Care During Chemotherapy and Beyond

Aranesp ®

Generic Name: Darbepoetin Alfa

Drug Type:

Aranesp is a biologic response modifier. It is an erythropoiesis stimulating protein. (For more detail, see "How Aranesp Works" section below).

What Aranesp Is Used For:

  • Aranesp is a support medication. It does not treat cancer. 
  • Aranesp is used to treat anemia caused by chemotherapy cancer treatment. 
  • Aranesp is not indicated for patients with myeloid cancers (cancers that originate in the bone marrow such as leukemia). 
  • Aranesp is not appropriate for the treatment of anemia from other causes such as iron or folate deficiency or gastrointestinal bleeding.  Aranesp is not a substitute for blood transfusion.

Note:  If Aranesp has been approved for one use, physicians may elect to use Aranesp for other problems if they believe it may be helpful.

How Aranesp Is Given:

  • Aranesp may be given by subcutaneous (layer of tissue between the skin and the muscle) injection into the arm, abdomen or thigh.  
  • Aranesp may also be given by infusion into a vein (intravenously, IV).
  • The amount of Aranesp that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated.  Your doctor will determine your dose and schedule.

Aranesp Side Effects:

Important things to remember about Aranesp side effects:

  • Most people do not experience all of the Aranesp side effects listed.
  • Aranesp side effects are often predictable in terms of their onset and duration.
  • Aranesp side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent Aranesp side effects.
  • There is no relationship between the presence or severity of Aranesp side effects and the effectiveness of Aranesp.
  • Aranesp side effects may also be attributed to the cancer and/or chemotherapy treatment.

The following Aranesp side effects are common (occurring in greater than 30%) for patients taking Aranesp: 

These Aranesp side effects are less common side effects (occurring in about 10-29%) of patients receiving Aranesp:

  • Edema (swelling, usually in the feet or hands)
  • Fever
  • Dizziness
  • Headache
  • Diarrhea
  • Constipation
  • Nausea
  • Vomiting
  • Joint pain
  • Shortness of breath

Uncommon but significant Aranesp side effects may include problems with blood clots.  Blood clots rarely can lead to pulmonary embolus or stroke - potentially life-threatening conditions.

Not all Aranesp side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.

When To Contact Your Doctor or Health Care Provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Tremors or seizures
  • Difficulty breathing
  • Chest pain

The following symptoms require medical attention, but are not an emergency.  Contact your health care provider within 24 hours of noticing any of the following:

  • Nausea (interferes with ability to eat and unrelieved with prescribed medication).
  • Vomiting (vomiting more than 4-5 times in a 24 hour period).
  • Diarrhea (4-6 episodes in a 24-hour period).
  • Swelling of face, hands, feet, arms or legs.
  • Extreme fatigue (unable to carry on self-care activities).
  • Swelling, redness and/or pain in one leg or arm and not the other.

Always inform your health care provider if you experience any unusual symptoms.

Aranesp Precautions: 

  • Before starting Aranesp treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).   
  • Aranesp should be used with caution in people with high blood pressure.  The manufacturer suggests that Aranesp should not be used in people with uncontrolled high blood pressure.  
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment.  Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus). 
  • Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • It is not known whether Aranesp is excreted in human milk.  Because many drugs are excreted in human milk, caution should be exercised when Aranesp is given to a nursing woman.

Aranesp Self Care Tips:

  • The manufacturer suggests that iron supplements may be helpful while taking Aranesp. However, you should consult with your doctor before starting this therapy. 
  • You may experience some nausea and vomiting within days of receiving Aranesp, but small frequent meals, chewing gum, lozenges, and good mouth care may help. 
  • Avoid contact sports or activities that could cause injury.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely.  You should discuss this with your doctor.
  • Get plenty of rest. 
  • Maintain good nutrition.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing While Taking Aranesp:

You will be checked regularly by your doctor while you are taking Aranesp, to monitor side effects and check your response to therapy.  Periodic blood work to monitor your complete blood count (CBC) will also be ordered by your doctor.  Your blood pressure will be checked regularly.  

How Aranesp Works:

Colony-Stimulating Factors

In the body's bone marrow (the soft, sponge-like material found inside bones) blood cells are produced.  There are three major types of blood cells; white blood cells, which fight infection; red blood cells, which carry oxygen to and remove waste products from organs and tissues; and platelets, which enable the blood to clot.  Cancer treatments such as chemotherapy and radiation therapy can effect these cells which put a person at risk for developing infections, anemia and bleeding problems.  Colony-stimulating factors are substances that stimulate the production of blood cells and promote their ability to function.   They do not directly affect tumors but through their role in stimulating blood cells they can be helpful as support of the persons immune system during cancer treatment.

Aranesp is a man-made erythropoiesis protein, similar to a natural substance in your body called erythropoietin (e-rith-ro-poy-e-tin), which is produced by the kidneys. Erythropoietin is then carried through the bloodstream to the bone marrow to make more red blood cells.  Aranesp acts like this natural substance, which during chemotherapy and in patients with cancer cannot always stimulate enough red blood cell production.  Patients are anemic from multiple causes including anemia of chronic disease.

Hemoglobin is the iron-containing substance in red blood cells that delivers oxygen throughout the body. The normal hemoglobin range is approximately 12 to 18 g/dl, and varies according to age and gender. Doctors may prescribe Aranesp to chemotherapy patients whose hemoglobin levels have fallen below normal levels.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice. is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit