Epoetin alfa nausea

Epoetin alfa (erythropoietin EPO) and darbepoetin alfa are usually well tolerated. The most common adverse reactions include hypertension, headache, tachycardia, nausea, vomiting, diarrhea, skin rashes, fever, myalgia, and skin reaction at tlie injection site. See the Summary Drug Table Drug Used in the Treatment of Anemia for more information on these drug. 

CRF patients - Epoetin alfa is generally well tolerated. The following adverse reactions are frequent (greater than 3%) sequelae of CRF and are not necessarily due to epoetin alfa therapy hypertension, headache, arthralgia, nausea, edema, fatigue, diarrhea, vomiting, chest pain, asthenia, dizziness, skin reaction, and clotted vascular access. 

Both epoetin alfa and beta and darbepoetin alfa are quite well tolerated (47). Common adverse effects are infection, hypertension, hypotension, shunt thrombosis, myalgia, nausea, headache, and chest pain (34,48). After the first few doses of epoetin, flu-like sjmptoms occur transiently, with an incidence of 5.4-18% (34,49). These can be avoided by injecting epoetin subcutaneously rather than intravenously (31,33,50,51). It has also been suggested that such symptoms can be avoided by dose escalation, starting with an ultra-low dose (49). Subcutaneous injection can cause local reactions, probably due to allergy (52). 

The most frequently reported adverse events are headache, polycythemia, tiredness, common cold, diarrhea, nausea, stomach pains, chest pressure sensation, back pain, leg pain, and dizziness, as confirmed in a phase I open bioequivalence parallel group study of two recombinant human epoetin alfa products the pattern of the adverse events revealed no relevant differences between the erythropoietin derivatives [95 ]. Patients who were randomized to early intervention with immediate epoetin alfa (n = 68) or to standard intervention with epoetin alfa (n = 68), and a further 50 who were not randomized, pain, injection-site pain, bone pain, and deep vein thrombosis were observed [96 ]. 

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