When This Medicine Should Not Be Used:
This medicine is not right for everyone. You should not receive it if you had an allergic reaction to epoetin alfa or if you had pure red cell aplasia after receiving epoetin alfa or similar medicines.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given as a shot under your skin or into a vein through a dialysis port.
• A nurse or other health provider will give you this medicine.
• You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
• Do not shake the medicine. Do not use the medicine if it is cloudy or discolored, or has particles in it.
• You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.
• Use a new needle and syringe each time you inject your medicine.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Call your doctor or pharmacist for instructions.
• If you store this medicine at home, keep it in the refrigerator. Do not freeze.
• Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding. This medicine contains benzyl alcohol, which can be harmful to infants and unborn babies.
• Tell your doctor if you have heart failure, heart disease, high blood pressure, kidney disease, or history of cancer, blood clots, or seizures. Also tell your doctor if you are scheduled for any type of surgery.
• This medicine may cause the following problems:
  
  • Serious heart and blood vessel problems, including heart attack, heart failure, stroke, and blood clots
  • For cancer patients, increased risk of the cancer worsening or coming back
  • Seizures
  • High blood pressure
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments. Your doctor will also monitor your blood pressure.
• This medicine is made from donated human blood. All donated blood is tested for certain viruses. Although your risk for getting a virus from the medicine is very low, talk with your doctor if you have concerns.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain that may spread, trouble breathing, nausea, unusual sweating, fainting
• Fever, chills, cough, stuffy or runny nose, sore throat
• Numbness or weakness on one side of your body, sudden or severe headache, problems with vision, speech, or walking
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet
• Pain or swelling in your lower leg (calf)
• Seizures
• Rapid weight gain, swelling in your hands, ankles, or feet
• Unusual bleeding, bruising, tiredness, or weakness

If you notice these less serious side effects, talk with your doctor:

• Nausea, vomiting
• Muscle or joint pain
• Pain, itching, burning, or swelling where the shot is given

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088