Epoetin beta

How it works

As an analogue of endogenous erythropoietin, it binds erythropoietin receptors on bone marrow erythroid progenitors, promoting red cell production.

Prescribing in practice

• Avoid overcorrecting haemoglobin, as targeting normal or high levels raises the risk of thromboembolic and cardiovascular events; use the lowest level that avoids transfusion.
• Correct functional or absolute iron deficiency and ensure adequate folate and B12 to support an effective response.
• Monitor for new or worsening hypertension, which may require dose adjustment or antihypertensive treatment.

Monitoring

Monitor haemoglobin, blood pressure and iron status regularly, titrating the dose to maintain the target haemoglobin range.

Counselling the patient

• Keep appointments for blood monitoring so dosing stays in the safe range.
• Report severe headache, visual symptoms or possible clot symptoms without delay.
• Continue any prescribed iron supplementation as advised.

Evidence & guidelines

NICE recommends erythropoiesis-stimulating agents for anaemia of chronic kidney disease, emphasising conservative haemoglobin targets.