Skip to main content


Generic name: filgrastimfil-GRAS-tim ]
Brand names: Neupogen, Neupogen SingleJect, Nivestym, Zarxio
Drug class: Colony stimulating factors

Medically reviewed by on Apr 21, 2022. Written by Cerner Multum.

What is Nivestym?

Nivestym is a man-made form of a protein that stimulates the growth of white blood cells in your body. White blood cells help your body fight against infection.

Nivestym is used to treat neutropenia, a lack of certain white blood cells caused by cancer, bone marrow transplant, receiving chemotherapy, or by other conditions.

Nivestym may also be used for purposes not listed in this medication guide.


Nivestym can cause your spleen to become enlarged and it could rupture (tear). Call your doctor right away if you have sudden or severe pain in your left upper stomach spreading up to your shoulder.

Before taking this medicine

You should not use Nivestym if you are allergic to Nivestym or pegfilgrastim, or to other medicines that contain the E. coli bacteria.

Tell your doctor if you have ever had:

  • sickle cell disorder;

  • kidney disease;

  • latex allergy; or

  • radiation treatment.

Tell your doctor if you are pregnant or breastfeeding.

How should I use Nivestym?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Nivestym is injected under the skin or as an infusion into a vein. A healthcare provider will give your first dose and may teach you how to properly use the medication by yourself.

Nivestym vials and prefilled syringes do not contain the same concentrations of this medicine. Do not give an injection unless you are trained in properly measuring your dose from either the vial or the prefilled syringe.

Read and carefully follow any Instructions for Use provided with your medicine. Do not use Nivestym if you don't understand all instructions for proper use. Ask your doctor or pharmacist if you have questions.

Prepare your injection only when you are ready to give it. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.

You may need frequent medical tests to help your doctor determine how long to treat you with Nivestym.

Store Nivestym in the original container in a refrigerator. Do not freeze and do not shake.

Take the medicine out of the refrigerator and allow it to reach room temperature for 30 minutes before injecting your dose. Do not leave the medicine at room temperature for longer than 24 hours.

Each single-use vial (bottle) or prefilled syringe is for one use only. Throw it away after one use, even if there is still medicine left inside.

Use a needle and syringe only once and then place them in a puncture-proof "sharps" container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Nivestym?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Nivestym side effects

Get emergency medical help if you have signs of an allergic reaction: hives, sweating; dizziness, fast heart rate; wheezing, difficult breathing; swelling of your face, lips, tongue, or throat.

Nivestym can cause your spleen to become enlarged and it could rupture (tear). Call your doctor right away if you have sudden or severe pain in your left upper stomach spreading up to your shoulder.

Nivestym may cause serious side effects. Stop using Nivestym and call your doctor at once if you have:

  • easy bruising, unusual bleeding, purple or red spots under your skin;

  • fever, tiredness, stomach pain, back pain;

  • rapid breathing, feeling short of breath, pain while breathing;

  • capillary leak syndrome--sudden dizziness or light-headed feeling, tiredness, trouble breathing, swelling or puffiness and feeling full;

  • kidney problems--little or no urinating, blood in your urine, swelling in your face or ankles;

  • low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet; or

  • signs of infection--fever, chills, sore throat, flu symptoms, loss of appetite, nausea and vomiting, mouth sores, unusual weakness.

Common side effects of Nivestym may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Nivestym?

If you also receive chemotherapy or bone marrow transplant: Do not use Nivestym within 24 hours before or 24 hours after you receive chemotherapy, or within 24 hours after a bone marrow transplant.

Other drugs may affect Nivestym, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Frequently asked questions

Further information

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.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.