When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to methoxy polyethylene glycol-epoetin beta.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin or into a vein.
• 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.
• If the medicine in the syringe has changed color, or if you see something floating in it, do not use it. Do not save any leftover medicine from an open syringe. Use each syringe only 1 time.
• 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. Keep it in the original package until you are ready to use it. Protect it from light. Do not shake the medicine. If necessary, you may store it at room temperature for up to 30 days.
• 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, or if you have cancer, heart failure, heart or blood vessel disease, high blood pressure, or a history of seizures, stroke, or blood clots. Tell your doctor if you had pure red cell aplasia (PRCA) after receiving an erythropoietin protein medicine.
• This medicine may cause the following problems:
  
  • Increased risk of blood clots, heart failure, heart attack, or stroke
  • High blood pressure
  • Seizures
  • Serious allergic reactions
• Tell any doctor or dentist who treats you that you are using this medicine. Your doctor may want you to take a blood thinner to prevent blood clots during or after surgery.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments. You may also need to monitor your blood pressure at home.
• 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 to your arms, jaw, back, or neck, trouble breathing, nausea, unusual sweating
• Lightheadedness, dizziness, or fainting
• Numbness or weakness on one side of your body, pain or swelling in your lower leg, sudden or severe headache, problems with vision, speech, or walking
• Seizures
• Swelling in your hands, ankles, or feet

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

• Back or muscle pain
• Diarrhea or vomiting
• Mild headache

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