and/or cause your tumor to grow faster. This medication should be stopped after completing a treatment course of chemotherapy as directed by your doctor.
WARNING: Discuss the risks and benefits of epoetin alfa with your doctor, as this medication may rarely cause very serious (possibly fatal) side effects, including blood clots, heart attack, stroke, or heart failure. It is very important to keep all lab appointments since your doctor will need to carefully check your red blood cell count and hemoglobin level. The lowest effective dose of this medication should be used.
When used to treat anemia related to cancer, this medication may also increase the risk of death and/or cause your tumor to grow faster. This medication should be stopped after completing a treatment course of chemotherapy as directed by your doctor.
The following icd codes are available for PROCRIT (epoetin alfa)'s list of indications:
| Anemia due to chemotherapy and radiotherapy combination | |
| D64.81 | Anemia due to antineoplastic chemotherapy |
| Z51.0 | Encounter for antineoplastic radiation therapy |
| Anemia in chronic kidney disease | |
| D63.1 | Anemia in chronic kidney disease |
| N18.4 | Chronic kidney disease, stage 4 (severe) |
| N18.5 | Chronic kidney disease, stage 5 |
| N18.6 | End stage renal disease |
| Z99.2 | Dependence on renal dialysis |
| Chemotherapy-induced anemia | |
| D64.81 | Anemia due to antineoplastic chemotherapy |
| Zidovudine-induced anemia | |
| D64.9 | Anemia, unspecified |
Formulary Reference Tool