Darbepoetin Alfa (Generic Name) 

Other names: Aranesp®

It is UPMC policy to give each patient receiving this drug a copy of the Amgen medication guide for Aranesp®. Download the medication guide here. (PDF)

About this drug

Darbepoetin alfa is used to treat anemia. It helps your body make more red blood cells. It is given in the vein (IV) or by a shot under your skin (injection).

Possible side effects (more common)

  • Swelling (fluid retention) in the arms, legs, ankles, and/or feet
  • Abdominal pain
  • High blood pressure. Your doctor will check your blood pressure as needed.
  • Skin and tissue irritation. You may have redness, pain, warmth, or swelling where you got the shot
  • Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue (low energy, feeling weak)

Possible side effects (less common)

  • Rash
  • Chills
  • Feeling your heart beat fast (palpitations)
  • Trouble breathing or feeling short of breath
  • Nausea and throwing up (vomiting). These symptoms may happen within a few hours after your treatment and may last up to 24 hours. Medicines are available to stop or lessen these side effects.
  • Heart problems. If you are treated with darbepoetin alfa to a hemoglobin level above 12 g/dL, you may get serious heart problems such as heart attack, stroke, or heart failure, which could result in death. Your hemoglobin levels will be checked to make sure they are in the right range to try to stop this problem from happening.
  • Blood clots. You may get blood clots at any time while taking darbepoetin alfa. A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause trouble breathing, pain when breathing, and/or chest pain.
  • Seizures
  • Antibodies to darbepoetin alfa. Your body may make antibodies to darbepoetin alfa. These antibodies can block or lessen your body’s ability to make red blood cells and can cause you to have severe anemia. This is very rare.

Important information

Your tumor may grow faster and you may die sooner if darbepoetin alfa is used as an experiment to try to raise your hemoglobin above the level needed to avoid red blood cell transfusion, or when it is given to patients who are not getting strong doses of chemotherapy. It is not known if these risks exist when darbepoetin alfa is given according to the FDA-approved directions for use. UPMC guidelines call for checking your hemoglobin levels to keep them in the right range.

Treating side effects

  • Ask your doctor or nurse about medicines that can to stop or lessen fever, headache, nausea, throwing up, loose bowel movements, muscle and joint aches, pain or rash where you got the shot.
  • Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid). 
  • Do not put anything on your rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.

Other instructions

  • If you have high blood pressure, it may become worse when you take this drug. Be sure to keep taking your blood pressure medicine and follow any diet your doctor prescribed.
  • You will be enrolled in a special program called REMS ESA APPRISE. Your doctor or nurse will give you more information about this.

Food and drug interactions

There are no known interactions of darbepoetin alfa with food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

Allergic reactions

  • Allergic reactions including anaphylaxis are rare but may happen in some patients. While you are getting this drug by IV, tell your nurse right away if you have any of these symptoms of an allergic reaction:
    Trouble breathing or feeling short of breath
  • Rash or itching
  • Feeling dizzy or lightheaded
  • Feeling your heart beat quickly (palpitations)

If you are getting this drug as a shot under the skin and have any of the symptoms listed above after the shot be sure to tell your doctor or nurse right away.

When to call the doctor

Call your doctor or nurse right away if you have any of these symptoms:

  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Nausea that stops you from eating or drinking
  • Rash
  • Fainting (loss of consciousness)
  • Sudden numbness or weakness in the face, arm, or leg, especially on one side of your body
  • Trouble seeing
  • Trouble walking
  • Loss of balance or coordination
  • Throwing up  more than three times in one day
  • Feeling dizzy or lightheaded
  • Hallucinations (seeing or hearing things that are not there) or sudden confusion
  • Trouble speaking or trouble understanding others’ speech
  • Seizures
  • Severe headache
  • Trouble breathing or feeling short of breath
  • Chest pain
  • Pain, cramping, swelling, redness, or warmth in an arm or leg
  • A cool or pale arm or leg

Call your doctor or nurse as soon as possible if you have any of these symptoms:

  • Nausea, throwing up, or loose bowel movements that are not relieved by prescribed medicines
  • Swelling in the legs, feet, or ankles
  • Headache that prescribed medicine doesn’t help
  • Extreme tiredness that interferes with normal activities
  • Five or six loose bowel movements in one day or weakness from too many loose bowel movements
  • Rash that does not get better with prescribed medicines
  • Pain at the injection site

Sexual problems and reproductive concerns

  • Infertility Warning: Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your treatment. Talk with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
    • In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.
    • In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.
    • Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.
    • Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.
  • Pregnancy warning: It is not known if this drug may harm an unborn child.  For this reason, be sure to talk with your doctor if you are pregnant or planning to become pregnant while getting this drug.
  • Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

Revised July 2014

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