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Pegfilgrastim Side Effects

In Summary

Commonly reported side effects of pegfilgrastim include: ostealgia. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to pegfilgrastim: subcutaneous solution

As well as its needed effects, pegfilgrastim may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking pegfilgrastim, check with your doctor immediately:

More common:
  • Chills
  • cough
  • fever
  • sore throat
  • ulcers, sores, or white spots in the mouth
  • Bluish lips or skin
  • pain, left upper abdomen or shoulder
  • tightness in the chest
  • troubled breathing
Incidence not known:
  • Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
  • blisters in the skin
  • blood in the urine
  • cloudy urine
  • decrease in how much or how often you urinate
  • difficulty with swallowing
  • dizziness
  • fainting or lightheadedness
  • fast heartbeat
  • flushing or redness of the skin
  • hives or welts or skin rash
  • itching, puffiness, or swelling of the eyelids or around the eyes, face, lips, or tongue
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • nausea
  • sores on the skin
  • stomach pain
  • swelling of the hands, ankles, feet, or lower legs
  • unusual tiredness or weakness
  • unusually warm skin

Minor Side Effects

Some pegfilgrastim side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:
  • Acid or sour stomach
  • belching
  • bone pain
  • change in sense of taste
  • constipation
  • cracked lips
  • diarrhea
  • hair loss or thinning of the hair
  • headache
  • heartburn
  • indigestion
  • joint pain
  • lack or loss of strength
  • loss of appetite
  • muscle soreness
  • swelling of the hands, ankles, feet, or lower legs
  • swelling or inflammation of the mouth
  • trouble sleeping
  • vomiting
  • weakness, generalized
  • weight loss
Incidence not known:
  • Body produces substance that can bind to drug making it less effective or cause side effects

For Healthcare Professionals

Applies to pegfilgrastim: subcutaneous solution


Musculoskeletal side effects associated with the administration of pegfilgrastim have included medullary bone pain, occurring in 26% of clinical trials patients.[Ref]


Metabolic side effects associated with the administration of pegfilgrastim have included reversible elevations in LDH (19%), alkaline phosphatase (9%), and uric acid (8%). Treatment intervention was not necessary.[Ref]


Hematologic side effects including splenic rupture have been reported rarely following the administration of filgrastim (the parent compound of pegfilgrastim) when used for peripheral blood progenitor cell mobilization in both healthy donors and patients with cancer. The administration of pegfilgrastim has been associated with asymptomatic leukocytosis (less than 1%).[Ref]

Pegfilgrastim should not be used for peripheral blood progenitor cell mobilization. Patients receiving pegfilgrastim who report left upper abdominal or shoulder tip pain should be evaluated for an enlarged spleen or splenic rupture.[Ref]


General side effects associated with the administration of pegfilgrastim have included many effects that have been associated with the chemotherapy that was given concomitantly. These have included nausea, fatigue, alopecia, diarrhea, vomiting, constipation, fever, anorexia, skeletal pain, headache, taste perversion, dyspepsia, myalgia, insomnia, abdominal pain, arthralgia, generalized weakness, peripheral edema, dizziness, granulocytopenia, stomatitis, mucositis, and neutropenic fever. Most of these effects have been attributed by the investigators to be the result of the underlying condition or the chemotherapy administered.[Ref]


Respiratory side effects including adult respiratory distress syndrome (ARDS) has been reported with the use of filgrastim (the parent compound of pegfilgrastim).

Because adult respiratory distress syndrome (ARDS) has been reported with the use of filgrastim, patients receiving pegfilgrastim who develop fever, lung infiltrates, or respiratory distress should be evaluated for the possibility of ARDS.


1. "Product Information. Neulasta (pegfilgrastim)." Amgen, Thousand Oaks, CA.

It is possible that some side effects of pegfilgrastim may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

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