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 produce more red blood cells. It is given intravenously or by injection under your skin (subcutaneously).

Possible side effects (More Common)

  • Swelling (fluid retention) in the arms, legs, ankles, and/or feet
  • Diarrhea
  • Skin and tissue irritation. You may have redness, pain, warmth, or swelling at the injection site.
  • Flu-like symptoms: fever, headache, muscle and joint aches, and fatigue

Possible side effects (Less Common)

  • Rash
  • Chills
  • Feeling your heart beat fast (palpitations)
  • Shortness of breath
  • Nausea and vomiting. These symptoms may occur within several hours after you receive the drug and may last up to 24 hours. Drugs are available to prevent and 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, and you may die sooner. UPMC guidelines call for monitoring your hemoglobin levels to keep them in the appropriate range.
  • Blood clots. You may get blood clots at any time while taking darbepoetin alfa. If you are receiving darbepoetin alfa and you are going to have surgery, talk to your health care provider about whether or not you need to take a blood thinner to lessen the chance of blood clots during surgery. Clots can form in blood vessels (veins), especially in your leg. This is called DVT, or deep venous thrombosis. Pieces of a blood clot may travel to the lungs and block the blood circulation in the lungs. This is called a pulmonary embolus.
  • 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 extremely rare.

Important Information

Your tumor may grow faster and you may die sooner if darbepoetin alfa is used experimentally to try to raise your hemoglobin beyond the amount 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 whether these risks exist when darbepoetin alfa is given according to the FDA-approved directions for use. UPMC guidelines call for monitoring your hemoglobin levels to keep them in the appropriate range.

Sexual Problems and Reproductive concerns

  • In men and women both, this drug may temporarily or permanently affect your ability to have children. This cannot be determined before your therapy. 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 receiving this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period. Women may experience signs of menopause like vaginal dryness or itching.
    • Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.
    • Speak with your doctor or nurse if you plan to have children.  Ask for information on sperm or egg banking.
    • Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred. 
    • Breast feeding warning: It is not known if this drug passes into breast milk.  For this reason, women are advised to discuss with their doctor the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and seriously harm a breast feeding infant.

Treating side effects

  • Ask your doctor or nurse about medicine that is available to help prevent or lessen nausea, vomiting, diarrhea, injection site pain, and rash.
  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated. 
  • 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 medication if your rash is bothersome.

Other Instructions 

  • If you have high blood pressure, it may become worse when you take this drug. Be sure to continue to take 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 medicine. Tell your  doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs, and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly 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 advice.

Allergic Reactions

Allergic reactions including anaphylaxis are rare but may occur in some patients. 

While you are receiving this drug by IV, tell your nurse immediately if you have any of the following symptoms of an allergic reaction:

  • Shortness of breath
  • Rash or itching
  • Dizziness or lightheadedness
  • Feeling your heart beat rapidly (palpitations)

If you are receiving this drug by injection and experience any of the symptoms listed above after an injection be sure to tell your doctor or nurse right away.

When to call the doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Uncontrolled nausea that prevents 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
  • Vomiting more than three times in one day
  • Dizziness or light-headedness
  • Hallucinations or sudden confusion
  • Trouble speaking or trouble understanding others’ speech
  • Seizures
  • Severe headache
  • Shortness 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 the following symptoms:

  • Nausea, vomiting, or diarrhea unrelieved by prescribed medicine
  • Swelling in the legs, feet, or ankles
  • Headache that prescribed medicine doesn’t help
  • EXtreme tiredness that interferes with normal activities
  • Diarrhea of five or six stools in one day or diarrhea with weakness
  • Rash that does not get better with prescribed medicines
  • Pain at the injection site

Revised November 2011

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