This medicine is a synthetic erythropoietin analog used to treat anemia in certain patients with chronic kidney disease. It is also used to treat anemia caused by chemotherapy in certain cancer patients. It may also be used to treat other conditions as determined by your doctor.
Follow the directions for using this medicine provided by your doctor. This medicine comes with a MEDICATION GUIDE approved by the U.S. Food and Drug Administration. Read it carefully each time you refill this medicine. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine. THIS MEDICINE IS USUALLY ADMINISTERED as an injection into a vein or under the skin at your doctor's office, hospital, or clinic. THIS MEDICINE IS SOMETIMES USED AT HOME as an injection. If you are using this medicine at home, a healthcare professional will provide detailed instructions for its appropriate use. Ask them any questions that you may have about your medicine or giving injections. DO NOT USE THIS MEDICINE if it is discolored, cloudy, or contains particles or if the vial or syringe is cracked or damaged in any way. DO NOT SHAKE this medicine. Do NOT use this medicine if it has been shaken. Do NOT use this medicine if it has been frozen. DO NOT MIX this medicine with IV solutions or with other injectable medicines. IF YOU ARE USING MEDICINE THAT COMES IN A VIAL, be sure to follow the procedure demonstrated to you to prevent contamination of the vial, syringe, or medicine. Never touch the rubber stopper of the vial or the needle of the syringe with your fingers. CAREFULLY CHECK that you have drawn the correct dose into the syringe before administration. CHOOSE A NEW SITE each time you inject this medicine. Do not inject into an area that is tender, red, bruised, hard, swollen, or has scars or stretch marks. DO NOT USE PAST THE EXPIRATION DATE on the vial or prefilled syringe. DISCARD ANY UNUSED PORTION of medicine left in the vial or syringe. THIS MEDICINE IS USUALLY HANDLED AND STORED by a health care provider. If you are using this medicine at home, store this medicine as directed by your pharmacist or health care provider. KEEP THIS PRODUCT, as well as syringes and needles, out of the reach of children and pets. Use this medicine regularly to receive the most benefit from it. Using this medicine at the same times each week will help you to remember. CONTINUE TO USE THIS MEDICINE even if you feel well. Do not miss any doses. IF YOU MISS A DOSE OF THIS MEDICINE, contact your doctor immediately.
WARNING: Clinical studies have shown this medicine to increase the risk of serious side effects (eg, blood clots, stroke, heart attack and heart failure) and death in some cases. It has also been shown to shorten overall survival and/or increase the risk of tumor growth or recurrence in patients with certain types of cancer. Talk with your doctor about the risks and benefits of using this medicine. Do not use more than the recommended dose without checking with your doctor. Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions, including a history of cancer, seizures, kidney problems (eg, decreased kidney function; kidney failure), blood problems (eg, sickle cell anemia, porphyria, hemolytic anemia, thalassemia), bleeding or clotting problems, stroke, heart attack or other heart problems (eg, congestive heart failure, ischemic heart disease), diabetes, high blood pressure, allergies, pregnancy, or breast-feeding. Tell your doctor if you have blood in your stools; an infection or recent injury; certain bone problems (eg, osteofibrosis cystica); an inflammatory condition (eg, bowel disease, rheumatoid arthritis); low blood iron, folic acid, or vitamin B12 levels; or high blood aluminum levels. Tell your doctor if you are on hemodialysis, have recently had surgery, or are scheduled to have surgery. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have uncontrolled high blood pressure. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have developed a certain type of anemia called pure red cell aplasia (PRCA) after receiving a previous dose of this medicine or other erythropoietin protein medicines (eg, epoetin). Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.
SIDE EFFECTS that may occur while taking this medicine include cough, mild pain at the injection site, or mild stomach pain. If they continue or are bothersome, check with your doctor. CONTACT YOUR DOCTOR IMMEDIATELY if you experience chest, jaw, or left arm pain; confusion; coughing up blood; fainting; fast or irregular heartbeat; new or worsening pale skin color, or tiredness or weakness; numbness of an arm or leg; one-sided weakness; redness, pain, tenderness, or swelling of the calf or leg; seizures; severe or persistent pain or irritation at the injection site; severe or persistent stomach pain; shortness of breath; sudden, severe headache, dizziness, or vomiting; sudden trouble walking, or loss of balance or coordination; swelling of the arms or legs; vision or speech problems; or weight gain. AN ALLERGIC REACTION to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; or unusual hoarseness. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your healthcare provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include severe or persistent headache or dizziness.
If your symptoms do not improve within a few weeks or if they become worse, check with your doctor. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor, nurse, or pharmacist to explain local regulations for selecting an appropriate container and properly disposing of the container when it is full. IF YOU WILL BE USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, be sure to obtain necessary refills before your supply runs out. CHECK WITH YOUR PHARMACIST about how to dispose of unused medicine.