Erythropoiesis-Stimulating Agents

Renal & Urinary

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Examples

epoetin alfadarbepoetin alfa

Prefix / Suffix: -poetin

Physiology

Diseased kidneys produce less erythropoietin, leading to decreased red blood cell production and anemia. ESAs stimulate the bone marrow to make red blood cells.

Mechanism of Action

They act like erythropoietin and stimulate erythroid progenitor cells in bone marrow to increase RBC production.

Indications

Anemia of chronic kidney disease
Anemia related to some chemotherapy regimens
Reduction of transfusion needs in selected patients

Side Effects / Adverse Effects

Hypertension
Thromboembolism
Headache
Seizures rarely with rapid hemoglobin rise
Injection-site reaction

Contraindications

Uncontrolled hypertension
Pure red cell aplasia after ESA use
Use caution with active malignancy depending on goals
Hypersensitivity

Nursing Considerations

Monitor hemoglobin/hematocrit and avoid overly rapid rise
Check blood pressure before administration
Ensure iron stores are adequate for response
Teach that effects take weeks, not hours
Monitor for clot symptoms such as chest pain, shortness of breath, or leg swelling

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.