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エポエチンアルファ

Epoetin Alfa

Recombinant Human Erythropoietin (rHuEPO)

赤血球造血刺激因子製剤 / ホルモンSCIM犬猫小型哺乳類フェレット

別名: Epogen · Procrit · Eprex · NeoRecormon · rHuEPO · epoetin alfa · r-HuEPO-alpha · Epoetin beta · rhEPO · Recombinant human erythropoietin

VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス

Initially, 100 Units/kg SC 3 times weekly, until the bottom of the target hematocrit range of 37-45% is attained. Once attained, change to twice weekly. As hematocrit approaches upper target, reduce to once weekly. Maintenance generally 75-100 Units/kg SC 1-2 times weekly.SC· 3 times weekly initially· Ongoing
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用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。

動物種別用量

🌎 NA — North America🌍 EU — Europe

犬

適応用量経路頻度期間地域
Adjunctive therapy for anemia associated with endstage renal diseaseInitially, 100 Units/kg SC 3 times weekly, until the bottom of the target hematocrit range of 37-45% is attained. Once attained, change to twice weekly. As hematocrit approaches upper target, reduce to once weekly. Maintenance generally 75-100 Units/kg SC 1-2 times weekly.SC3 times weekly initiallyOngoing🌎 NA
Adjunctive therapy for anemia associated with endstage renal diseaseInitially, 48.4-145 Units/kg SC three times a week. Most dogs should be started at 97 Units/kg SC 3 times a week.SC3 times a weekOngoing🌎 NA
  • Adjunctive therapy for anemia associated with endstage renal disease: A lower initial dosage of 50-100 Units/kg 3 times weekly may be used. Iron supplementation required.
  • Adjunctive therapy for anemia associated with endstage renal disease: Monitor hematocrit weekly until target 37-45% is reached, then decrease to two times weekly. Oral iron supplements recommended.

猫

適応用量経路頻度期間地域
Adjunctive therapy for anemia associated with endstage renal diseaseInitially, 100 Units/kg SC 3 times weekly (or 48.4-145 Units/kg SC 3 times a week).SC3 times weeklyOngoing🌎 NA
Anemia associated with endstage renal disease (PCV <20%)75-100 Units/kg SC three times a week until PCV is in the low normal range (35%), then reduce dose and frequency to 50-75 Units/kg two times per week.SC3 times a week initiallyOngoing🌎 NA
Problematic clinical signs and PCV <20%Initially, 100 Units/kg SC 3 times per week.SC3 times per weekOngoing🌎 NA
  • Adjunctive therapy for anemia associated with endstage renal disease: Target hematocrit is 30-40%.
  • Anemia associated with endstage renal disease (PCV <20%): Administer iron at start of regime and until appetite is good.
  • Problematic clinical signs and PCV <20%: Provide oral supplementation with ferrous sulfate (5-50 mg per cat per day). Reduce to twice per week when target PCV (30-40%) is reached.

小型哺乳類

適応用量経路頻度期間地域
Anemia (Rabbits)50-150 Units/kg SC every 2-3 days until PVC is normal; then once weekly (q7 days) for at least 4 weeksSCevery 2-3 days initiallyat least 4 weeks maintenance🌎 NA

フェレット

適応用量経路頻度期間地域
Anemia50-150 Units/kg IM 3 times weekly; may decrease to once weekly if RBC indices are significantly improvedIM3 times weeklyOngoing🌎 NA

用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。

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概要

エポエチンアルファは組換えヒトエリスロポエチン（rHuEPO）であり、主に犬や猫の慢性腎不全に伴う非再生性貧血の治療に使用されます。獣医療では自己抗体が形成されるリスクが高く（20〜70％）、重篤な難治性貧血を引き起こす可能性があるため、通常は「最終手段」と見なされます。治療中は通常、鉄分の補給が必要です。

作用機序

Erythropoietin is an endogenous hormone primarily produced by the kidneys that regulates erythropoiesis.

  • ​Receptor Binding:​ Epoetin alfa binds to erythropoietin receptors on the surface of committed erythroid progenitor cells in the bone marrow.
  • ​Proliferation & Differentiation:​ This binding activates intracellular signaling pathways (such as JAK2/STAT5) → stimulates the survival, proliferation, and differentiation of red cell precursors.
  • ​Reticulocyte Release:​ It also accelerates the release of reticulocytes from the bone marrow into the systemic circulation, ultimately increasing the hematocrit and hemoglobin levels.

安全性・警告

禁忌

  • Uncontrolled hypertension
  • Hypersensitivity to epoetin alfa
  • Formation of significant autoantibodies with prior treatment
  • Equines (not recommended for use)

有害事象

  • Autoantibody formation (leading to refractory anemia)
  • Systemic hypertension
  • Vomiting
  • Seizures
  • Uveitis
  • Iron depletion
  • Local reactions at injection sites
  • Fever
  • Arthralgia
  • Mucocutaneous ulcers
  • Polycythemia (with chronic overdosage)

注意事項

Therapy should be started with caution or withheld until corrected in animals with moderate to severe hypertension or iron deficiency.

​Autoantibody Risk:​ Up to 30% of patients may develop antibodies significant enough to cause profound anemia and arrestment of erythropoiesis. A bone marrow aspirate showing a myeloid:erythroid ratio >6 predicts significant autoantibody formation and contraindicates further therapy. Discontinue therapy if polycythemia, fever, anorexia, joint pain, cellulitis, or cutaneous/mucosal ulceration occurs.

医薬品相互作用

Androgens

May increase the sensitivity of erythroid progenitors; safety of this combination is not fully determined.

Desmopressin

Concurrent use with EPO can decrease bleeding times.

Probenecid

Has been demonstrated to reduce the renal tubular excretion of EPO; clinical significance remains unclear.

Iron supplementsMinor

Synergistic/Required; EPO increases demand for iron to synthesize hemoglobin for new RBCs

監視

  • Hematocrit / PCV (weekly to every other week initially, then every 1-2 months)
  • Blood Pressure (at least monthly initially)
  • Renal Function Status
  • Iron status (serum iron, TIBC)
  • RBC indices

薬物動態

吸収

Absorbed only after parenteral administration.

分布

It is unclear whether the drug crosses the placenta or enters milk.

代謝

The drug's metabolic fate is unknown.

消失

In patients with chronic renal failure, half-lives are prolonged approximately 20% over those with normal renal function.

過剰投与

Acute overdoses appear to be relatively free of adverse effects. Single doses of up to 1600 Units/kg in humans demonstrated no signs of toxicity.

Chronic overdoses may lead to polycythemia or other adverse effects. Cautious phlebotomy may be employed should polycythemia occur.

製品

製剤

  • Solution for Injection

ヒト用医薬品

  • Epoetin Alfa Solution for Injection: 2000 Units/mL, 3000 Units/mL, 4000 Units/mL, 10,000 Units/mL, 20,000 Units/mL and 40,000 Units/mL in single-dose and multidose vials (Epogen®, Procrit®)

規制ステータス

European Union✓ 承認済み処方箋医薬品EMA

POM (Prescription Only Medicine). Approved for human use, used off-label in veterinary medicine.

United Kingdom✓ 承認済み処方箋医薬品VMD

POM (Prescription Only Medicine). Approved for human use, used off-label in veterinary medicine.

規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

保管・安定性

Store in the refrigerator (2-8°C); do not freeze. Do not shake the solution as denaturation of the protein with resultant loss of activity may occur. Protect from light. Because the solution contains no preservatives, the manufacturer recommends using each vial only as a single use.

飼主向け情報

自宅で注射する場合は、獣医療チームから適切な皮下注射の訓練を受ける必要があります。​冷蔵庫（2〜8°C）で保管し、絶対に冷凍したり振ったりしないでください​（振るとタンパク質が変性します）。治療中は定期的に通院し、PCV、血圧、鉄分の状態をモニタリングする必要があります。ペットに異常な疲労感、脱力感、食欲不振が見られた場合は、自己抗体形成のサインである可能性があるため、すぐに獣医師に連絡してください。

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