Epomax 3000IU/ml IV/SC Injection

✔️ Overdose

Excessive doses may cause hemoglobin levels to rise too high, increasing the risk of complications such as severe hypertension. Treatment includes reducing or stopping the medication and providing supportive care as needed.

✔️ Dosage & Administration

Treatment should always be individualized and supervised by a healthcare professional.

Before Starting Treatment

• Check iron stores and correct any iron deficiency.
• Evaluate and treat other possible causes of anemia such as vitamin deficiencies, chronic inflammation, or bleeding.
• Monitor hemoglobin levels regularly during therapy.

Chronic Kidney Disease (CKD)

Patients on Dialysis

• Start treatment when hemoglobin is below 10 g/dL.
• Recommended starting dose: 50–100 IU/kg, administered 3 times weekly by intravenous (preferred for hemodialysis patients) or subcutaneous injection.
• Reduce or temporarily stop treatment if hemoglobin approaches or exceeds 11 g/dL.

Patients Not on Dialysis

• Treatment may be considered when hemoglobin is below 10 g/dL and reducing transfusion requirements is an important goal.
• Recommended starting dose: 50–100 IU/kg, 3 times weekly by IV or SC injection.
• Maintain the lowest effective dose to minimize the need for blood transfusions.

HIV Patients Receiving Zidovudine

• Starting dose: 100 IU/kg, given IV or SC 3 times weekly.
• If there is inadequate response after 8 weeks, the dose may be increased gradually.
• Stop treatment if no meaningful response occurs after adequate dose escalation.

Cancer Patients Receiving Chemotherapy

• Start only if:
  • Hemoglobin is below 10 g/dL, and
  • At least 2 more months of chemotherapy are planned.
• Adults:
  • 150 IU/kg SC three times weekly, or
  • 40,000 IU SC once weekly
• Children (5–18 years):
  • 600 IU/kg IV once weekly

Prevention of Anemia in Premature Infants

• 250 IU/kg SC, 3 times weekly
• Begin as early as possible, preferably by the third day of life, and continue for 6 weeks.

Administration Guidelines

• Do not shake or freeze the syringe.
• Keep protected from light.
• Inspect the solution before use and discard if it contains particles or discoloration.
• Discard any unused medicine.

Drug Interactions

No major clinically significant drug interactions have been identified. However, iron supplements (such as ferrous sulfate) may improve the response to treatment in patients with iron deficiency.

Contraindications

Do not use Epomax in patients with:

• Uncontrolled hypertension
• Known severe allergy to Erythropoietin Alfa or any component of the formulation
• Pure Red Cell Aplasia (PRCA) that developed after previous erythropoietin therapy

Possible Side Effects

In CKD Patients

• High blood pressure
• Joint pain
• Muscle cramps
• Fever
• Dizziness
• Vascular access complications
• Upper respiratory tract infections

In HIV Patients

• Fever
• Cough
• Rash
• Injection-site irritation

In Cancer Patients

• Nausea
• Vomiting
• Muscle and joint pain
• Mouth sores
• Cough
• Weight loss
• Low white blood cell count
• Bone pain
• Headache
• Depression
• Blood clots
• High blood sugar

In Surgical Patients

• Nausea
• Vomiting
• Itching
• Headache
• Injection-site pain
• Chills
• Deep vein thrombosis (DVT)
• High blood pressure

In Premature Infants

• Reduced serum ferritin (iron stores)

Pregnancy & Breastfeeding

• Use during pregnancy only if the expected benefit outweighs the potential risk to the baby.
• Use is generally not recommended for pregnant or breastfeeding women participating in autologous blood donation programs.
• It is unknown whether Erythropoietin Alfa passes into breast milk. Consult a healthcare provider before breastfeeding.

Storage

• Store refrigerated at 2°C–8°C.
• Do not freeze or shake.
• Keep in the original package to protect from light.
• Keep out of the reach of children.