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Erythropoiesis-stimulating agent (biosimilar)

Epoetin zeta

Brand names: Retacrit

Epoetin zeta is a biosimilar recombinant human erythropoietin (an erythropoiesis-stimulating agent) used to treat anaemia of chronic kidney disease and other indicated anaemias.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It acts like endogenous erythropoietin, binding erythropoietin receptors on erythroid progenitor cells to stimulate red blood cell formation in the bone marrow.

Prescribing in practice

  • Avoid aiming for a normal or high haemoglobin, as overcorrection increases thrombotic and cardiovascular risk; target the lowest level that avoids transfusion.
  • Ensure adequate iron, folate and B12 stores, since deficiency commonly blunts the response.
  • Watch for rising blood pressure, which can develop or worsen during treatment.

Monitoring

Monitor haemoglobin, blood pressure and iron indices regularly and adjust the dose to keep haemoglobin within the target range.

Counselling the patient

  • Attend regular blood tests so the dose can be optimised.
  • Report severe headache, visual disturbance or symptoms suggesting a clot urgently.
  • Maintain prescribed iron intake to help the medicine work effectively.

Evidence & guidelines

Biosimilar epoetins are supported by comparability data and NICE guidance favouring conservative haemoglobin targets in renal anaemia.

Reference: NICE TA323; KDIGO 2012 anaemia guideline; Confirm identity and dosing against the manufacturer SPC (eMC) and NICE. Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Pathways