Epoetin Alfa Side Effects

Medically reviewed by Drugs.com. Last updated on Apr 11, 2025.

Applies to epoetin alfa: injection solution.

Precautions

It is very important that your doctor check the blood of you or your child on a regular basis while you are using this medicine. You may also need to monitor your blood pressure at home. If you notice any changes to your recommended blood pressure, call your doctor right away. .

Do not use this medicine if you or your child have had an allergic reaction to albumin or products derived from human or animal cells.

This medicine contains benzyl alcohol which may cause serious reactions to newborn or premature infants. Discuss this with your doctor if you are concerned.

Epoetin sometimes causes seizures, especially during the first 90 days of treatment. During this time, it is best to avoid driving, using heavy machinery, or doing other activities that could cause serious injury if a seizure occurs while you are performing them.

People with severe anemia usually feel very tired and sick. When epoetin begins to work, usually in about 6 weeks, most people start to feel better. Some people are able to be more active. However, epoetin only corrects anemia. It has no effect on kidney disease, cancer, or any other medical problem that needs regular medical attention. Even if you or your child are feeling much better, it is very important that you do not miss any appointments with your doctor or any dialysis treatments. .

This medicine may increase your risk of having serious heart and blood vessel problems, such as congestive heart failure, heart attacks, or stroke. Check with your doctor right away if you or your child start having dizziness, fainting spells, severe tiredness, chest pain, trouble with breathing, sudden or severe headache, or problems with vision, speech, or walking. .

This medicine may increase your risk of having blood clots. This is more likely in patients who use high doses of this medicine, or who use this medicine before a major surgery. Call your doctor right away if you have chest pain, trouble breathing, or pain, redness, or swelling in your arms or legs while using this medicine. If you are getting dialysis treatments, tell your doctor right away if you notice blood clots at the injection site. Your doctor may give you a blood thinner before surgery to help prevent blood clots.

This medicine may cause blood clots to form in the access port (A-V shunt) for patients with chronic kidney disease who receive dialysis treatments. This would cause the access port to stop working. Tell your doctor right away if you or your child see blood clots forming in the access port.

When used in patients with certain types of cancer (eg, breast, cervix, lymphoid, lung, head, or neck cancer), this medicine has shortened survival time and worsened the tumor or cancer in some patients. If you or your child are concerned about this, talk with your doctor.

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema. These can be life-threatening and require immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after using this medicine.

Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or a skin rash, sores or ulcers on the skin, or fever or chills with this medicine.

Epoetin is made from donated human blood. Some human blood products have transmitted certain viruses to people who have received them, although the risk is low. Human donors and donated blood are both tested for viruses to keep the transmission risk low. Talk with your doctor if you have concerns.

Many people with kidney problems need to be on a special diet. Also, people with high blood pressure (which may be caused by kidney disease or by epoetin treatment) may need to be on a special diet or to take medicine to keep their blood pressure under control. After their anemia has been corrected, some people feel so much better that they want to eat more than before. To keep your kidney disease or your high blood pressure from getting worse, it is very important that you or your child follow your special diet and take your medicines regularly, even if you are feeling better.

In addition to epoetin, your body needs iron and vitamins to make red blood cells. Your doctor may direct you or your child to take iron or vitamin supplements. Be sure to follow your doctor's orders carefully. Epoetin will not work properly if there is not enough iron or vitamins in your body.

Serious side effects of epoetin alfa

Along with its needed effects, epoetin alfa may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking epoetin alfa:

Other side effects of epoetin alfa

Some side effects of epoetin alfa may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

See also:

For healthcare professionals

Applies to epoetin alfa: injectable solution.

General adverse events

The most common adverse reaction was dose-dependent increase in blood pressure or aggravation of existing hypertension.^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (up to 56%), diarrhea (up to 30%), vomiting (up to 28%), stomatitis (10%)
• Common (1% to 10%): Dysphagia
• Frequency not reported: Vomiting^[Ref]

Other

• Very common (10% or more): Pyrexia (up to 42%)
• Common (1% to 10%): Chills, influenza-like illness, peripheral edema, artificial kidney clotting during dialysis, edema^[Ref]

Nervous system

• Very common (10% or more): Headache (up to 34%)
• Common (1% to 10%): Convulsion, dizziness
• Frequency not reported: Cerebrovascular accident, transient ischemic attack^[Ref]

Cardiovascular

• Very common (10% or more): Hypertension (up to 33%), embolism and thrombosis (up to 15%)
• Common (1% to 10%): Deep vein thrombosis, thrombosis
• Uncommon (0.1% to 1%): Myocardial infarction
• Frequency not reported: Blood pressure increased, aneurysm^[Ref]

Respiratory

• Very common (10% or more): Cough (up to 26%)
• Common (1% to 10%): Respiratory tract congestion, upper respiratory tract infection, pulmonary embolism^[Ref]

Dermatologic

• Very common (10% or more): Rash (up to 25%), pruritus (up to 21%)
• Common (1% to 10%): Urticaria
• Uncommon (0.1% to 1%): Erythema
• Frequency not reported: Angioedema
• Postmarketing reports: Severe cutaneous reactions^[Ref]

Musculoskeletal

• Very common (10% or more): Arthralgia (up to 24%), pain in extremity (up to 15%), myalgia (up to 10%)
• Common (1% to 10%): Bone pain, muscle spasm
• Frequency not reported: Porphyria^[Ref]

Local

• Very common (10% or more): Injection site reaction (up to 18%), injection site pain (up to 13%)
• Common (1% to 10%): Vascular access thrombosis^[Ref]

Metabolic

• Very common (10% or more): Hyperkalemia (up to 10%)
• Common (1% to 10%): Weight decrease, hyperglycemia, hypokalemia^[Ref]

Psychiatric

• Common (1% to 10%): Insomnia, depression^[Ref]

Hematologic

• Common (1% to 10%): Leukopenia
• Postmarketing reports: Erythropoietin antibody-mediated pure red cell aplasia, thrombocytopenia^[Ref]

Immunologic

• Frequency not reported: Anaphylactic reaction, hypersensitivity
• Postmarketing reports: Serious allergic reaction^[Ref]

Frequently asked questions

• What biosimilars have been approved in the United States?

Further information

Epoetin alfa side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer