roxadustat at a glance
Medicine class
HIF prolyl-hydroxylase inhibitor and anti-anaemic treatment
Licensed use
Symptomatic anaemia associated with chronic kidney disease in adults
Form
Film-coated tablets taken by mouth
Food
May be taken with or without food
What is roxadustat used for?
Roxadustat is licensed for:
Treatment of adults with symptomatic anaemia associated with chronic kidney disease, whether or not they receive dialysis.
How does roxadustat work?
Roxadustat reversibly blocks HIF prolyl-hydroxylase enzymes, stabilising the body's low-oxygen response pathway. This increases natural erythropoietin signalling, improves iron transport and lowers hepcidin, helping the bone marrow produce red blood cells and haemoglobin.
roxadustat preparations and strengths
Tablet
Route: Oral
Strengths: 150 mg
How to take roxadustat
Take roxadustat as directed by the renal or anaemia team.
Swallow tablets whole; do not chew, break or crush them.
Take with or without food.
Take roxadustat at least one hour after phosphate binders, except lanthanum, or products containing calcium, iron, magnesium or aluminium.
roxadustat side effects
Common or expected effects
- High blood pressure
- Raised blood potassium
- Diarrhoea or nausea
- Swelling of the ankles or limbs
- Headache, difficulty sleeping, constipation or vomiting
- Thrombosis of a haemodialysis vascular access
- Reduced platelet count
Get urgent medical advice
- Blood clot symptoms, including a painful swollen leg, sudden chest pain or breathlessness
- Stroke symptoms
- Seizure
- Sepsis or another serious infection
- Unexplained or prolonged bleeding, blood in urine or stools, or widespread pinpoint bruising
- Widespread redness, pain or peeling of the skin
roxadustat in pregnancy
Roxadustat should not be started during pregnancy or when pregnancy is planned. It is not recommended in the first and second trimesters and is contraindicated in the third trimester. Anyone who becomes pregnant while taking it should contact their specialist promptly; effective contraception is required during treatment and for at least one week afterwards.
roxadustat while breastfeeding
Roxadustat is contraindicated while breastfeeding. It is unknown whether it enters human milk, although transfer into milk occurred in animal studies; discuss an alternative treatment or feeding plan with the specialist team.
roxadustat interactions
Tell the renal team and pharmacist about prescribed, over-the-counter and complementary products. Important interactions include:
Phosphate binders and calcium, iron, magnesium or aluminium products
These can reduce roxadustat absorption. Take roxadustat at least one hour afterwards; this restriction does not apply to lanthanum.
Gemfibrozil, probenecid and strong CYP2C8 or UGT1A9 modifiers
These may alter roxadustat exposure, requiring closer haemoglobin monitoring and clinical review.
Statins, including simvastatin, atorvastatin and rosuvastatin
Roxadustat can increase statin exposure and adverse-effect risk; statin monitoring and adjustment may be needed.
Common questions about roxadustat
Answers are fully visible for fast scanning and source review.
What is roxadustat used for?
It is licensed for symptomatic anaemia associated with chronic kidney disease in adults.
Is roxadustat the same as erythropoietin?
No. It is an oral HIF prolyl-hydroxylase inhibitor that stimulates the body's low-oxygen response, including endogenous erythropoietin production and improved iron availability.
Can roxadustat be taken with food?
Yes. Food may reduce the peak concentration but does not meaningfully change overall exposure.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.