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

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 is 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. Neulasta 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 Neulasta 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.

The Neulasta On-body Injector is a special device placed on the skin that delivers your Neulasta dose at a specific time. Read and carefully follow all instructions for using this product. 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. While wearing the On-body Injector, you or a caregiver will need to check the device to make sure it is working properly.

Each prefilled Neulasta syringe or On-body Injector is for one use only. Throw away after one use, even if there is still some medicine left in it after injecting your dose.

Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

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

Store Neulasta in the refrigerator, do not freeze. Protect from light and do not shake.

Take the medicine out of the refrigerator and allow it to reach room temperature before injecting your dose. Do not leave the medicine at room temperature for longer than 48 hours.

Throw away any unused syringes after the expiration date on the label has passed.

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

See also: Dosage Information (in more detail)

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, flushing (warmth, redness, or tingly feeling); wheezing, difficulty breathing; swelling of your face, lips, tongue, or throat.

A rare but serious side effect of Neulasta 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:

  • sudden or severe pain in your left upper stomach spreading up to your shoulder;

  • rapid breathing, feeling short of breath;

  • bruising, swelling, or a hard lump where the medicine was injected;

  • kidney problems - little or no urination, pink or dark urine, swelling in your feet or ankles, feeling tired or short of breath; or

  • low white blood cell counts - fever, swollen gums, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms, cough.

Common Neulasta side effects may include:

  • bone pain, muscle aches;

  • pain in your arms or legs; or

  • pain and redness where the injection was given.

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.

See also: Side effects (in more detail)

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.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about Neulasta.
  • 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.
  • Disclaimer: 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 1996-2016 Cerner Multum, Inc. Version: 3.01. Revision Date: 2015-11-12, 10:13:10 AM.