What Is Retacrit? Uses, Dosage, and What You Need to Know in 2026

Whether you've just been prescribed Retacrit or you're trying to understand a loved one's treatment, this guide gives you a clear, accurate overview of what Retacrit is, what it treats, how it's used, and what to expect.

What Is Retacrit?

Retacrit (epoetin alfa-epbx) is a biosimilar to Epogen and Procrit (epoetin alfa). It was approved by the FDA on May 15, 2018, becoming the first biosimilar erythropoiesis-stimulating agent (ESA) in the United States. It is manufactured by Hospira, a Pfizer company.

A biosimilar is a biological product that is highly similar to an already-approved reference biologic — in Retacrit's case, that reference is epoetin alfa (sold as Epogen by Amgen and Procrit by Janssen). The FDA confirmed that Retacrit has no clinically meaningful differences from these reference products in terms of safety, purity, or potency.

Retacrit is not designated as interchangeable with its reference products, meaning a pharmacist cannot automatically substitute it for Epogen or Procrit (or vice versa) without a new prescription from your doctor.

What Is Retacrit Used For?

Retacrit is FDA-approved to treat anemia caused by four specific conditions:

1. Chronic Kidney Disease (CKD): Retacrit is used for patients with CKD both on dialysis and not on dialysis. When kidneys fail, they stop producing enough erythropoietin — the hormone that signals red blood cell production. Retacrit replaces this signal.
2. HIV treatment with zidovudine (AZT): Zidovudine, one of the oldest antiretroviral drugs, can suppress bone marrow and cause anemia. Retacrit can help correct this anemia in HIV-positive patients.
3. Chemotherapy-induced anemia: Myelosuppressive chemotherapy suppresses red blood cell production. Retacrit is approved for cancer patients receiving chemotherapy when at least 2 more months of chemotherapy are planned, and when the treatment is not given with curative intent.
4. Elective surgery: Retacrit can be used before and after certain elective, noncardiac, nonvascular surgeries to reduce the need for blood transfusions in patients with a pre-surgical hemoglobin of >10 to ≤13 g/dL.

How Is Retacrit Given?

Retacrit is given as an injection — either intravenously (IV, into a vein) or subcutaneously (SC, under the skin). The route and frequency depend on the indication:

• CKD on hemodialysis: IV route recommended, given 3 times per week (starting dose 50–100 Units/kg)
• CKD not on dialysis: SC or IV, 3 times per week
• HIV: SC or IV, 3 times per week (starting dose 100 Units/kg for 8 weeks)
• Chemotherapy anemia: SC, 150 Units/kg 3 times weekly or 40,000 Units once weekly
• Surgery: SC, 300 Units/kg daily x 10 days before and 4 days after surgery, OR 600 Units/kg SC weekly x 4 doses

Your prescriber will determine your starting dose, adjust it based on your hemoglobin response, and use the lowest effective dose to avoid transfusions while minimizing cardiovascular risks.

Available Retacrit Vial Strengths

Retacrit comes in single-dose and multi-dose vials. Single-dose vials (preservative-free): 2,000, 3,000, 4,000, 10,000, and 40,000 Units/mL. Multi-dose vials (contain benzyl alcohol): 20,000 Units/2 mL and 20,000 Units/mL. Note: Multi-dose vials containing benzyl alcohol are contraindicated in neonates, infants, pregnant women, and lactating women.

How Long Does Retacrit Take to Work?

After starting Retacrit, your body begins producing more red blood cells. Hemoglobin levels typically begin rising within 2–6 weeks. Your doctor will check your hemoglobin levels weekly until stable. If your hemoglobin doesn't respond adequately within 12 weeks of dose escalation, Retacrit is unlikely to help and should be reconsidered.

What Are the Main Risks?

Retacrit carries an FDA Boxed Warning for increased risk of death, heart attack, stroke, and blood clots — particularly if hemoglobin is driven too high (above 11 g/dL in CKD patients). In cancer patients, it may increase tumor progression. Regular monitoring is essential.

Is Retacrit a Controlled Substance?

No. Retacrit is not a controlled substance and is not scheduled by the DEA. It does require a prescription and prior authorization from most insurance plans, but there are no special DEA-related prescribing restrictions.

The Bottom Line

Retacrit is a well-established, FDA-approved biosimilar that effectively treats anemia in CKD, HIV, chemotherapy, and surgical settings. It must be used at the lowest effective dose with regular hemoglobin monitoring. To understand how it works in the body, see our explainer on Retacrit's mechanism of action. If you need help finding a pharmacy with your prescribed strength in stock, medfinder can help.