II. Indications

  1. Illicit use by athletes as ergonomic aid (banned)
  2. Anemia
    1. Chronic Renal Failure
      1. Indicated to maintain Hemoglobin 10-12 mg/dl
      2. Decreases cardiovascular morbidity and mortality
      3. Increases quality of life
    2. Cancer Chemotherapy
      1. Indicated to maintain Hemoglobin >10 g/dl
      2. Contraindicated if serum Erythropoietin >200 mU/ml
      3. Increases Hemoglobin 2 g/dl
      4. Decreases transfusion need
      5. Increases quality of life
      6. Does not improve survival or delay disease progress
        1. Henke (2003) Lancet 362:1255-60 [PubMed]
    3. Anemia secondary to HIV Management (e.g. Zidovudine)
      1. Contraindicated if serum Erythropoietin >500 mU/ml
      2. Increases quality of life (e.g. Energy)
      3. Prolongs AIDS survival
    4. Prophylaxis before elective surgery (non-cardiac)
      1. Indicated before surgery where transfusion is otherwise predicted
    5. Other possible indications (covered by Medicare)
      1. Myelodysplastic Syndrome
      2. Hepatitis C (during treatment)
      3. Inflammatory Bowel Disease
      4. Rheumatoid Arthritis
      5. Systemic Lupus Erythematosus

III. Adverse effects

  1. Hypertension (25% of Renal Failure patients)
    1. Hypertensive Encephalopathy
    2. Seizures
  2. Thrombotic events (e.g. Myocardial Infarction)
  3. May promote growth of certain Breast Cancers

IV. Disadvantages

  1. See adverse effects above
  2. Cost: $3000 for 8 week cancer course

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Cost: Medications

procrit (on 1/14/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
PROCRIT 10,000 UNITS/ML VIAL $236.20 per ml
PROCRIT 20,000 UNITS/ML VIAL $470.35 per ml
PROCRIT 4,000 UNITS/ML VIAL $96.22 per ml
PROCRIT 40,000 UNITS/ML VIAL $943.60 per ml

Ontology: Erythropoietin (C0014822)

Definition (CHV) a hormone produced in the adult kidney
Definition (CHV) a hormone produced in the adult kidney
Definition (CHV) a hormone produced in the adult kidney
Definition (CHV) a hormone produced in the adult kidney
Definition (MSH) Glycoprotein hormone, secreted chiefly by the KIDNEY in the adult and the LIVER in the FETUS, that acts on erythroid stem cells of the BONE MARROW to stimulate proliferation and differentiation.
Definition (NCI) Human erythropoietin is an acidic glycoprotein hormone with a molecular mass of 34 kD. As the prime regulator of red cell production, its major functions are to promote erythroid differentiation and to initiate hemoglobin synthesis.[supplied by OMIM](LocusLink)
Definition (NCI_NCI-GLOSS) A substance that is naturally produced by the kidneys, and that stimulates the bone marrow to make red blood cells. When erythropoietin is made in the laboratory, it is called epoetin alfa or epoetin beta.
Definition (CSP) glycoprotein hormone, secreted chiefly by the kidney in the adult and the liver in the fetus, that acts on erythroid stem cells of the bone marrow to stimulate proliferation and differentiation.
Concepts Hormone (T125) , Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121)
MSH D004921
SnomedCT 111167001, 386993000, 327705006, 83042003
LNC LP15554-6, MTHU004935
English Erythropoietin, Erythropoietin product, hematopoietin, ECSF (erythrocyte colony stimulating factor), Epo, epoetin (medication), epoetin, Erythropoietin [Chemical/Ingredient], epos, erythropoietins, epo, Erythropoietin stimulating agent, ESA - Erythropoietin stimulating agent, ECSF, erythrocyte colony stimulating factor, erythropoietin, Erythropoietin product (product), Erythropoietin preparation (substance), Erythropoetin, EPO - Erythropoietin, Erythropoietin preparation, Erythropoietin (substance), Erythropoietin preparation (product), Epoetin, EPO, Erythrocyte Colony Stimulating Factor, Hematopoietin
Swedish Erytropoietin
Czech erythropoetin
Finnish Erytropoietiini
Russian ERITROPOETIN, РЕКОМБИНАНТНЫЙ ЭРИТРОПОЭТИН, ERITROPOETIN REKOMBINANTNYI, REKOMBINANTNYI ERITROPOETIN, ЭПОЭТИН АЛЬФА, ЭРИТРОПОЭТИН РЕКОМБИНАНТНЫЙ, EPOETIN AL'FA, ЭРИТРОПОЭТИН
Spanish preparado con eritropoyetina (producto), eritropoyetina (producto), preparado con eritropoyetina, preparado de eritropoyetina (sustancia), preparado de eritropoyetina, eritropoyetina (sustancia), eritropoyetina, hematopoyetina, hemopoyetina, hormona eritropoyética, preparado de eritropoyetina (producto), Eritropoyetina
Croatian ERITROPOETIN
Polish Erytropoetyna, Erytropoetyna alfa, Erytropoetyna rekombinowana
Portuguese Eritropoietina, Eritropoetina
French Érythropoïétine, Hémopoïétine
German Erythropoetin
Italian Eritropoietina

Ontology: Epogen (C0700704)

Concepts Pharmacologic Substance (T121) , Hormone (T125) , Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129)
MSH C554041
English Epogen, epoetin (Epogen), epogen, Amgen brand of epoetin alpha

Ontology: Procrit (C0733467)

Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116)
English Procrit, procrit