Pegfilgrastim (Generic Name)

Other Names: Neulasta™

About This Drug

Pegfilgrastim belongs to a special class of drugs called G-CSF (granulocyte colony-stimulating factor). G-CSF drugs help white blood cells grow and mature. White blood cells help your body fight infection. Pegfilgrastim helps build up your white blood cells after chemotherapy. It is given by injection under the skin (subcutaneously).

Possible Side Effects (More Common)

  • Bone, joint, or muscle pain. Mild to moderate pain may be felt in the back, chest, ribs, or legs. This pain can be controlled with medicine.
  • Tiredness
  • Swelling in the legs, ankles, and/or feet
  • Nausea and vomiting. These symptoms may occur within several hours after you receive the drug and may last up to 24 hours. Drugs are available to prevent and lessen these side effects.
  • Hair thinning or hair loss (rare)
  • Fever
  • Skin and tissue irritation. You may have redness, pain, warmth, or swelling at the injection site.

Possible Side Effects (Less Common)

  • Constipation

Sexual Problems and Reproductive Concerns

Pregnancy Warning: It is not known if this drug may have harmful effects on an unborn child.  For this reason, be sure to speak with your doctor if you are pregnant or planning to become pregnant while receiving this drug.  Ask for information on sperm or egg banking.

Genetic counseling is available to you to discuss the effects of this drug therapy on future pregnancies. In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.

Breast Feeding Warning: It is not known if this drug passes into breast milk.  For this reason, women are advised to discuss with their doctor the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and seriously harm a breast feeding infant. 

Treating Side Effects

  • Drink 6-8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition. A cup is 8 ounces of fluid. If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
  • Ask your doctor or nurse about medicine that is available to help prevent or lessen bone, joint, and muscle pain.
  • Ask your doctor or nurse about medicine that is available to help prevent or lessen nausea, vomiting, and diarrhea.
  • If administering at home rotate injection sites.
  • Check with your doctor or nurse before you use enemas, laxatives, or suppositories.

Allergic Reactions

Allergic reactions including anaphylaxis are rare but may occur in some patients. Signs of allergic reactions to this drug may include swelling of the face, feeling like your tongue or throat are swelling, shortness of breath, rash, itching, fever, chills, dizziness, and/or palpitations (feeling your heart beat rapidly). Do not take another dose of this drug and seek immediate medical treatment.

Other Instructions

If you are to receive pegfilgrastim by subcutaneous injection at home, you will receive guidelines for injecting the drug.

Store the pre-filled syringes in the refrigerator. They should be kept in their carton to protect them from light until time of use. Do not shake the syringe. You may remove a syringe containing the drug from the refrigerator for a maximum of 48 hours to let it reach room temperature, but it should be protected from light. If you leave a syringe out for more than 48 hours, throw it away. Avoid freezing the syringes. If a syringe containing the drug is accidentally frozen, it can be allowed to thaw in the refrigerator. If the drug is frozen a second time, do not use it. Throw it away.

Food and Drug Interactions

There are no known interactions of pegfilgrastim with food. This drug may interact with other medicine. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs, and others) that you are currently taking. The safety and effectiveness of dietary supplements and alternative diets are often unknown. Using these might unexpectedly affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor’s advice.

When to Call the Doctor

Call your doctor or nurse immediately if you have any of the following symptoms:

  • After an injection, you develop a rash, fever, chills, dizziness, rapid heartbeat (palpitations), and/or shortness of breath
  • Temperature of 100.5 F (38 C) or above
  • Chills
  • Pain in your left upper abdomen or shoulder
  • Uncontrolled nausea that prevents you from eating or drinking
  • Vomiting more than 3 times in 1 day

Call your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Nausea, vomiting, or diarrhea that prescribed medicine doesn’t help
  • Bone, joint, or muscle pain that prescribed medicine doesn’t help
  • Swelling in the legs, feet, or ankles
  • Diarrhea of 5 or 6 stools in 1 day or diarrhea with weakness

Revised January 2012

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