Subcutaneous injection of citrate-buffered epoetin alpha (EPO-α) causes pain. Substitution of citrate buffer with a phosphate buffer in the EPO-α resulted in a significant reduction in duration and severity of pain. It is possible that sodium citrate which is present in the EPO-α may be the agent that causes discomfort in the patients.
TomsonC.R.V., FeehallyJ., WallsJ.. Crossover comparison of intravenous and subcutaneous erythropoietin in haemodialysis patients. Nephrol Dial Transplant1992; 7: 129–32.
2.
BommerJ., BarthH.P., ZeierM.Efficacy comparison of intravenous and subcutaneous recombinant human erythropoietin administration in hemodialysis patients. Contrib Nephrol1991; 88: 136–43.
3.
ZehnderC., BlumbergA.. Recombinant human erythropoietin in anemic patients on maintenance hemodialysis: comparison between intravenous and subcutaneous administration. Nephron1991; 57: 485–6.
4.
LuiS.F., ChungW.W.M., LeungC.B., ChanK., LaiK.N.. Pharmacokinetics and pharmacodynamics of subcutaneous and intraperitoneal administration of recombinant human erythropoietin in patients on continuous ambulatory peritoneal dialysis. Clin Nephrol1990; 33: 47–51.
5.
VeysN., VanholderR., LameireN.. Pain at the injection site of subcutaneously administered erythropoietin in maintenance hemodialysis patients: a comparison of two brands of erythropoietin. Am J Nephrol1992; 12: 68–72.
6.
GranollerasC., LeskopfW., ShaldonS., FourcadeJ.. Experience of pain after subcutaneous administration of different preparations of recombinant human erythropoietin: a randomized, double-blind crossover study. Clin Nephrol1991; 36: 294–8.
7.
FrenkenL.A.M., van LierH.J.J., JordansJ.G.M.Identification of the component part in an epoetin alfa preparation that causes pain after subcutaneous injection. Am J Kidney Dis1993; 22: 553–6.
8.
FrenkenL.A.M., van LierH.J.J., GerlagP.G.G., den HartogM., KoeneR.A.P.. Assessment of pain after subcutaneous injection of erythropoietin in patients receiving haemodialysis. Br Med J1991; 303: 288.
9.
LuiS.F., LeungC.B., LiP.K.T., LaiK.N.. Pain after subcutaneous injection of erythropoietin. Br Med J1991; 303: 856.
