THE PREPARATION DESCRIPTION IS NOT INTENDED FOR MEDICATION WITHOUT PARTICIPATION OF THE DOCTOR!

What is it used for?
Eprex is synthetic erythropoietin (epoetin alfa) and is used to replace the erythropoietin that is lacking in people who can't make enough, usually because their kidneys are not working properly.
It is also used to treat anemia in cancer patients, certain surgical patients, and patients with HIV who are taking the medication zidovudine.
It can also be used to increase RBC production in certain patients scheduled for surgery. It takes at least two weeks for a noticeable response to the medication, and can take as long as six weeks.

Contraindications and cautions:
Do not use Eprex
* If you have an allergy to Eprex or any of the ingredients.
* If you have high blood pressure that is not properly controlled with blood pressure-lowering drugs.
* If you are a surgery patient who should not be given medicines to thin the blood.
* If you are due to have elective surgery and you have severe heart disease, disorders of the veins or arteries, or have recently had a heart attack or stroke.
* If you have been diagnosed with pure red cell aplasia (your bone marrow cannot produce enough red blood cells) after previous treatment with an erythropoietin product, including Eprex.
You must tell your doctor if you have or have had:
* high blood pressure
* heart disease (such as angina)
* disorders of blood circulation resulting in pins and needles or cold hands or feet or muscle cramps in the legs.
* blood clotting disorders
* seizures or epileptic fits
* cancer. If you are a cancer patient be aware that erythropoietins like Eprex may act as a growth factor and therefore in theory may affect the progression of your cancer.
* anaemia from other causes
* liver disease
* porphyria (a rare blood pigment disorder).
Also, tell your doctor if you are:
* pregnant or planning to become pregnant
* breastfeeding or wish to breastfeed.
In many women with severe kidney failure, their monthly periods may stop. In these women, erythropoietin may restart the monthly cycle. Before starting Eprex, you should discuss the need for contraception with your doctor.

Side effects:
All medicines can have side effects. Sometimes they are serious, most of the time they are not.
Tell your doctor if you experience any of the following
* Flu-like symptoms such as dizziness, drowsiness, fever, chills, headache, muscle and joint pain and weakness.
* Redness, burning and pain at the site Eprex is given.
Tell your doctor immediately if you notice any of the following, as you may need urgent medical care
* Severe, sudden, stabbing migraine-like headaches.
* Seizures or epileptic fits.
* Raised blood pressure, which may require treatment with drugs or adjustment of the doses of
drugs you already take for high blood pressure.
* Clotting of your blood in the haemodialysis system, or blockage of your fistula if you are on dialysis. There may be a need to increase your heparin dose during dialysis.
* Chest pain, breathlessness, painful swelling in the leg that may be symptoms of a blood clot (thrombosis).
* Skin rashes and accumulation of fluid under the skin of the eyelids (oedema), which may result from an allergic reaction.
* Sudden tiredness, dizziness or sudden shortness of breath. Your doctor will want to investigate this. These symptoms may be caused by a condition called pure red cell aplasia (PRCA).
Other side effects not listed above may also occur in some people. Tell your doctor if you notice any other effects.

Interactions:
If you are taking ciclosporin while receiving this medicine your ciclosporin blood levels should be monitored.
Iron is also a constituent of red blood cells. Therefore, iron supplements and other blood stimulating drugs may increase your response to Eprex treatment.

If you are receiving haemodialysis to treat kidney failure you may need an increased dose of heparin while using this medicine. This is because epoetin increases the volume of cells in the blood and may therefore increase the risk of blood clotting in the dialysis system.
Your doctor will decide whether you should take other medicines while using Eprex.