Why Your Oncologist Might Prescribe Procrit or Aranesp During Chemo

Drugs Used to Treat Chemotherapy-Induced Anemia

A syringe and two vials of chemotherapy drugs
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While undergoing chemotherapy, you will be monitored and screened for any complications. One common test is a Complete Blood Count (CBC), which gives your doctor important information about the kinds and quantities of cells in your blood. If your CBC test shows that your red blood cell count is low, you may be anemic.

The Link Between Breast Cancer, Chemotherapy, and Anemia

Anemia can make fighting breast cancer even harder on you; you may feel especially weak, faint, dizzy or exhausted. You might bruise more easily or have frequent nosebleeds. Anemia can weaken your body and immune system, making it more difficult for your body to fight off disease and infection.

If your doctor finds you have anemia as a result of chemotherapy, he may prescribe you medications to help you produce more red blood cells. Aranesp (darbepoetin alfa) and Procrit (epoetin alfa) are two of the most common drugs used for this purpose. Delivered either by injection or through an intravenous infusion (IV), they can boost your red blood cell production and potentially help you avoid needing a blood transfusion.

How These Drugs Work as Red Blood Cell Boosters

Blood is made in your bone marrow, the soft, spongy tissue in the core of your bones. Bone marrow cells are fast-dividing cells, which are affected by chemotherapy. Fewer bone marrow cells mean fewer blood cells. Your CBC may reveal that your red blood counts are low, and you are anemic. Usually, your kidneys produce erythropoietin, a protein that stimulates the production of red blood cells.

But during chemo for breast cancer, your kidneys may not make enough erythropoietin. Procrit and Aranesp are man-made substitutes for erythropoietin, and the proper dose of this drug will boost production of your red blood cells.

Side Effects of Procrit

Procrit is a very safe drug, and most patients do not experience side effects. Some patients may develop a fever. You have a less than 22% chance of having these reactions:

  • Diarrhea
  • Nausea
  • Vomiting
  • Fluid retention (edema)
  • Fatigue

Call Your Doctor if You Have These Symptoms:

  • Allergic reaction (hives, problems breathing, swelling of face, lips, tongue or throat)
  • Chest pain
  • Shortness of breath
  • Sudden feeling of numbness or weakness (especially asymmetrical)
  • Pain or swelling in your legs, feet, or ankles
  • High blood pressure
  • Light-headedness (dizzy, faint)

Side Effects of Aranesp

Aranesp does have serious side effects, so be sure to discuss possible risks with your doctor. He will work with you to determine the lowest possible dose to control your blood cell count while managing potential risks. In patients with breast cancer, the tumor can grow faster and there is the potential of dying sooner if you take Aranesp. 

It can cause serious heart issues, including heart attack, heart failure, and stroke. Blood clots have also been reported while undergoing treatment with Aranesp. Call your healthcare provider right away if you have any of these symptoms:

  • Chest pain
  • Trouble breathing or shortness of breath
  • Pain or swelling in your legs
  • A cool or pale arm or leg
  • Sudden confusion, trouble speaking or difficulty understanding others
  • Weakness in your face, arms, legs or on one side of your body
  • Sudden trouble seeing
  • Sudden trouble walking
  • Loss of consciousness

Aranesp has other serious side effects, including high blood pressure, seizures, antibodies to Aranesp, meaning your body can block Aranesp and aggravate anemia and serious allergic reactions. 

Recommendations During Treatment

Before your first Aranesp or Procrit treatment, your doctor will order a CBC to get the levels of your red blood cells, hemoglobinhematocrit, and iron. As treatment progresses, you will have more blood tests to check the effectiveness of the drug and to be sure you are getting the right dose.

Before beginning any treatment, talk to your doctor about your need and potential risks and side effects. 

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Article Sources

  • "Araspen Labeling Revision." FDA Postmarket Drug Safety Information for Patients and Doctors, 2013.  
  • Food & Drug Administration. "Procrit Prescribing Information," Revised 2013. 
  • Muller, R., Baribeault, D. "Extended-dosage-interval regimens of erythropoietic agents in chemotherapy-induced anemia". American Journal of Health-System Pharmacy, 2007, 2547-2556.