EPO is sold in recombinant form (rhEPO) for injection. It usually is packaged as a lyophilized (freeze dried) powder that is reconstituted with sterile water before injection. One popular form is called Epogen (r), and it is made for subcutaneous usage. A starting dosage is typically 20 i.u. per kilogram bodyweight, 3 times/week. After two to four weeks, a maintenance dose of 20 i.u. /kg BW can be taken once a week.

EPO use can be very dangerous if the user allows their hematocrit to creep too high. The ideal hematocrit for athletic performance is thought to be 55 (expressed in percent). Levels above this can result in "sludging" of the blood, which reduces microcirculation. This is counterproductive to oxygen transport. Additionally, at high hematocrit levels one is at greater risk for deadly vascular events such as stroke, especially if he/she becomes dehydrated during competition (which increases hematocrit even further).

In addition to increasing aerobic efficiency through greater oxygen transport in the blood, there is some evidence suggesting EPO may also have anabolic effects. EPO has been shown in rat studies to substantially increase weight gain and injury repair after surgery. Furthermore, EPO receptors are present on myoblasts (immature muscle cell progenitors) and may have a potential in muscle development and repair.

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