epoetin beta: clinical use

Prescribing considerations

• Correct or investigate iron, folate and vitamin B12 deficiency and other causes of inadequate response.
• Use particular caution with poor response or escalating exposure because cardiovascular and cerebrovascular risk may increase.
• Discuss transfusion alternatives and tumour-related uncertainties when treating chemotherapy-associated anaemia.
• Record the product name and batch number for biological-medicine traceability.
• Consider phenylalanine content in severe phenylketonuria and polysorbate-related allergy risk.

Contraindications and cautions

• Hypersensitivity to epoetin beta or an excipient
• Poorly controlled hypertension
• For autologous blood collection: recent myocardial infarction or stroke, unstable angina, or increased deep-vein thrombosis risk
• Do not switch patients with suspected or confirmed neutralising anti-erythropoietin antibodies to another erythropoietic protein

Monitoring

• Haemoglobin and clinical response
• Blood pressure, particularly when starting treatment
• Iron status before and during therapy
• Platelet count, particularly early in chronic kidney disease treatment and regularly in cancer
• Potassium and phosphate in renal disease
• Reticulocytes and anti-erythropoietin antibodies if haemoglobin falls paradoxically or severe anaemia develops
• Dialysis access for thrombosis where relevant

Clinical pharmacology

Recombinant human erythropoietin produced using Chinese hamster ovary cells. It stimulates erythroid progenitor proliferation and differentiation, increasing reticulocytes, erythrocytes and haemoglobin.

Formulation and product differences

• Available as ready-to-use pre-filled syringes in several strengths and fill volumes.
• The solution is preservative-free and each syringe is for single use.
• Administration may be under the skin or into a vein according to indication and clinical circumstances.
• The formulation contains phenylalanine and polysorbate 20 and is essentially sodium-free.