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All about: pegfilgrastim

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Generic Name: pegfilgrastim (peg fill GRAH stim)
Brand Names: Neulasta

What is pegfilgrastim?

Pegfilgrastim is a protein that stimulates production of white blood cells. White blood cells are important for protecting the body from infection.

Pegfilgrastim is used to increase white blood cells and therefore decrease the risk of infection in patients with non-myeloid (not bone marrow) cancers while receiving cancer chemotherapy (drugs).

Pegfilgrastim may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about pegfilgrastim?

Do not administer an injection if you are unsure how to properly give the injection, how much to inject, or how often to inject the medication. Call your doctor, nurse, or pharmacist to go over the instructions with you. Contact your doctor if you develop a fever; chills; sore throat; congestion; or redness, pain, or swelling around a wound or sore while using pegfilgrastim. These may be signs of infection.

Your spleen may become enlarged and, in rare instances, may rupture while taking pegfilgrastim. The spleen is located in the upper left section of your stomach area. Call your doctor right away if you have pain in your left upper stomach area or left shoulder tip area. This pain could mean your spleen is enlarged or ruptured.

What should I discuss with my healthcare provider before using pegfilgrastim?

Do not use pegfilgrastim if you have an allergy to the bacterium E. coli or the drug filgrastim (Neupogen). You may also have an allergic reaction to pegfilgrastim.

Before using this medication, tell your doctor if you:

  • are undergoing radiation or chemotherapy;

  • have sickle cell disease;

  • have myeloid (bone marrow) cancer;

  • have kidney disease; or

  • have liver disease.

You may not be able to uses pegfilgrastim or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Pegfilgrastim is in the FDA pregnancy category C. This means that it is not known whether pegfilgrastim will be harmful to an unborn baby. Do not use pegfilgrastim without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether pegfilgrastim passes into breast milk. Do not use pegfilgrastim without first talking to your doctor if you are breast-feeding a baby.

How should I use pegfilgrastim?

Use pegfilgrastim exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Pegfilgrastim is administered by subcutaneous (SC) injection. If you are injecting the medication at home, your doctor, nurse, or pharmacist will give you specific instructions on how and where it should be injected. Do not administer an injection if you are unsure how to properly give the injection, how much to inject, or how often to inject the medication. Call your doctor, nurse, or pharmacist to go over the instructions with you.

Pegfilgrastim is supplied in prefilled syringes, each intended to administer a single dose.

Do not shake the syringes containing pegfilgrastim. Do not inject pegfilgrastim that is discolored or that has particles in it.

Before injection, a prefilled syringe of pegfilgrastim may be allowed to reach room temperature for a maximum of 48 hours but should be protected from light. Pegfilgrastim left at room temperature for more than 48 hours should be thrown away.

After injecting a dose of pegfilgrastim, slide the needle guard into place until the needle is completely covered and the guard clicks into place. Throw away the syringe, with the needle guard in place, in a puncture resistant container.

Your doctor will want you to have periodic blood tests during treatment with pegfilgrastim to monitor effectiveness and possible side effects of the medication.

Store pegfilgrastim prefilled syringes in the refrigerator between 2 and 8 degrees Celsius (36 to 46 degrees Fahrenheit) in the original carton to protect from light. Do not allow the medication to freeze. If a vial of medication is accidentally frozen, it can be thawed in the refrigerator and used at a later time. If the vial is frozen a second time, do not use it at all. Discard all unused medication on the expiration date.

What happens if I miss a dose?

Contact your doctor if you miss a dose of pegfilgrastim.

What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

Symptoms of a pegfilgrastim overdose are not known.

What should I avoid while using pegfilgrastim?

There are no restrictions regarding foods, beverages, or activities during treatment with pegfilgrastim unless your doctor directs otherwise.

Pegfilgrastim side effects

Your spleen may become enlarged and, in rare instances, may rupture while taking pegfilgrastim. The spleen is located in the upper left section of your stomach area. Call your doctor right away if you have pain in your left upper stomach area or left shoulder tip area. This pain could mean your spleen is enlarged or ruptured.

If you experience any of the following serious side effects, seek emergency medical treatment or contact your doctor immediately:
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

  • fever or chills;

  • sore throat or congestion;

  • redness, pain, or swelling around a wound or sore;

  • difficulty breathing or shortness of breath; or

  • left upper stomach or shoulder pain.

Other, less serious side effects may be more likely to occur. Continue to use pegfilgrastim and talk to your doctor if you experience:

  • muscle, joint, or bone pain;

  • fatigue;

  • headache;

  • weakness;

  • dizziness;

  • sores in the mouth or throat; or

  • nausea, vomiting, diarrhea, or constipation.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect pegfilgrastim?

Before using this medication, tell your doctor if you

  • are taking lithium (Eskalith, Lithobid, Lithane, others); or

  • are undergoing radiation or chemotherapy.

You may not be able to use pegfilgrastim or you may require special monitoring if you are taking any of the medications listed above.

Drugs other than those listed here may also interact with pegfilgrastim. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

  • Your pharmacist has additional information about pegfilgrastim written for health professionals that you may read.

What does my medication look like?

Pegfilgrastim is available with a prescription under the brand name Neulasta. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • Neulasta 6 mg--single-dose, preservative-free prefilled syringe

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 2.01. Revision Date: 2/28/05 11:13:46 AM.

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