Epoetin beta (NeoRecormon)

How does it work?

NeoRecormon injection contains the active ingredient epoetin beta, which is a synthetic version of the naturally-occurring hormone erythropoietin. Erythropoietin is produced by healthy kidneys. It stimulates the bone marrow to produce red blood cells, which carry oxygen around the body.

Epoetin beta is used to treat anaemia in people with chronic kidney failure who are undergoing dialysis, and in people with impaired kidney function who do not yet need dialysis. These people produce very little erythropoietin as a result of their kidney disease, so the number of red blood cells in their blood is low (anaemia). When epoetin beta is injected, it stimulates the bone marrow to produce more red blood cells, and this corrects the anaemia.

Epoetin beta is also used to treat anaemia in people with certain types of cancer. It is used to treat anaemia in adults with solid tumours who are receiving platinum-based chemotherapy. It is also used to treat anaemia in people with non-Hodgkins lymphoma, bone marrow cancer (multiple myeloma) or chronic lymphocytic leukaemia who are receiving anti-tumour therapy. The increased red blood cell production stimulated by epoetin beta reduces the chances of these people needing a blood transfusion.

Premature babies born at less than 34 weeks gestation may also be given epoetin beta to stimulate the production of red blood cells and prevent the development of anaemia.

Doctors may also prescribe epoetin beta for anaemic people who are going to donate blood prior to surgery so that their own blood can be given to them during or after surgery. This is called an autologous blood pre-donation programme. Because the epoetin increases blood cell production, it means that a larger volume of blood can be taken from these people, and stored for transfusion during or after the surgery.

Your doctor may also prescribe you iron supplements while you are receiving this medicine so that the body has adequate iron stores for producing new red blood cells.

What is it used for?

  • Treating anaemia due to kidney disease
  • Treating anaemia in people with solid tumours being treated with platinum-based chemotherapy
  • Treating anaemia in people with bone marrow cancer (multiple myeloma), low-grade non-Hodgkins lymphoma or chronic lymphocytic leukaemia who are receiving chemotherapy
  • Preventing anaemia in premature babies of less than 34 weeks gestation with a birth weight of 750-1500g
  • Increasing the volume of blood that can be donated by anaemic patients due to have surgery, so they can receive transfusions of their own blood during or after the surgery

Warning!

  • All other causes of anaemia, eg vitamin B12 or folate deficiency, should be considered by your doctor and treated if necessary, before you start treatment with this medicine.
  • The number of platelets in your blood should be regularly monitored during the first eight weeks of treatment with this medicine.
  • While receiving this medicine you should also have regular blood tests to monitor the levels of salts (electrolytes such as potassium), haemoglobin and blood cells in your blood.
  • Your blood pressure should be regularly monitored while you are taking this medicine. If your blood pressure rises too high you may be prescribed a medicine to lower it.
  • Tell your doctor if you experience sudden stabbing migraine-like headaches while receiving this medicine, as this may be a possible warning sign that your blood pressure is too high.
  • If you are receiving dialysis treatment, your dialysis regimen may need adjusting while receiving this medicine. Your doctor will decide this.
  • This medicine may become less effective in people who experience severe aluminium overload due to the treatment of their kidney failure.

Use with caution in

  • People with kidney disease not yet in need of dialysis
  • High blood pressure (hypertension)
  • High platelet count (thrombocytosis)
  • Malignant disease
  • Chronic liver failure
  • Epilepsy
  • High levels of potassium in the blood (hyperkalaemia)
  • An inherited disorder of protein metabolism (phenylketonuria)

Not to be used in

  • Uncontrolled high blood pressure (hypertension)
  • People who have experienced a sudden drop in red blood cell production (pure red cell aplasia) during previous treatment with epoetin
  • Autologous blood pre-donation patients who are at risk of developing a blood clot in the veins of the leg (deep vein thrombosis), for example becuase they have a history of blood clots in the blood vessels
  • Autologous blood pre-donation patients who have had a heart attack or stroke in the last month
  • Autologous blood pre-donation patients with unstable angina

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

  • The safety of this medicine in breastfeeding and pregnancy have not been established. However, the manufacturer states that the potential risks appear to be minimal. It should be used with caution during pregnancy and breastfeeding and only if the potential benefits outweigh any potential risks. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

  • Headache
  • Rise in blood pressure
  • Cold or flu-like symptoms
  • Reactions at injection site
  • Skin reactions such as rash and itch
  • Increased numbers of platelets in the blood
  • Increased risk of blood clots in the blood vessels (thrombosis) when used for anaemia in adults receiving cancer chemotherapy
  • Dangerously high blood pressure (hypertensive crisis)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

If you are receiving haemodialysis to treat kidney failure you may need an increased dose of heparin while using this medicine. This is because epoetin increases the volume of cells in the blood and may therefore increase the risk of blood clotting in the dialysis system.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain epoetin beta as the active ingredient.