Neupogen Warnings and Precautions

Let your healthcare provider know if you have sickle cell anemia or any allergies before taking Neupogen. Warnings and precautions also include avoiding the drug any time within 24 hours before or after chemotherapy, watching out for potential drug interactions, and being aware that Neupogen may cause enlargement and rupture of the spleen. You should not take Neupogen if you are allergic to E. coli proteins.

• Sickle cell anemia
• Any allergies, including allergies to food, dyes, or preservatives.
   

• Pregnant or thinking of becoming pregnant
• Breastfeeding.
   

• Very rarely, Neupogen may cause enlargement and rupture of the spleen. Tell your healthcare provider if you have symptoms of an enlarged spleen, such as upper abdominal or shoulder pain.
   
• Neupogen can cause adult respiratory distress syndrome (ARDS), a lung problem that can quickly become fatal. Tell your healthcare provider immediately if you develop any breathing problems.
   
• Neupogen can make sickle cell anemia worse. If you have sickle cell anemia, make sure your healthcare provider has specialty training or experience in the treatment of sickle cell anemia before you take Neupogen.
   
• If Neupogen is taken anytime within 24 hours before or after chemotherapy, the risk of infection is actually increased. Usually, Neupogen is given the day after chemotherapy (at least 24 hours afterwards).
   
• Neupogen stimulates the growth of cells. There is a possibility that it may stimulate the growth of cancer cells. When used to collect stem cells for transplantation, theoretically, there is a possibility that Neupogen may increase the risk of collecting cancer cells, as well as stem cells.
   
• Some people taking Neupogen long-term for treating severe chronic neutropenia have developed leukemia. However, since people with severe chronic neutropenia seem to have a higher risk for leukemia anyway, it is not known whether Neupogen actually increases the risk of leukemia.
   
• Your healthcare provider should regularly perform blood tests to measure the level of neutrophils in your blood to make sure the medicine is working and to make sure your neutrophil levels do not get too high.
   
• Neupogen has not been approved to be used in people undergoing radiation treatments.
   
• Neupogen can interact with a few other medications (see Neupogen Drug Interactions).
   
• Neupogen is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy. Talk to your healthcare provider about the risks and benefits of the drug during pregnancy (see Neupogen and Pregnancy).
   
• It is not known if Neupogen passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Neupogen and Breastfeeding).