Retacrit for Anemia: Benefits, Risks, Dosage, and Pricing

Red blood cells carry oxygen in your blood for delivery throughout your body. When you don’t have enough red blood cells, you can develop a condition called anemia. Anemia can cause symptoms such as dizziness, shortness of breath, and fatigue. If left untreated, severe anemia can become life-threatening. 

Anemia can be caused by certain conditions, such as chronic kidney disease, or by certain medications like blood thinners or acid-reflux medications. However, blood transfusions may not always be the best or most practical treatment option. That’s where medications like Retacrit can help. Retacrit helps your body produce more red blood cells, which makes it easier to manage anemia and improve symptoms. In this article, we’ll explore everything you need to know about Retacrit, including its uses, dosage, side effects, and much more.

What Is Retacrit?

Retacrit (epoetin alfa-epbx) is an FDA-approved medication used to treat anemia in certain patients. The active ingredient in Retacrit is epoetin alfa-epbx, a lab-made version of the natural protein, erythropoietin (EPO). EPO is a hormone produced mainly by the kidneys that signals the bone marrow to produce red blood cells. When your body does not produce enough EPO, your RBC count drops and you can develop anemia.

Retacrit was developed by Pfizer and was first approved by the FDA in 2018 [3]. It is a biosimilar to Epogen and Procrit. This means the medications have no clinically meaningful differences in safety or effectiveness. However, Retacrit is often less expensive than the other two products. 

What Is Retacrit Used To Treat?

Retacrit is an FDA-approved medication used to treat anemia caused by certain medical conditions and medications. The FDA has approved Retacrit for use in the following situations [1]:

Anemia Treatment: Retacrit is used to treat anemia due to:

• Chronic Kidney Disease (CKD), including patients on dialysis and those not on dialysis.
• Chemotherapy that suppresses bone marrow activity, when chemotherapy is expected to continue for at least 2 additional months. 
• Zidovudine (a medication used to treat HIV).

Reducing Blood Transfusions in Some Surgeries: Retacrit is used to reduce the frequency of blood transfusions in patients undergoing elective surgeries that are not related to the heart or blood vessels.

Retacrit is not intended for the immediate treatment of severe anemia when urgent blood transfusions are required. 

How Does Retacrit Work?

Retacrit works by replacing missing or insufficient EPO, which stimulates the bone marrow to produce more red blood cells [1]. As red blood cell levels increase, the blood can carry more oxygen throughout the body. This helps improve common anemia symptoms such as fatigue, weakness, and shortness of breath.

Side Effects

Like all medications, Retacrit may cause side effects. Some side effects are mild, while others may be serious and require immediate medical attention. Below are some common and serious side effects associated with Retacrit [1,2]: 

Common Side Effects

Common side effects include: 

• Headache and dizziness
• Fever and chills
• Pain in your bones, joints, or muscles
• Nausea and vomiting
• High blood sugar
• Itching and rash
• Trouble sleeping
• Weight loss
• Depressed mood

These side effects are usually mild and may improve as the body adjusts to the medication. However, if they persist or become worse, contact your doctor.

Severe Side Effects

In rare cases, Retacrit can also cause some serious side effects. Here are some of the serious side effects of Retacrit:

• Blood Clots: Retacrit may increase the risk of blood clots in the veins or arteries, which can lead to a heart attack or stroke. Seek immediate medical attention if you experience symptoms like chest pain, trouble breathing, sudden weakness, or swelling in your arms or legs.
• Severe Allergic Reactions: Stop using Retacrit and seek help right away if you experience symptoms of a serious allergic reaction, including difficulty breathing, rash, swelling, or a fast heartbeat.
• High Blood Pressure: Retacrit can cause or worsen high blood pressure. During treatment, your doctor may regularly monitor your blood pressure.
• Pure Red Cell Aplasia (PRCA): In rare cases, your body may stop producing red blood cells, causing severe anemia due to an immune reaction against Retacrit. This condition is called pure red cell aplasia. Contact your doctor if your anemia worsens suddenly.
• Heart Failure: Retacrit may increase your risk of heart failure. Tell your doctor right away if you experience symptoms such as shortness of breath, unusual tiredness, rapid weight gain, or swelling in your feet, ankles, or legs.

Please note that this is not a complete list of all possible side effects. Contact your healthcare provider immediately if you experience any severe side effects of Retacrit.

Dosing

Retacrit is available as a solution for injection in single-dose and multi-dose vials. The dosage of Retacrit depends on body weight, medical condition, hemoglobin levels, and response to treatment. Before starting treatment, your healthcare provider may check your iron levels and continue monitoring them during therapy. Iron supplementation may also be recommended if necessary. Also, other possible causes of anemia should be identified and treated before beginning therapy.

Recommended dosages include [1]: 

Chronic Kidney Disease (CKD): For adult patients, the usual starting dose is 50 to 100 units per kilogram of body weight given three times per week. Pediatric patients usually receive 50 units per kilogram of body weight three times weekly. The maintenance dose is adjusted individually based on the patient’s response.

HIV Patients Taking Zidovudine: The recommended dose is 100 units per kg of body weight three times weekly.

Cancer Patients Receiving Chemotherapy: Adult patients may receive 40,000 units once weekly or 150 units/kg three times weekly. Children older than 5 years may receive 600 units/kg intravenously once weekly.

Surgery Patients: The recommended dose is 300 units/kg daily for 15 days or 600 units/kg once weekly.

Before Starting Retacrit

Before starting treatment, tell your healthcare provider about your complete medical history. This helps ensure that Retacrit is safe and appropriate for you. Make sure to tell your provider if you:

• Have high blood pressure
• Have a history of heart disease or stroke
• Have seizures or epilepsy
• Have ever had an allergic reaction to epoetin alfa products

Here are some important risks that you should consider carefully before starting Retacrit treatment:

• In patients with chronic kidney disease (CKD), using Retacrit to raise hemoglobin levels above 11 g/dl may increase the risk of death, stroke, and heart problems.
• In some cancer patients, Retacrit may increase the risk of tumor growth or shorter survival. These cancers include breast, lung, head and neck, lymphoid, and cervical cancers.
• Patients undergoing surgery may have a higher risk of blood clots, so preventive treatment may be necessary. 

Cost

Retacrit is available in different strengths and vial sizes. The cost of treatment can vary depending on your weight, dosage, treatment duration, insurance coverage, and the pharmacy you visit.

The following is an example of treatment cost: Suppose your weight is 70 kg and you are prescribed a dose of 100 units/kg three times weekly. In this example, the total weekly dose would be 21,000 units. A 1 ml vial containing 2,000 units costs around $22.87 [4]. Therefore, the weekly treatment cost may exceed $240 without insurance coverage. 

Contact us if you are interested in financial assistance or copay assistance for Retacrit.