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Epoetins alfa, beta, lambda, theta, and zeta are recombinant human erythropoietins with the same pharmacological actions as endogenous erythropoietin (EPO). It is produced in the kidney and stimulates the production of red blood cells.
Like natural EPO, epoetins are glycoproteins with a sequence of about 165 amino acids. They differ from each other in their degree and type of glycosylation. Alpha is identical to natural EPO and zeta is a biosimilar to alpha.
Epoetins are indicated in anemia secondary to kidney failure, chemotherapy or other treatments and for the prevention of anemia of prematurity. They differ from each other in their degree and type of glycosylation. E. Alpha is identical to natural erythropoietin, and E. zeta is a biosimilar to E. alfa.
Subcutaneous or intravenous administration.
Since the last update we have not found any published data on its excretion in breast milk.
Its very high molecular weight makes transfer into breastmilk in clinically significant quantities unlikely.
Erythropoietin is a normal component of human milk (Lawrence 2016 p 139, 147 y 150, Juul 2000, Kling 1998).
Due to its protein nature, it is inactivated in the gastrointestinal tract, and is not absorbed, (it has virtually no oral bioavailability), which hinders or prevents its transfer from breastmilk to infant.
Plasma levels of EPO and hematocrit did not increase significantly in premature infants treated with oral epoetin (Pasha 2008, Juul 2003).
No problems have been observed in infants of mothers treated with epoetin (Makrydimas 1998).
The use of this mediation is authorized for preterm infants (Aher 2020, Ema 2007, Reiter 2000).
Experts authors and expert consensus, consider the use of this medication to be safe during breastfeeding (Hale (accessed 01.2021), Briggs 2015, Pistilli 2013).