You currently receive a medication called EPREX, which is used to increase your blood
count. Recently, Janssen-Ortho, the manufacturers of EPREX, and Health Canada issued
a recommendation that EPREX be given intravenously rather than subcutaneously, if
This recommendation is as a result of a rare condition called pure red cell aplasia that can
develop in people using EPREX. The manufacturer suggests that the risk of developing
this condition appears to be greater when the medication is given subcutaneously as
compared to intravenously. People who develop pure red cell aplasia become
unresponsive to EPEX and become dependent on blood transfusions to maintain their
blood count. Overall, the risk of developing pure red cell aplasia is quite rare,
approximately one chance in 5000 for each year you are treated with EPREX, which is
comparable to that of developing a life threatening allergic reaction to penicillin.
A group of medical experts, organized by The Canadian Society of Nephrology, has
reviewed the information on this issue to assess the best course of action for the care of
patients. This committee felt that the scientific data did not support a change to the
intravenous administration of EPREX from the subcutaneous route of administration.
However, this expert group did recommend that physicians consider either a change from
the pre-filled syringe formulation of EPREX to the multi-dose vials of EPREX or
consider a change to an alternative medication altogether. The Canadian Society of
Nephrology will continue to monitor this issue and advise physicians of any further
changes which may improve your care.
Please speak to your nephrologist if you have any questions.