Epoetin alfa / Darbepoetin alfa
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-EPOETIN-ALFA |
|---|---|
| Type | Drug |
| Aliases | Aranesp (darbepoetin)ESAEpogenEprexErythropoiesis-stimulating agentProcritrHuEPOЕпоетин альфа / Дарбепоетин альфа |
| Status | reviewed 2026-04-25 | pending_clinical_signoff |
| Diseases | DIS-MDS-LR |
| Sources | SRC-ESMO-MDS-2021 SRC-NCCN-AML-2025 |
Drug Facts
| Class | Erythropoiesis-stimulating agent (ESA, recombinant erythropoietin) |
|---|---|
| Mechanism | Recombinant human erythropoietin / hyperglycosylated analog (darbepoetin). Binds erythroid progenitor EPO receptor → erythroid expansion. 1L for symptomatic anemia in lower-risk MDS with low endogenous EPO (≤500 mU/mL) and modest transfusion burden (≤2U/mo). |
| Typical dosing | MDS-LR anemia: epoetin alfa 60,000 IU SC weekly OR darbepoetin 150-300 μg SC weekly. Re-evaluate at 8-12 weeks; if Hb response (≥1.5 g/dL rise) → continue, else discontinue. Target Hb 11-12 g/dL (do not exceed). |
| Ukraine registered | True |
| NSZU reimbursed | True |
| Ukraine last verified | 2026-04-27 |
Warnings
- Increased mortality, MI, stroke when targeting Hb >12 g/dL — keep target lower
- Increased VTE risk
- Tumor progression / mortality in some cancer settings (ESA must NOT be used in solid tumors with curative intent)
Notes
MDS-LR 1L for symptomatic anemia if endogenous EPO ≤500 mU/mL AND TD ≤2U/month — response rate ~50-60% in this selected population. Add G-CSF in non-responders if RS-MDS. Target Hb 10-12 g/dL — do NOT exceed (boxed warning). Iron supplementation as needed. Switch to luspatercept on ESA failure (MEDALIST) — both reimbursement-asymmetric in Ukraine (ESA reimbursed, luspatercept not).
Used By
Regimens
REG-ESA-MDS-LR- ESA (epoetin alfa or darbepoetin) — MDS-LR symptomatic anemia 1L