Epoetin Alfa (Generic Name)

Other names: Procrit®

It is UPMC policy to give each patient receiving this drug a copy of the Amgen medication guide for Procrit®. Download the medication guide here. (PDF)

About this drug

Epoetin alfa is used to treat anemia. It helps your body produce more red blood cells. It is given by IV (intravenously) or by injection under your skin (subcutaneously).

Possible side effects (More Common)

  • Rash
  • Swelling (fluid retention) in the arms, legs, ankles, and/or feet
  • Mild nausea and vomiting
  • Diarrhea
  • You may have redness, pain, warmth, or swelling at the injection site.
  • Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue
  • Heart problems. If you are treated with epoetin alfa to a hemoglobin level above 12 g/dL, you may get serious heart problems such as heart attack, stroke, or heart failure, and you may die sooner. UPMC guidelines call for monitoring your hemoglobin levels to keep them in the appropriate range.
  • Blood clots. You may get blood clots at any time while taking epoetin alfa. If you are receiving epoetin alfa and you are going to have surgery, talk to your health care provider about whether or not you need to take a blood thinner to lessen the chance of blood clots during surgery. Clots can form in blood vessels (veins), especially in your leg. This is called DVT, or deep venous thrombosis. Pieces of a blood clot may travel to the lungs and block the blood circulation in the lungs. This is called a pulmonary embolus.
  • This medication can cause your blood pressure to increase.
  • This medication can cause upper respiratory changes including infections.

Possible side effects (Less Common)

  • Seizures
  • Antibodies to epoetin alfa. Your body may make antibodies to epoetin alfa. These antibodies can block or lessen your body’s ability to make red blood cells and can cause you to have severe anemia. This is extremely rare.

Important Information

Your tumor may grow faster and you may die sooner if epoetin alfa is used experimentally to try to raise your hemoglobin beyond the amount needed to avoid red blood cell transfusion, or when it is given to patients who are not getting strong doses of chemotherapy. It is not known whether these risks exist when epoetin alfa is given according to the FDA-approved directions for use. UPMC guidelines call for monitoring your hemoglobin levels to keep them in the appropriate range.

Sexual Problems and Reproductive Concerns

Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment. Speak to your doctor or nurse about effective methods of birth control.

Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women are advised to discuss with their doctor the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and seriously harm a breast feeding infant.

Treating side effects

  • Ask your doctor or nurse about medicine that is available to help prevent or lessen nausea, vomiting, diarrhea, injection site pain, and rash.
  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
  • If you have a rash, do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry.
  • During the IV infusion, if you experience pain, redness, or swelling at the site of the IV infusion, please tell your nurse immediately.
  • Let your doctor know if you have a history of seizures.

Other instructions

  • If you have high blood pressure, it may become worse when you take this drug. Be sure to continue to take your blood pressure medicine and follow any diet your doctor prescribed.
  • You will be enrolled in a special program called REMS ESA APPRISE. Your doctor or nurse will give you more information about this. 

Food and drug interactions

There are no known interactions of epoetin alfa with food. This drug may interact with other medicine. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs, and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor’s advice.

When to call the doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Right after an injection, you develop a rash, fever, chills, dizziness, heart palpitations, or shortness of breath
  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Uncontrolled nausea that prevents you from eating or drinking
  • Rash
  • Fainting (loss of consciousness)
  • Sudden numbness or weakness in the face, arm, or leg, especially on one side of your body
  • Trouble seeing
  • Trouble walking
  • Loss of balance or coordination
  • Vomiting more than three times in one day
  • Dizziness or light-headedness
  • Hallucinations or sudden confusion
  • Trouble speaking or trouble understanding others’ speech
  • Seizures
  • Severe headache
  • Shortness of breath
  • Chest pain
  • Pain, cramping, swelling, redness, or warmth in an arm or leg
  • A cool or pale arm or leg


Call your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Nausea, vomiting, or diarrhea unrelieved by prescribed medicine
  • Swelling in the legs, feet, or ankles
  • Headache that prescribed medicine doesn’t help
  • Extreme tiredness that interferes with normal activities
  • Diarrhea of five or six stools in one day or diarrhea with weakness
  • Rash that does not get better with prescribed medicines
  • Pain at the injection site

Revised November 2011

©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

Pittsburgh, PA, USA UPMC.com