Side Effects of Erythropoietin Shots

Erythropoietin injections (Procrit, Epogen) are used to treat anemia in patients with chronic kidney disease, cancer patients receiving chemotherapy and HIV patients taking certain medications. Erythropoietin injections, hereafter referred to as EPO, are designed to decrease the chance of these patients needing blood transfusions by helping the body generate red blood cells to increase the amount of oxygen being carried to cells. Side effects of varying degrees of severity have been reported in patients taking EPO.

Patients receiving EPO shots need to be monitored closely. Credit: Jupiterimages/Polka Dot/Getty Images

Common Side Effects

The most common side effects of EPO are relatively mild and include cough, headaches, joint and muscle pain and/or spasms, pain or redness at the injection sit, stomach discomfort, vomiting, trouble sleeping and weight loss. If these symptoms persist or become bothersome, contact your doctor.

Serious Side Effects

Formation of blood clots in various locations has been reported in those taking EPO, which, if displaced, can lead to a stroke and possibly death. EPO can also raise your blood pressure. Headaches, dizziness and seizures are neurological symptoms known to be caused by EPO. Leukopenia, or decrease in white blood cells, can compromise your immune system. Acquired pure red cell aplasia, or PRCA, has been reported to be caused by EPO in some patients. PRCA is a serious bone marrow disorder that decreases the production of red blood cells. Cancer patients taking EPO may be at additional risk. A November 2006 review in "Critical Reviews in Oncology Hematology" notes a possible link between EPO and increased cancer growth. Lung, breast and ovarian cancer were all found to have receptor sites for EPO on tumor cells, meaning that EPO could stimulate tumor growth. Your doctor will determine the best treatment plan for you based on your risk for metastasis, or spread of cancer, and hemoglobin levels.

Symptoms Requiring Immediate Medical Attention

Allergic reactions to EPO have been reported. Symptoms of an allergic reaction include hives, trouble breathing and chest tightness. Blood clots are also a risk. Leg pain or a pale or cool-feeling leg could be symptoms of a blood clot. If the clot gets loose and travels through the blood stream to the brain, it can cause a stroke. Symptoms of a stroke include sudden confusion or trouble speaking, vision loss, sudden numbness or loss of balance and loss of consciousness.


Contraindications to taking or continuing EPO include uncontrolled high blood pressure or development of pure red cell aplasia after taking EPO. The active ingredient is epoetin alfa. If you have a known allergy to epoetin alfa or other components of the injection, don't take EPO. Talk to your doctor before taking EPO if you've been diagnosed with cancer, even if you're in remission.

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