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Ziextenzo Side Effects

Generic name: pegfilgrastim

Medically reviewed by Philip Thornton, DipPharm. Last updated on Dec 23, 2023.

Note: This document contains side effect information about pegfilgrastim. Some dosage forms listed on this page may not apply to the brand name Ziextenzo.

Applies to pegfilgrastim: subcutaneous solution.

Serious side effects of Ziextenzo

Along with its needed effects, pegfilgrastim (the active ingredient contained in Ziextenzo) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking pegfilgrastim:

More common


Incidence not known

Get emergency help immediately if any of the following symptoms of overdose occur while taking pegfilgrastim:

Symptoms of overdose

Other side effects of Ziextenzo

Some side effects of pegfilgrastim may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Incidence not known

For Healthcare Professionals

Applies to pegfilgrastim: subcutaneous solution.


The most commonly reported side effects included bone pain, skeletal pain, medullary bone pain, and spontaneously reversible mild to moderate lactate dehydrogenase elevations.[Ref]


Very common (10% or more): Bone pain (up to 31%), skeletal pain (up to 27%), medullary bone pain (up to 26%)

Common (1% to 10%): Arthralgia, back pain, extremity pain, limb pain, musculoskeletal pain, myalgia, neck pain, polyarthralgia, polymyalgia[Ref]


Very common (10% or more): Spontaneously reversible mild to moderate lactate dehydrogenase elevations (up to 18%), spontaneously reversible mild to moderate alkaline phosphatase elevations (up to 11%), spontaneously reversible mild to moderate uric acid elevations (up to 11%)

Common (1% to 10%): Spontaneously reversible severe uric acid elevations

Frequency not reported: Anorexia[Ref]


Common (1% to 10%): Fever, non-cardiac chest pain, pain, pyrexia

Frequency not reported: Fatigue, generalized weakness, mucositis[Ref]


Common (1% to 10%): Alopecia, contact dermatitis

Uncommon (0.1% to 1%): Acute febrile dermatosis, cutaneous vasculitis, erythema/generalized erythema, pruritus, skin rash, Sweet's syndrome, urticaria[Ref]


Common (1% to 10%): Leukocytosis, thrombocytopenia

Uncommon (0.1% to 1%): Asymptomatic splenomegaly, fatal splenic rupture, sickle cell crisis, splenic rupture, splenomegaly/enlarged spleen

Frequency not reported: Granulocytopenia, neutropenic fever[Ref]


Common (1% to 10%): Application site reactions, injection site pain

Uncommon (0.1% to 1%): Injection site erythema, injection site reactions

Postmarketing reports: Application site bruise, application site discomfort, application site hemorrhage, local skin reactions[Ref]


Common (1 to 10%): Diarrhea, nausea

Frequency not reported: Abdominal pain, constipation, dyspepsia, stomatitis, vomiting[Ref]


Common (1% to 10%): Influenza, preexisting binding antibodies[Ref]


Common (1% to 10%): Chest pain

Uncommon (0.1% to 1%): Capillary leak syndrome, flushing, hypotension

Rare (0.01% to 0.1%): Aortitis

Frequency not reported: Peripheral edema[Ref]

Nervous system

Common (1% to 10%): Headache

Frequency not reported: Dizziness, taste perversion[Ref]


Common (1% to 10%): Periorbital edema[Ref]


Uncommon (0.1% to 1%): Acute respiratory distress syndrome (ARDS), dyspnea, fatal ARDS, interstitial pneumonia, pulmonary adverse reactions, pulmonary edema, pulmonary fibrosis, pulmonary infiltrates, respiratory failure[Ref]


Uncommon (0.1% to 1%): Anaphylaxis, angioedema, hypersensitivity reactions/hypersensitivity-type reactions, serious allergic reactions

Frequency not reported: Allergies to acrylics

Postmarketing reports: Allergic reactions, allergic-type reactions, anaphylactic reactions[Ref]


Uncommon (0.1% to 1%): Transient elevations in ALT, transient elevations in AST, transient elevations in liver function tests[Ref]


Uncommon (0.1% to 1%): Glomerulonephritis[Ref]


Frequency not reported: Potential for tumor growth stimulatory effects on malignant cells[Ref]


Frequency not reported: Insomnia[Ref]

Frequently asked questions


1. Product Information. Neulasta (pegfilgrastim). Amgen. 2002.

2. Cerner Multum, Inc. UK Summary of Product Characteristics.

3. Cerner Multum, Inc. Australian Product Information.

Further information

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

Some side effects may not be reported. You may report them to the FDA.