Erythropoiesis-stimulating agent (biosimilar)
Epoetin zeta
Brand names: Retacrit
Adult dose
Dose: Initial 50 units/kg 3× weekly SC/IV; titrate to Hb 100–120 g/L
Route: SC / IV
Frequency: 3× weekly
Clinical pearls
- Biosimilar of epoetin alfa; NICE TA323
- Routine substitution permitted across ESA biosimilars where local policy allows (KDIGO/NICE)
Contraindications
- Uncontrolled hypertension
- Hypersensitivity
- PRCA after ESA
Side effects
- Hypertension
- Thromboembolism
- PRCA
- Headache
- Hyperkalaemia
Interactions
- Iron deficiency reduces response
Monitoring
- Hb
- Iron status
- BP
- K+
Reference: BNF; NICE TA323; KDIGO 2012 anaemia guideline; https://bnf.nice.org.uk/drugs/epoetin-zeta/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Hyperkalaemia Management · UK Kidney Association Guidelines 2020; NICE CKD Guidelines
- Rhabdomyolysis · Renal Association 2018; UpToDate 2024
- Hypocalcaemia (Adult) · Society for Endocrinology
- SIADH (Endocrine Perspective) · European Hyponatraemia Guidelines 2014
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Acute Kidney Injury (AKI) · KDIGO 2012 / NICE AKI 2019