Common side effects

• Hypertension
• Arthralgia
• Fever
• Fatigue
• General weakness
• Edema
• Tachycardia
• Nausea
• Vomiting
• Diarrhea
• Vascular access thrombosis
• Injection site sequelae
• Muscle spasm
• Depression
• Dysphagia
• Acute myocardial infarction
• Pulmonary thromboembolism
• Transient cerebral ischemia
• Cerebrovascular accident
• Upper respiratory infection

If any of these effects persist or worsen, tell your doctor or pharmacist promptly

• Headache
• Body aches
• Cough
• Injection site irritation/pain

Tell your doctor right away if you have any serious side effects, including

• Symptoms of heart failure

Get medical help right away if you have any very serious side effects, including

• Seizures

This medication may rarely cause serious problems from blood clots . Get medical help right away if you have

• Shortness of breath/rapid breathing
• Chest/jaw/left arm pain
• Unusual sweating
• Confusion
• Sudden dizziness/fainting
• Pain/swelling/warmth in the groin/calf
• Sudden/severe headaches
• Trouble speaking
• Weakness on one side of the body
• Sudden vision changes
• Blood clots in your hemodialysis vascular access site

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including

• Rash
• Itching/swelling
• Severe dizziness
• Trouble breathing

Other things to note

• Epoetin alfa may sometimes cause or worsen high blood pressure, especially in patients with long-term kidney failure. This effect may be caused by the number of red blood cells increasing too quickly, usually within the first 3 months of starting treatment. If you have high blood pressure, it should be well controlled before beginning treatment with this medication. Your blood pressure should be checked often. Ask your doctor if you should learn how to check your own blood pressure. If high blood pressure develops or worsens, follow your doctor's instructions about diet changes and starting or adjusting your high blood pressure medication. Lowering high blood pressure helps prevent strokes, heart attacks, and further kidney problems. Keep all lab appointments to have your red blood cell count/hemoglobin level tested regularly to reduce the chance of this side effect.
• Rarely, this medication may suddenly stop working well after a period of time because your body may make antibodies to it. A very serious anemia can result. Tell your doctor right away if symptoms of anemia return .

• Important to read patient package insert & med guide
• Read directions carefully before start of therapy
• It is important to check blood pressure regularly
• Watch for heart attack, stroke & blood clot signs
• Lab tests may be ordered to monitor therapy
• Tell doctor your complete medical history
• Store in refrigerator. Do not freeze or shake.
• Protect from light

• Keep in refrigerator. Do not freeze.
• Do not shake
• Protect from light
• Bring to room temperature before preparing for use.

Before taking this medication, tell your doctor if you've had:

• High blood pressure
• Heart disease (such as heart failure, past heart attack/stroke)
• Seizure disorder
• Severe anemia caused by antibodies to past erythropoietin-type treatment (pure red cell aplasia)

Product interactions for this drug/drug-class include:

• Erythropoietic agents with Lenalidomide (Severe Interaction)