Epoetin alfa and darbepoetin alfa

Say it: eh-POH-eh-tin AL-fuh and dar-beh-POH-eh-tin AL-fuh · Brand names: Epogen, Procrit, Retacrit, Aranesp

Epoetin alfa and darbepoetin alfa are shots that help your body make more red blood cells.

What it is

Red blood cells carry oxygen through your body. Your kidneys make a hormone that tells your bone marrow to make red blood cells. These medicines are man-made copies of that hormone, so they can raise a low red blood cell count and lower the need for blood transfusions.

Often used for

• low red blood cells (anemia) caused by chemotherapy, when the goal of treatment is not cure
• anemia from long-term kidney disease
• anemia from some HIV medicines (epoetin alfa)
• lowering the need for blood transfusions around some surgeries (epoetin alfa)

How you get it

They are given as a shot under the skin or into a vein. Epoetin alfa is often given once a week. Darbepoetin alfa lasts longer and is often given every 2 or 3 weeks. Your schedule may be different.

Common side effects and what helps

• High blood pressure. Your team will check it often.
• Joint, bone, or muscle aches. Ask your team which pain medicine is safe.
• Fever or chills. Check your temperature and tell your team.
• Swelling in the hands, feet, or ankles. Raise your legs when you sit.
• Feeling dizzy. Stand up slowly.
• Cough. Tell your team if it is new or getting worse.
• Redness or soreness where the shot goes in. Change spots each time.

Call your care team right away if you have

• Chest pain, trouble breathing, or pain in the legs with swelling or warmth
• Signs of a stroke, like sudden weakness on one side, trouble speaking, or a drooping face
• A seizure, a very bad headache, or confusion
• Very high blood pressure if you check it at home
• Signs of an allergic reaction, like a rash all over, swelling of the face or throat, or wheezing
• A new skin rash with blisters or peeling

Before you start, tell your team

• If you have ever had a stroke, heart attack, or blood clot
• If you have high blood pressure or seizures
• Your type of cancer and the goal of your treatment
• If you are pregnant, may become pregnant, or are breastfeeding
• If you have had a reaction to these medicines before

Good to know

• In people with cancer, these medicines may raise the risk of blood clots, heart attack, and stroke, and may make some cancers grow faster or shorten life. Your team will use the lowest dose that avoids transfusions.
• These medicines should not be used when chemotherapy is being given with the goal of cure.
• You will have blood tests to check your hemoglobin. Your team may stop the medicine if it gets too high.
• Your body needs enough iron for these medicines to work. Your team will check your iron and may give you iron.
• Your blood pressure will be checked often.

At home

• If you give the shot at home, your team will show you how.
• Keep it in the refrigerator. Do not freeze or shake it.
• Put used needles in a hard sharps container.
• If you miss a dose, ask your team what to do.

Questions to ask

• Why is this medicine a good choice for me, instead of a transfusion?
• How often will my blood be checked?
• Do I need iron too?
• What blood pressure numbers should make me call?

Side effect guides

• Cough
• Pain

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.