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Neulasta

Generic Name: pegfilgrastim (PEG fil GRAS tim)
Brand Names: Neulasta

Medically reviewed by P. Thornton, DipPharm Last updated on Oct 8, 2019.

What is Neulasta?

Neulasta (pegfilgrastim) 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.

Neulasta injection is a prescription medicine used to prevent neutropenia, a lack of certain white blood cells caused by receiving chemotherapy.

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

Important information

Before using Neulasta, tell your doctor if you have sickle cell disorder, chronic myeloid leukemia, myelodysplasia (also called "preleukemia"), or if you are allergic to latex.

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Do not self-inject Neulasta if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

Neulasta is usually given once per chemotherapy cycle. It should not be given within 14 days before or 24 hours after you receive chemotherapy.

Before taking this medicine

You should not use Neulasta if you are allergic to pegfilgrastim or filgrastim (Neupogen).

To make sure you can safely use Neulasta, tell your doctor if you have any of these other conditions:

  • sickle cell disorder;

  • kidney disease;

  • chronic myeloid leukemia;

  • myelodysplasia (also called "preleukemia"); or

  • a latex allergy.

It is not known whether pegfilgrastim will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of Neulasta on the baby.

It is not known whether pegfilgrastim passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I use Neulasta?

Neulasta is injected under the skin. You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Neulasta is usually given once per chemotherapy cycle. This medication should not be given within 14 days before or 24 hours after you receive chemotherapy.

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

Carefully follow your doctor's instructions when giving Neulasta to a child who weighs less than 99 pounds (45 kilograms). The correct dose for a child this size cannot be accurately measured using the prefilled syringe.

Store the prefilled syringe in its original package in the refrigerator, protected from light. Do not shake or freeze.

Take the syringe out of the refrigerator and let it reach room temperature for 30 minutes before injecting your dose. If a syringe has become frozen, thaw it in a refrigerator. Do not use any syringe that has been frozen more than one time.

Do not use a Neulasta syringe that has been left at room temperature for longer than 48 hours.

The Neulasta Onpro Injector is a special device placed on the skin that delivers your pegfilgrastim dose at a specific time. You will need to wear the device for 27 hours before the dose begins. The timed dose will then be released from the device slowly over a 45-minute period.

Keep Neulasta Onpro refrigerated until you are ready to wear it. Do not use an Onpro device that has been left out of a refrigerator for longer than 12 hours.

While wearing Neulasta Onpro, you or a caregiver will need to check the device to make sure it is working properly.

Each prefilled syringe or Onpro Injector 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 reachof children and pets.

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

Neulasta dosing information

Usual Adult Dose for Neutropenia Associated with Chemotherapy:

6 mg subcutaneously once per chemotherapy cycle, beginning 24 to 72 hours after completion of chemotherapy

Usual Pediatric Dose for Neutropenia Associated with Chemotherapy:

Based on limited studies:
1 to 12 years old: 100 mcg/kg (maximum dose: 6 mg) once per chemotherapy cycle, beginning 24 to 72 hours after completion of chemotherapy

13 to 18 years old and greater than 45 kg: 6 mg once per chemotherapy cycle, beginning 24 to 72 hours after completion of chemotherapy

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of Neulasta, or if you have a problem with the On-body Injector device.

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 Neulasta?

When using the On-body Injector: Avoid traveling, driving, or operating machinery while wearing the device.

Neulasta side effects

Get emergency medical help if you have signs of an allergic reaction to Neulasta: hives, skin rash, sweating; dizziness, warmth or tingly feeling); wheezing, difficulty breathing; swelling of your face, lips, tongue, or throat.

A rare but serious side effect of pegfilgrastim is called capillary leak syndrome. Call your doctor right away if you have signs of this condition, which may include: decreased urination, tiredness, dizziness or light-headed feeling, and sudden swelling, puffiness, or feeling of fullness.

Call your doctor at once if you have:

  • fever, tiredness, stomach pain, back pain;
  • sudden or severe pain in your left upper stomach spreading up to your shoulder;
  • easy bruising, unusual bleeding, purple or red spots under your skin;
  • rapid breathing, feeling short of breath, pain while breathing;
  • bruising, swelling, or a hard lump where the medicine was injected; or
  • kidney problems - little or no urination, pink or dark urine, swelling in your face or lower legs.
Common Neulasta side effects may include:
  • bone pain; or
  • pain in your arms or legs.

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 Neulasta?

Other drugs may interact with pegfilgrastim, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Neulasta only for the indication prescribed.

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

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