Rankings / Muscle & Strength

EPO / erythropoiesis-stimulating agents (ESAs)

Muscle & Strength · Erythropoietin receptor agonist

Tier C+

High-risk evidence profile

wadaerythropoiesisendurancebanned-sport
High-risk evidence profile
5.6 / 10
Tier C+
Ev 8 Bn 8 Sf 2

Bottom line

Read Off Label grades EPO / erythropoiesis-stimulating agents (ESAs) as C+ (5.6/10) based on strong evidence, high benefit magnitude, and a high-risk safety profile.

Its high-risk evidence profile reflects a Safety score of 2/10; reported benefits and harms can differ by indication, dose, route, duration, and population.

WADA coverage: erythropoietins/EPO, darbepoetins/dEPO, EPO-based constructs, EPO-Fc, methoxy polyethylene glycol-epoetin beta/CERA, EPO-mimetic agents and constructs, CNTO-530, peginesatide and pegmolesatide.

Studied, labeled, or reported-use context: Clinical anemia dosing is individualized by hemoglobin response; no safe performance dose — Rx for anemia indications; WADA S2 prohibited at all times; not individualized guidance.

What the evidence says

WADA coverage: erythropoietins/EPO, darbepoetins/dEPO, EPO-based constructs, EPO-Fc, methoxy polyethylene glycol-epoetin beta/CERA, EPO-mimetic agents and constructs, CNTO-530, peginesatide and pegmolesatide. Additional WADA alias coverage: EPO-mimetic agents and their constructs, Asialo EPO and Carbamylated EPO (CEPO).

Mechanism

EPO receptor agonists increase red-cell mass and oxygen-carrying capacity, which can improve endurance but also increases blood viscosity and thrombotic risk.

Studied, labeled, or reported dose & route

Clinical anemia dosing is individualized by hemoglobin response; no safe performance dose

This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.

Citations

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Common questions

What does the evidence show about EPO / erythropoiesis-stimulating agents (ESAs)'s effects?
Read Off Label rates the evidence for EPO / erythropoiesis-stimulating agents (ESAs) as Strong and the benefit magnitude as high, producing an overall grade of C+ (5.6/10). WADA coverage: erythropoietins/EPO, darbepoetins/dEPO, EPO-based constructs, EPO-Fc, methoxy polyethylene glycol-epoetin beta/CERA, EPO-mimetic agents and constructs, CNTO-530, peginesatide and pegmolesatide.
What safety findings are reported for EPO / erythropoiesis-stimulating agents (ESAs)?
EPO / erythropoiesis-stimulating agents (ESAs) has a high risk profile in the database. High (hypertension, thrombosis, stroke, polycythemia, pure red-cell aplasia with some products) Legal status: Rx for anemia indications; WADA S2 prohibited at all times.
What does the low Safety score for EPO / erythropoiesis-stimulating agents (ESAs) represent?
The Safety score is 2/10. It records the substantial harms described for one or more use contexts; the Benefit score, indication, dose, route, duration, population, and legal status remain separate parts of the evidence profile.
What doses or routes are reported for EPO / erythropoiesis-stimulating agents (ESAs)?
Clinical anemia dosing is individualized by hemoglobin response; no safe performance dose This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
How does EPO / erythropoiesis-stimulating agents (ESAs) work?
EPO receptor agonists increase red-cell mass and oxygen-carrying capacity, which can improve endurance but also increases blood viscosity and thrombotic risk.

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.