Epoetin alfa 10,000units/1ml solution for injection pre-filled syringes
Requires a prescription from a doctor or prescriber
Erythropoietin (EPO) is a growth factor produced in the kidneys that stimulates the production of red blood cells.
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Data from the MHRA Yellow Card scheme. A reported reaction does not necessarily mean the medicine caused it. Contains public sector information licensed under the Open Government Licence v3.0.
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Suspected adverse reactions reported for Epoetin alfa
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3 branded products available
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Eprex 10,000units/1ml solution for injection pre-filled syringes
This is the NHS Drug Tariff indicative price used for reimbursement purposes. It may not reflect the price paid by patients or pharmacies.
View full Drug TariffSource: NHS Drug Tariff via NHSBSA. Derived from dm+d VMPP (Virtual Medicinal Product Pack) pricing data. Contains public sector information licensed under the Open Government Licence v3.0.
WHO defined daily dose (DDD)
1000 unit
Not a recommended dose. The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults. It is a statistical measure used for research and comparison purposes only.
Source: WHO Collaborating Centre for Drug Statistics Methodology, distributed via the NHS dm+d supplementary BNF/ATC mapping files (NHSBSA). Contains public sector information licensed under the Open Government Licence v3.0.
Therapeutically similar medicines
Similarity is based on WHO Anatomical Therapeutic Chemical (ATC) classification and on a factual NHS dm+d therapeutic-grouping code prefix. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
NHS prescribing volume and spending trends
Guidelines from the National Institute for Health and Care Excellence
NICE clinical guidance(1)
Source: National Institute for Health and Care Excellence (NICE). Contains public sector information licensed under the Open Government Licence v3.0.
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Codes for healthcare professionals and prescribing systems
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NHS UK identifiers
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SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. BNF code shown is the factual mapping value distributed by NHS Business Services Authority (NHSBSA) in the dm+d supplementary file under OGL v3.0; it is not affiliated with, nor licensed from, the publishers of the British National Formulary. ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).
Active and completed clinical studies from ClinicalTrials.gov
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Academic studies and reviews for this medicine's active substance
Showing the 50 most relevant studies.
Reviews & meta-analyses: 8 · Randomised trials: 22 · 1991–2026
Showing the 50 most relevant studies, sorted by most relevant.
Michael Jones, Lloyd S. Ibels, Brad Schenkel, et al.
Kidney International, 2004
- Epoetin Alfa
- Anemia
- Erythropoietin
Uwe Platzbecker, Matteo Giovanni Della Porta, Valeria Santini, et al.
The Lancet, 2023
- COVID-19
- Anemia
- Hematinics
Jayne S. Wilson, Guiqing Yao, James Raftery, et al.
Health Technology Assessment, 2007
- Cost-Benefit Analysis
- Darbepoetin alfa
- Epoetin Alfa
T. Littlewood, E. Bajetta, J. Nortier, et al.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2001
- Blood Transfusion
- Epoetin Alfa
- Activities of Daily Living
Hans Furuland
Nephrology Dialysis Transplantation, 2003
- Renal Dialysis
- Epoetin Alfa
- Anemia
Bertazza Partigiani N, D'Uva A, Vigezzi S, et al.
2025
- Anemia
- Epoetin Alfa
- Hematinics
BackgroundRecombinant human erythropoietin (rHuEPO) and darbepoetin alfa (DA) are key treatments for anemia in individuals with chronic kidney disease (CKD), including children, but evidence comparing their efficacy in the pediatric population remains inconclusive.MethodsThis systematic review, adhering to PRISMA guidelines, analyzed randomized controlled trials and observational studies comparing rHuEPO and DA in pediatric patients with CKD (≤ 18 years; ≥ 10 children per study), searched across medical databases and clinical trial registries until 31/12/2024. The Cochrane Risk of Bias was used for assessment. Meta-analysis evaluated hemoglobin (Hb) increase and cost-effectiveness using the incremental cost-effectiveness ratio.ResultsFrom 1298 screened articles, 7 studies were included: 3 prospective studies, 2 randomized open-label non-inferiority trials, and 2 retrospective cohort studies, comprising 208 children for direct comparisons and 357 for transitioning studies. Meta-analysis found no significant Hb improvement differences between rHuEPO and DA after 21-28 weeks of treatment (DA + 0.15 g/dL, 95% CI - 0.22 to + 0.52). rHuEPO was more cost-effective than DA. Transitioning to DA increased Hb by + 0.93 g/dL (95% CI 0.53-1.33) in children with suboptimal levels, after 21-28 weeks of rHuEPO. The incremental cost-effectiveness ratio of switching to DA was ~ €340 per g/dL of Hb over 24 weeks.ConclusionsrHuEPO is the most cost-effective initial anemia treatment in pediatric CKD. However, transitioning to DA may be considered for patients who do not achieve adequate Hb response. The small number of randomized controlled trials (RCTs), variability in dose conversion, and study heterogeneity may limit generalizability.Prospero idCRD42023460872.
Abstract licence: CC BY
Emilee R. Wilhelm-Leen, W. Winkelmayer
American journal of kidney diseases : the official journal of the National Kidney Foundation, 2015
- Darbepoetin alfa
- Epoetin Alfa
- Anemia
Matteo Giovanni Della Porta, Guillermo Garcia‐manero, V. Santini, et al.
The Lancet. Haematology, 2024
- Anemia
- Myelodysplastic Syndromes
- Epoetin Alfa
Robert Provenzano, Anatole Besarab, Steven Charles Wright, et al.
American Journal of Kidney Diseases, 2016
- Renal Dialysis
- Epoetin Alfa
- Anemia
A. Zeidan, R. Komrokji, R. Buckstein, et al.
Blood, 2023
Sources: aggregated from Europe PMC (EMBL-EBI), OpenAlex, Crossref, PubMed and other open scholarly databases. Retracted articles are excluded. Study information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
None known
Half-life
4 hours
Mechanism
Erythropoietin or exogenous epoetin alfa binds to the erythropoietin receptor (E…
Food interactions
1 warning
Human targets
1 target
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Absorption
20 to 25 hours
Half-life
4 hours
Protein binding
Volume of distribution
40–63.80 mL
Metabolism
Elimination
Clearance
1.00 mL
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
- treatment of anemia due to Chronic Kidney Disease (CKD) in patients on dialysis and not on dialysis.
- treatment of anemia due to zidovudine in patients with HIV-infection.
- treatment of anemia due to the effects of concomitant myelosuppressive chemotherapy, and upon initiation, there is a minimum of two additional months of planned chemotherapy.
- reduction of allogeneic RBC transfusions in patients undergoing elective, noncardiac, nonvascular surgery.
Known interactions with other medications. Always consult a healthcare professional.
Showing 50 of 625 interactions
Following resolution of the overdose, reintroduction of epoetin alfa therapy should be accompanied by close monitoring for evidence of rapid increases in hemoglobin concentration (>1 gm/dL per 14 days). In patients with an excessive hematopoietic response, reduce the dose in accordance with the recommendations described in the drug label [FDA Label].
Epoetin alfa serves to restore erythropoietin deficiency in pathological and other clinical conditions where normal production of erythropoietin is impaired or compromised. In anemic patients with chronic renal failure (CRF), administration with epoetin alfa stimulated erythropoiesis by increasing the reticulocyte count within 10 days, followed by increases in the red cell count, hemoglobin, and hematocrit, usually within 2 to 6 weeks [FDA Label]. Epoetin alfa was shown to be effective in increasing hematocrit in zidovudine-treated HIV-infected patients and anemic cancer patients undergoing chemotherapy [FDA Label].
How the body processes this drug — absorption, distribution, metabolism, and elimination
[A33080]
The bioavailability of subcutaneous injectable erythropoietin is much lower than that of the intravenously administered product and is approximately 20-40%.
[A33080]
Adult and paediatric patients with CRF: Following subcutaneous administration, the peak plasma levels are achieved within 5 to 24 hours [FDA Label].
Cancer patients receiving cyclic chemotherapy: The average time to reach peak plasma concentration was approximately 13.3 ± 12.4 hours after 150 Units/kg three times per week (TIW) subcutaneous (SC) dosing. The Cmax is expected be 3- to 7- fold higher and the Tmax is expected to be 2- to 3-fold longer in patients receiving a 40,000 Units SC weekly dosing regimen [FDA Label].
Adult and paediatric patients with CRF: The elimination half life following intravenous administration ranges from 4 to 13 hours, which is about 20% longer in CRF patients than that in healthy subjects. The half life is reported to be similar between adult patients receiving or not receiving dialysis [FDA Label].
Cancer patients receiving cyclic chemotherapy: Following subcutaneous administration, the average half life is 40 hours with range of 16 to 67 hours [FDA Label].
[A33080][A33076]
[A33080]
[A33080]
Only a small amount of unchanged epoetin alfa is found in the urine F86.
[A33076]
Cancer patients receiving cyclic chemotherapy: The average clearance was approximately 20.2 ± 15.9 mL/h/kg after 150 Units/kg three times per week (TIW) subcutaneous (SC) dosing [FDA Label]. The patients receiving a 40,000 Units SC weekly dosing regimen display a lower clearance (9.2 ± 4.7 mL/h/kg) [FDA Label].
Proteins and enzymes this drug interacts with in the body
PMID:10388848 PMID:2163695 PMID:2163696 PMID:8662939 PMID:9774108
Upon EPO stimulation, EPOR dimerizes triggering the JAK2/STAT5 signaling cascade (By similarity). In some cell types, can also activate STAT1 and STAT3 .
PMID:11756159
May also activate the LYN tyrosine kinase (By similarity)
ATC B03XA01
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
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Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Linked compound data from DrugBank Open Data (CC BY-NC 4.0)
Erythropoietin
Matched from: Epoetin alfa
Additional database identifiers
Drugs Product Database (DPD)
299
HUGO Gene Nomenclature Committee (HGNC)
HGNC:3416
GenAtlas
EPOR
GeneCards
EPOR
GenBank Gene Database
M60459
GenBank Protein Database
182245
Guide to Pharmacology
1718
UniProt Accession
EPOR_HUMAN
DrugBank citations
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Structured knowledge from the free knowledge base
ATC classifications (Wikidata)
Linked open data from Wikidata (Q28852443), a free and open knowledge base operated by the Wikimedia Foundation. Data is available under the Creative Commons CC0 1.0 Public Domain Dedication.