AIDS Home > Precautions and Warnings With Epoetin Alfa

Before starting a new drug, make sure you are aware of its precautions and warnings. With epoetin alfa, tell your healthcare provider if you have porphyria, heart disease, or any allergies before beginning treatment. Precautions and warnings with epoetin alfa also extend to people who are allergic to any components of the medicine, have uncontrolled high blood pressure, or are allergic to mammalian cell-derived products.

Epoetin Alfa: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking epoetin alfa (Epogen®, Procrit®) if you have:
Also, let your healthcare provider know if you are:
  • Breastfeeding
  • Pregnant or thinking of becoming pregnant.
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Epoetin Alfa

Warnings and precautions to be aware of prior to taking epoetin alfa include the following:
  • In studies of people with chronic kidney disease, an increase in risk of death, stroke, and serious cardiovascular reactions (such as heart attacks) was reported when epoetin alfa was used to target a hemoglobin level (a measure of red blood cells) greater than 11 g/dL. None of the studies that have been completed have identified a hemoglobin target level, epoetin alfa dose, or dosing strategy that does not increase these risks.


  • Your healthcare provider should measure your hemoglobin frequently and adjust your epoetin alfa dosage so that your hemoglobin does not increase too quickly or too much. However, this will not prevent all cardiovascular problems, and you and your healthcare provider must weigh the potential benefits of the drug against these risks.


  • The medication can accelerate the worsening of cancer and may shorten survival, particularly when it increases hemoglobin levels too much. This risk must be weighed against the potential benefits of epoetin alfa.
  • Epoetin alfa may cause high blood pressure (hypertension). This can be a problem, especially if you already have high blood pressure. Your healthcare provider should monitor your blood pressure closely while you are taking the drug.
  • In studies, some people who took epoetin alfa experienced seizures. If you have a seizure while taking the medication, tell your healthcare provider immediately.
  • The multi-dose epoetin alfa vials contain benzyl alcohol, which can cause problems in premature infants. The single-dose vials do not contain benzyl alcohol.
  • In rare cases, people can form antibodies to epoetin alfa, causing severe anemia. If your anemia worsens while you are taking the drug, your healthcare provider should check to see if you are forming these antibodies. If this occurs, you may need to stop taking epoetin alfa permanently.
  • Epoetin alfa contains albumin, a human blood protein. As with all albumin products, theoretically, there is an extremely small risk of contracting an infection (including serious infections) from the albumin. However, there are no cases of this ever happening with an albumin product.
  • In rare cases, epoetin alfa can cause worsening of porphyria (a blood condition). If you have porphyria, your healthcare provider may need to monitor you more closely.
  • Epoetin alfa is unlikely to interact with other medications (see Drug Interactions With Epoetin Alfa).
  • Epoetin alfa is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy. Talk to your healthcare provider about the risks and benefits of taking the drug while pregnant (see Epogen and Pregnancy).
  • It is not known if epoetin alfa passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Epogen and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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