Neulasta
® (
pegfilgrastim) is a prescription medication used to prevent infections in people undergoing certain kinds of chemotherapy. Many types of chemotherapy increase the risk of dangerous infections, and Neulasta can help prevent such infections.
It is made by Amgen, Inc.
Chemotherapy often decreases the bone marrow's ability to produce neutrophils, a certain type of white blood cell (WBC). Neutrophils help protect the body from infection, and having a low neutrophil count (known medically as neutropenia) increases the risk of infection.
Neulasta belongs to a group of medications called granulocyte colony-stimulating factors. Colony-stimulating factors bind to stem cells in the bone marrow, stimulating the production of blood cells. Granulocyte colony-stimulating factor (G-CSF) is a naturally occurring chemical in the body that stimulates the production of neutrophils. Neulasta is a synthetic version of G-CSF attached to another molecule designed to make it stay in the body longer. This means that it needs to be injected only once per chemotherapy cycle. Neulasta binds to stem cells and stimulates the production of neutrophils, helping to decrease the risk of infection.
In studies, Neulasta has been compared to a placebo (no treatment) or to
filgrastim (
Neupogen®), a short-acting version of Neulasta that must be taken daily. These studies measured the frequency and duration of febrile neutropenia, which is a fever combined with a low neutrophil count. Febrile neutropenia is essentially infection caused by chemotherapy. In one study, only 1 percent of those taking Neulasta experienced febrile neutropenia, compared to 17 percent of those taking a placebo (receiving no treatment). Another study showed that Neulasta appears to work as well as Neupogen for preventing infections.
When and How to Take Neulasta
General considerations for when and how to take the medication include the following:
- Neulasta comes as an injection that is given under the skin. It is given once per chemotherapy cycle.
- It should not be taken any time within two weeks before to 24 hours after chemotherapy. It is usually taken on the day after chemotherapy (more than 24 hours after chemotherapy).
- If you feel comfortable doing so, you may give yourself the injections. If you would prefer, your healthcare provider can give the injection.
- Never shake Neulasta, as it is a delicate molecule that could be damaged by shaking.
- You will need regular blood tests while taking this medication to see if it is working.
- If you choose to give the injections yourself, make sure you know exactly how to inject Neulasta.
- For the medication to work properly, it must be taken as prescribed.
There is only one recommended dose of Neulasta for adults, regardless of your age or liver or kidney function. Neulasta is not recommended for infants, children, and smaller adolescents weighing less than 99 pounds.
As is always the case with any medication, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
As with any medicine, side effects are possible with Neulasta. However, not everyone who takes the drug will experience side effects. In fact, most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
Common side effects of Neulasta include, but are not limited to:
Hair loss is very common in people taking this drug, but it is most likely due to the chemotherapy, rather than to Neulasta
(see Neulasta and Hair Loss).
(Click Neulasta Side Effects to learn about specific side effects of this medication, including some of the more serious side effects that you should report to your healthcare provider.)
Drug Interactions With Neulasta
What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider prior to taking this medication if you have:
- Sickle cell anemia
- Myeloid cancers or precancerous conditions, such as:
- Acute myelogenous leukemia (AML), also known as chronic myeloid leukemia
- Chronic myelogenous leukemia (CML), also known as chronic myeloid leukemia
- Myelodysplastic syndromes (MDS)
- Myeloproliferative disease
- Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
- Breastfeeding.
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
What If I Take an Overdose?
Taking too much Neulasta can increase the white blood cells too much. Other than high white blood cells, it is not known exactly what to expect from a Neulasta overdose.
How Should Neulasta Be Stored?
Neulasta should be stored under refrigeration. However, each prefilled syringe should be taken out of the refrigerator and allowed to reach room temperature before injection. It can be kept outside the refrigerator for up to 48 hours but must be discarded after 48 hours.
Keep Neulasta and all medications out of the reach of children.
What Should I Do If I Miss a Dose?
If you do not take your Neulasta as scheduled, contact your healthcare provider. Depending on how much time has passed (and how soon your next chemotherapy cycle is scheduled), your healthcare provider may or may not recommended that you take the missed dose.
Neulasta comes in one strength -- Neulasta 6 mg. Each syringe is prefilled with just the right dose and has a needle attached.
Is There a Generic Version of Neulasta?
Currently, there is no generic Neulasta licensed for sale
(see Generic Neulasta).
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