Care During Chemotherapy and Beyond

Neulasta Onpro

Generic Name: Pegfilgrastim

(peg fil GRA stim)

Trade Name: Neulasta Onpro

Other Name(s): G-CSF, Granulocyte - Colony Stimulating Factor

Pegfilgrastim is the generic name for the trade name drug Neulasta Onpro. In some cases, health care professionals may use the trade name Neulasta Onpro when referring to the generic drug name Pegfilgrastim.

Drug Type: Pegfilgrastim is the biologic response modifier. This medication is classified as a "granulocyte-colony stimulating factor" (for more detail, see "How Neulasta Onpro Works" below).

What Neulasta Onpro Is Used For

  • This medicine is used to stimulate the growth of "healthy" white blood cells in the bone marrow, once chemotherapy is given. White blood cells help the body to fight infection. This is not a chemotherapy drug.
  • This medication is usually given at least 24 hours after chemotherapy to stimulate the growth of new, healthy, white blood cells (WBC).
  • Pegfilgrastim is a longer acting form of filgrastim and the manufacturer recommends that it should be given within 14 days prior to chemotherapy.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Neulasta Onpro Is Given

  • Neulasta Onpro is an On-body injector that delivers Neulasta with an under the skin (sub-cutaneous) injection.
  • The Neulasta Onpro Kit contains a Neulasta prefilled syringe, an on-body injector, instructions, and a reference guide.
  • Your healthcare provider will prepare an area of skin and apply the on-body injector. Once the on-body injector is placed on your skin, it will beep and the yellow light will flash.
  • A short needle will inset with is designed to allow Neulasta to be delivered under your skin 27 hours later. The needle is designed to go back into the on-body injector, but the cannula will remain in place until the on-body injector is removed.
  • For the next 27 hours, the green light will flash every 5 seconds. This means the on-body injector is working properly.

Side Effects

Important things to remember about the side effects of Neulasta Onpro:

  • Most people will not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset, duration and severity.
  • Side effects will improve after therapy is complete.
  • Side effects may be quite manageable. There are many options to minimize or prevent the side effects of Neulasta Onpro.

The following side effects are common (occurring in greater than 30%) for patients taking Neulasta Onpro:

  • Bone Pain
    • Bone pain may be relieved with over the counter medications which includes pain relievers such as NSAIDS (ibuprofen) or antihistimines (loratidine). Talk with your doctor before taking any over the counter agents.

These are less common side effects (occurring in 10-29%) for patients receiving Neulasta Onpro:

  • Blood test abnormalities (temporary elevation in lactate dehydrogenase). These will return to normal once treatment is discontinued.
  • Tenderness and redness at the site of injection.
  • Pain in muscles, arms, or legs.

Not all side effects are listed above. Side effects that are very rare - occurring in less than about 10 percent of patients - are not listed here. You should always inform your health care provider if you experience any unusual symptoms.

When to Contact Your Doctor or Health Care Provider

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • 100.4º F (38º C) or higher, chills (possible signs of infection)
  • Any signs of an allergic reaction, such as a rash, hives, wheezing, trouble breathing, swelling of the mouth, face, lips, tongue, or throat.
  • Shortness of breath
  • Rapid heart beat
  • Pain, discomfort, or bleeding around your on-body injector

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • Bone pain that does not go away despite taking recommended pain reliever.

Note: Always inform your health care provider if you experience any unusual symptoms.


  • Before starting Neulasta Onpro treatment make sure you tell your doctor about any other medications you are taking (including prescription, over-the counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking Neulasta Onpro.
  • Neulasta Onpro should be avoided for those experiencing a serious allergic reaction to pegfilgrastim (Neulasta) or filgrastim (Neupogen).
  • Tell your healthcare provider if you have had severe skin reactions to acrylic adhesives.
  • Keep the on-body injector dry for 3 hours prior to the dose delivery start.
  • Keep the on-body injector at least 4 inches away from electrical equipment, including cell phones, cordless phones, microwaves, and other common appliances.
  • Do not expose the on-body injector to MRI, E-Ray (including airport X-Ray), CT scan or ultrasound. Tell your doctor if you have this device before these exams.
  • Avoid the use of heat sources, such as sunlamps, tanning beds, heating pads, electric blankets, saunas, hot tubs, etc. while wearing the on-body injector.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus).
  • For both men and women: use contraceptives, and do not conceive a child (get pregnant) while taking Neulasta Onpro. Barrier methods of contraception, such as condoms, are recommended
  • Talk to you doctor before breast feeding while taking this medication.

Self-Care Tips

  • Your healthcare provider will apply your Neulasta on-body injector. Over the next 27 hours, occasionally check the status light for at least 10 seconds. If the status light is flashing green, it is okay.
  • After about 27 hours, your on-body injector will produce a series of beeps to let you know your dose delivery is about to begin.
  • For the next 45-minutes, monitor your on-body injector frequently for leaks during dose delivery. Your dose delivery will take around 45 minutes to complete. When dose delivery is complete, a long beep will sound and the status light will be solid green.
  • After the beep, check the color of the status light. If the status light is solid green or has switched off, you may remove the on-body injector.
  • To remove the on-body injector, grab the edge of the adhesive pad and slowly peel off the on-body injector.
  • Check to see if you on-body injector is empty by seeing a black line next to the empty indicator.
  • After the on-body injector is removed, place it in a sharps disposal container.
  • Call your healthcare provider if any of the following occur: if the status light is flashing red, if the adhesive becomes noticeably wet with fluid or is dripping, or if the on-body injector comes off before the full dose is delivered.

How Neulasta Onpro Works

In the body's bone marrow (the soft, sponge-like material found inside bones) blood cells are produced. There are three major types of blood cells; white blood cells, which fight infection; red blood cells, which carry oxygen to and remove waster products from organs and tissues; and platelets, which enable the blood to clot. Cancer treatments such as chemotherapy and radiation therapy can affect these cells which put a person at risk for developing infection, anemia and bleeding problems. Colony-stimulating factors are substances that stimulate the production of blood cells and promote their ability to function. They do not directly affect tumors but through their role in stimulating blood cells they can be helpful as support of the person's immune system during care treatment.

Pegfilgrastim is a growth factor that stimulates the production, maturation and activation of neutrophils. Pegfilgrastim also stimulates the release of neutrophils (a type of white blood cell) from the bone marrow. In patients receiving chemotherapy, pegfilgrastim can accelerate the recovery of neutrophils, reducing the neutropenic phase (the time in which people are susceptible to infections). Pegfilgrastim is a long-acting version of filgrastim.

Pegfilgrastim is filgrastim with a substance called polyethylene glycol (PEG) attached to it. The attachment process is called pegylation, and is used to allow active substances (filgrastim) to stay in the body longer before they are broken down and eliminated.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice. is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit