Epogen (Erythropoietin [EPO])

Erythropoietin is a type of protein that is produced in the kidneys, and is responsible for stimulating red blood cell production. Epoetin alfa is the pharmaceutical form of erythropoietin, which was manufactured using recombinant DNA technology. The compound is produced from animal cells into which the gene coding for human erythropoietin has been inserted. The biological activity and structure of epoetin alfa are indistinguishable from that of human erythropoietin. This drug is used to treat many forms of anemia, effectively stimulating and maintaining erythropoietin in a large percentage of patients treated. EPO was developed by the biotechnologies firm Amgen, and was first intrduced to the U.S. market in 1984. The release of the drug was looked upon as a breakthrough in the treatment of anemia, which beforehand was being addressed mainly with agents that indirectly or nonspecifically targeted red cell production, such as oxymetholone, which may present a number of unwanted side effects to the patient.

As for its use in athletics, epoietin alpha offers endurance athletes an effective means by which they are able to elevate their red blood cell production and concentration in a relatively convenient and efficient manner. Prior to the development of synthetic erythropoietin many endurance athletes relied on a procedure often referred to as “blood doping”. This simply referred to the action of removing and then storing a quantity of blood from an individual, and then transfusing that same blood back into the individual prior to an athletic event. This procedure results in a greater number of circulating red blood cells for the individual due to the fact that the body will reproduce the volume of blood initially removed, and then the blood that was removed along with the requisite red blood cells are added back. Epoietin alpha offers these same advantages without the need for the transfusion and storing of the blood of the individual. Obviously administering epoietin alpha is by far a more efficient and convenient method for achieving these results. The reason that an increase in red blood cell count is so advantageous for endurance athletes is that red blood cells are responsible for delivering oxygen to muscle tissues. By having more of them available to fulfill this role, the blood of an athlete is far more efficient at delivering oxygen to muscles resulting in improvement in the endurance, strength and speed of an athlete. Therefore the use of epoietin alpha obviously helps an athlete in improving their various athletic responses, including oxygen uptake, exercise capacity and energy efficiency. For this reason, it should apparent why endurance athletes find this compound so beneficial.

Epoietin alpha can be administered using either intravenous or subcutaneous injections. The difference between the two methods is, not surprisingly, the rate at which the blood level of the compound peaks. When epoietin alpha is injected subcutaneously, blood levels of the compound will peak approximately twelve to eighteen hours after administration. Intravenous injections will peak rapidly after administration, due to the immediate entry of the drug into the blood stream. The half life of the drug is also greatly affected by the injection method used, with intravenous injections netting a half life of about four to five hours. As for the dosing that is required to see results, medically the usual protocol is usually to prescribed roughly 15-60ius per kilogram of bodyweight three to four times per week for the patient. At these levels, an athlete looking for performance enhancement should see improvement. However, anecdotally many athletes have reported simply using 1000ius per day for the weeks running up to a competition.