ESA's are erythropoiesis-stimulating agents such as Erythropoietin ( EPO )and Darbepoetin ( DARB ). Usually Iron- either oral or I.V. is prescribed with them.
Recent changes in ESA prescribing information and coverage appear to have decreased ESA utilization and the EPO: DARB dose ratio over time.
Jan. 9, 2012 Hospira Announces Start of U.S. Phase III Biosimilar EPO Clinical Program.
Erythropoietin is associated with an increased risk of adverse cardiovascular complications in patients with kidney disease if it is used to increase hemoglobin levels above 13.0 g/dl. and in certain cancers above 10.0 gm/gl
A full workup is recommended along with close monitoring of adverse reactions.