Short answer: Epoetin alfa has a half-life of about 4 to 13 hours (IV, kidney disease). Levels peak 5 to 24 hours (under the skin) after a dose. People vary, so treat these as estimates.
Epoetin alfa is a lab-made version of erythropoietin (EPO), the kidney hormone that tells the bone marrow to make red blood cells. It is sold as Epogen and Procrit, and as the biosimilar Retacrit, and is injected to treat anemia from chronic kidney disease, chemotherapy or the HIV drug zidovudine, and to cut blood transfusions around some surgeries.
Also known as: Epogen, Procrit, Retacrit, EPO, erythropoietin.
Epogen comes as single-dose vials of 2,000, 3,000, 4,000 and 10,000 Units/mL, and multiple-dose vials of 20,000 Units/2 mL and 20,000 Units/mL. The multiple-dose vials contain benzyl alcohol. It is injected into a vein or under the skin.
The Epogen label approves epoetin alfa for anemia from chronic kidney disease (on or off dialysis), from zidovudine in HIV, and from chemotherapy for some cancers, and to reduce transfusions before certain elective surgeries. For kidney disease it is started when hemoglobin is below 10 g/dL, at 50 to 100 Units/kg three times a week in adults, and reduced or paused as hemoglobin approaches or passes 11 g/dL. The label says it has not been shown to improve quality of life, fatigue or well-being.
Its boxed warning says ESAs raise the risk of death, heart attack, stroke, blood clots and clots in dialysis access; in kidney disease trials, targeting hemoglobin above 11 g/dL raised these risks, and no target or dose has been found that avoids them. In several cancers, ESAs shortened survival or sped tumor growth. It is not used with uncontrolled high blood pressure or after pure red cell aplasia from an EPO drug.
WADA bans erythropoietins (S2.1.1) at all times. In a 2017 trial in 48 trained amateur cyclists (Heuberger, Lancet Haematology), 8 weeks of EPO raised hemoglobin, peak power and VO2 max in a lab test, but did not change submaximal performance or race time up Mont Ventoux.
The Epogen label gives an elimination half-life of 4 to 13 hours after an IV dose in adults and children with chronic kidney disease. After an injection under the skin, peak levels came 5 to 24 hours later. The effect on red blood cells builds over weeks, and the label says not to raise the dose more often than once every 4 weeks.
Numbers shown are taken from the source above. Half-life varies from person to person.
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