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Epoetin alfa Disease Interactions

There are 5 disease interactions with epoetin alfa:

Major

Erythropoiesis-Stimulating Agents (Includes Epoetin alfa) ↔ Hemodialysis

Severe Potential Hazard, Moderate plausibility

Applies to: hemodialysis

The increase in hematocrit and decrease in plasma volume associated with erythropoiesis-stimulating agents therapy may, theoretically, affect dialysis efficiency. During hemodialysis, patients may require increased anticoagulation with heparin to prevent clotting.

References

  1. "Product Information. Procrit (epoetin alfa)." Ortho Biotech Inc, Raritan, NJ.
  2. Lago M, Perezgarcia R, Devinuesa MSG, Anaya F, Valderrabano F "Efficiency of once-weekly subcutaneous administration of recombinant human erythropoietin versus three times a week administration in hemodialysis patients." Nephron 72 (1996): 723-4
  3. Kindler J, Echardt KU, Ehmer B, et al "Single-dose pharmacokinetics of recombinant human erythropoietin in patients with various degrees of renal failure." Nephrol Dial Transplant 4 (1989): 345-9
View all 9 references
Major

Erythropoiesis-Stimulating Agents (Includes Epoetin alfa) ↔ Hypertension

Severe Potential Hazard, High plausibility

Applies to: Hypertension

The use of erythropoiesis-stimulating agents is contraindicated in patients with uncontrolled hypertension. Epoetin alfa and darbepoetin alfa may cause blood pressure to rise. Hypertensive encephalopathy and seizures have been observed in patients with chronic renal failure treated with these agents. Blood pressure should be adequately controlled prior to initiation of therapy, and monitored closely during treatment. Aggressive antihypertensive measures may be necessary, particularly early on in treatment when the hematocrit is increasing. It is recommended to reduce or withhold the use of these agents if blood pressure becomes difficult to control.

References

  1. Eschbach JW, Abdulhadi MH, Browne JK, Delano BG, Downing MR, Egrie JC, Evans RW, Friedman EA, Graber SE, Haley NR, et al "Recombinant human erythropoietin in anemic patients with end-stage renal disease. Results of a phase III multicenter clinical trial." Ann Intern Med 111 (1989): 992-1000
  2. Raine AE "Hypertension, blood viscosity, and cardiovascular morbidity in renal failure: implications of erythropoietin therapy." Lancet 1 (1988): 97-100
  3. Buckner FS, Eschbach JW, Haley NR, Davidson RC, Adamson JW "Hypertension following erythropoietin therapy in anemic hemodialysis patients." Am J Hypertens 3 (1990): 947-55
View all 7 references
Major

Erythropoiesis-Stimulating Agents (Includes Epoetin alfa) ↔ Seizures

Severe Potential Hazard, Moderate plausibility

Applies to: Seizures

The use of erythropoiesis-stimulating agents increases the risk of seizures in patients with chronic renal failure. Seizure development may be related to the rate of rise in hematocrit, which is also associated with blood pressure elevations. It is recommended to monitor patients closely for the development of premonitory neurologic symptoms during the first several months after the administration of these agents. Patients with epilepsy or predisposed to seizures should be monitored closely for blood pressure changes and neurologic symptoms during therapy with these agents.

References

  1. "Product Information. Epogen (epoetin alfa)." Amgen, Thousand Oaks, CA.
  2. Bennett WM "Side effects of erythropoietin therapy." Am J Kidney Dis 18 (1991): 84-6
  3. Singbartl G "Adverse events of erythropoietin in long-term and in acute short-term treatment." Clin Investig 72 (1994): s36-43
View all 6 references
Major

Erythropoiesis-Stimulating Agents (Includes Epoetin alfa) ↔ Thrombotic Events

Severe Potential Hazard, Moderate plausibility

Applies to: Cerebral Vascular Disorder, Congestive Heart Failure, Ischemic Heart Disease, Thrombotic/Thromboembolic Disorder, History - Thrombotic/Thromboembolic Disorder, Peripheral Arterial Disease

The use of erythropoiesis-stimulating agents may be associated with an increased risk of thrombotic events and mortality. During clinical trials, an increased risk was observed in: 1) patients with chronic renal failure (CRF) and ischemic heart disease or congestive heart failure targeted to a maintenance hematocrit of 42%, and 2) in patients without CRF undergoing coronary artery bypass surgery. Although a causal relationship has not been established, therapy with these agents should be administered cautiously in patients with preexisting cardiovascular disease and/or a history of thrombotic events.

References

  1. Wirtz JJ, van Esser JW, Hamulyak K, Leunissen KM, van Hooff JP "The effects of recombinant human erythropoietin on hemostasis and fibrinolysis in hemodialysis patients." Clin Nephrol 38 (1992): 277-82
  2. Raine AE "Hypertension, blood viscosity, and cardiovascular morbidity in renal failure: implications of erythropoietin therapy." Lancet 1 (1988): 97-100
  3. Bennett WM "Side effects of erythropoietin therapy." Am J Kidney Dis 18 (1991): 84-6
View all 8 references
Moderate

Epoetin Alfa (Includes Epoetin alfa) ↔ Porphyria

Moderate Potential Hazard, Low plausibility

Applies to: Porphyria

The use of epoetin alfa has rarely been associated with exacerbation of porphyria in patients with chronic renal failure. In healthy volunteers, however, epoetin alfa has not been shown to cause increased urinary excretion of porphyrin metabolites. Nevertheless, therapy with epoetin alfa should be administered cautiously in patients with porphyria.

References

  1. "Product Information. Epogen (epoetin alfa)." Amgen, Thousand Oaks, CA.
  2. "Product Information. Procrit (epoetin alfa)." Ortho Biotech Inc, Raritan, NJ.
  3. Singbartl G "Adverse events of erythropoietin in long-term and in acute short-term treatment." Clin Investig 72 (1994): s36-43

epoetin alfa drug Interactions

There are 27 drug interactions with epoetin alfa

epoetin alfa alcohol/food Interactions

There is 1 alcohol/food interaction with epoetin alfa

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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