Meta Information
ID:erythropoietin
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/condition/uncontrolled-hypertension
Target name:
Uncontrolled Hypertension
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Erythropoietin can cause or worsen high blood pressure by increasing blood viscosity and through direct effects on blood vessels.
Actionable advice:
Do not use if blood pressure is not well-controlled; monitor blood pressure closely during treatment.
Target id:
/condition/history-of-thrombosis
Target name:
History of Stroke, Heart Attack, or Blood Clots
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Erythropoietin increases red blood cell count, which thickens the blood and significantly raises the risk of serious cardiovascular and thromboembolic events.
Actionable advice:
Avoid use if you have a history of blood clots, stroke, or heart attack, unless under strict medical supervision for a critical indication.
Target id:
/condition/active-malignancy
Target name:
Active Cancer
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Some tumors have erythropoietin receptors, and stimulating them may promote tumor growth and worsen outcomes, particularly in certain cancers.
Actionable advice:
Avoid use in the presence of active cancer unless for palliative care of chemotherapy-induced anemia under an oncologist's direction.
Target id:
/condition/pure-red-cell-aplasia
Target name:
History of Pure Red Cell Aplasia (PRCA)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
A history of antibody-mediated PRCA due to any erythropoietin product is a contraindication, as re-exposure will likely trigger a severe anemic response.
Actionable advice:
Never use if you have a history of PRCA caused by an erythropoiesis-stimulating agent.
Target id:
/biomarker/iron-panel
Target name:
Adequate Iron Stores
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Erythropoietin stimulates red blood cell production, a process that requires significant amounts of iron; without adequate iron, the response will be blunted or absent.
Actionable advice:
Ensure iron levels (ferritin and transferrin saturation) are adequate before starting and throughout therapy; supplement with iron as needed.
Target id:
/biomarker/hemoglobin-target-level
Target name:
Target Hemoglobin Level (e.g., >11-12 g/dL)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Raising hemoglobin too high or too quickly increases blood viscosity and the risk of hypertension, stroke, and heart attack.
Actionable advice:
Monitor hemoglobin levels regularly and adjust the dose to avoid exceeding the target range (typically 10-12 g/dL).
Target id:
/condition/healthy-individual
Target name:
Healthy Individuals (Off-Label Use)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
In healthy individuals without anemia, using erythropoietin (blood doping) dangerously thickens the blood, severely increasing the risk of stroke, heart attack, and pulmonary embolism.
Actionable advice:
Do not use erythropoietin for performance enhancement or unproven longevity benefits due to life-threatening risks.
Target id:
/procedure/major-surgery
Target name:
Major Surgery
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The increased risk of blood clots from erythropoietin is compounded by the immobility and inflammatory state associated with major surgery.
Actionable advice:
Discontinue use well before major elective surgery and ensure appropriate DVT prophylaxis is in place if use is unavoidable.
Target id:
/intervention/lenalidomide
Target name:
Lenalidomide
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Both lenalidomide and erythropoietin independently increase the risk of blood clots; using them together significantly elevates this risk.
Actionable advice:
Avoid concurrent use unless absolutely necessary and with appropriate thromboprophylaxis under medical supervision.
Target id:
/biomarker/vitamin-b12
Target name:
Adequate Vitamin B12 Levels
Severity:
moderate
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Vitamin B12 is a crucial cofactor for DNA synthesis in new red blood cells; deficiency can limit the effectiveness of erythropoietin therapy.
Actionable advice:
Check Vitamin B12 levels and correct any deficiency before or during treatment.
Target id:
/intervention/folate
Target name:
Adequate Folate (Vitamin B9) Levels
Severity:
moderate
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Folate (Vitamin B9) is essential for the production of new red blood cells, and a deficiency will impair the body's response to erythropoietin.
Actionable advice:
Ensure adequate folate status through diet or supplementation during therapy.
Target id:
/class/ace-inhibitors
Target name:
ACE Inhibitors
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
ACE inhibitors can suppress the production of red blood cells (erythropoiesis), potentially blunting the therapeutic effect of exogenous erythropoietin.
Actionable advice:
Be aware that a higher dose of erythropoietin may be needed if you are also taking an ACE inhibitor.
Target id:
/class/arbs
Target name:
Angiotensin II Receptor Blockers (ARBs)
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
ARBs can suppress erythropoiesis, similar to ACE inhibitors, potentially reducing the effectiveness of erythropoietin treatment.
Actionable advice:
Monitor hemoglobin response closely, as a higher erythropoietin dose may be required when taking an ARB.
Target id:
/condition/seizure-disorder
Target name:
Seizure Disorder / Epilepsy
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Seizures have been reported in patients receiving erythropoietin, possibly related to a rapid rise in blood pressure or hematocrit.
Actionable advice:
Use with caution in patients with a history of seizures and monitor closely for any neurological changes.
Target id:
/condition/inflammation-infection
Target name:
Active Inflammation or Infection
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Inflammatory states increase hepcidin levels, which blocks iron release and absorption, leading to a poor response to erythropoietin (functional iron deficiency).
Actionable advice:
Address the underlying cause of inflammation or infection to improve the effectiveness of erythropoietin therapy.
Target id:
/class/androgens
Target name:
Androgens (e.g., Testosterone)
Severity:
moderate
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Androgens can stimulate the bone marrow to produce more red blood cells, potentially enhancing the effect of erythropoietin.
Actionable advice:
Monitor hemoglobin levels carefully, as the dose of erythropoietin may need to be reduced when co-administered with androgens.
Target id:
/biomarker/serum-potassium
Target name:
Serum Potassium
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Erythropoietin can occasionally cause an increase in serum potassium levels, particularly in patients with kidney disease.
Actionable advice:
Monitor potassium levels periodically during therapy, especially in patients with renal impairment.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
There is limited data on the safety of erythropoietin in human pregnancy; it should only be used if the potential benefit justifies the potential risk to the fetus.
Actionable advice:
Use during pregnancy only under strict medical guidance when clearly needed.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
It is unknown whether erythropoietin is excreted in human milk, and caution should be exercised when administering to a nursing woman.
Actionable advice:
Discuss the risks and benefits with a healthcare provider before using while breastfeeding.
Target id:
/condition/renal-impairment
Target name:
Renal Impairment
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Erythropoietin is a primary treatment for anemia caused by chronic kidney disease, as the kidneys are the main site of natural EPO production.
Actionable advice:
Use is indicated for anemia of CKD, but requires careful dose titration and monitoring of hemoglobin, iron, and blood pressure.
Target id:
/class/antacids
Target name:
Aluminum-Containing Antacids
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
High doses of aluminum-containing products, sometimes used as phosphate binders in renal disease, can potentially interfere with iron utilization and blunt the response to erythropoietin.
Actionable advice:
If taking aluminum-based binders, ensure iron status is closely monitored and consider alternative phosphate binders if EPO response is poor.