(oh PREL ve kin)

Trade name:  Neumega^®
Other names:  IL-11, interleukin-11

Chemocare.com uses generic names in all descriptions of drugs. Neumega is the trade name for oprelvekin. IL-11 and interleukin-11 are other names for oprelvekin. In some cases, health care professionals may use the trade name neumega or other names IL-11 and interleukin-11 when referring to the generic drug name oprelvekin.

Drug type:  Oprelvekin is a biologic response modifier.  It is classified as a cytokine.  (For more detail, see "How this drug works" section below).

What Oprelvekin Is Used For:

• Oprelvekin is used to stimulate the bone marrow to produce platelets in order to prevent low platelets that may be caused by chemotherapy. Platelets are blood cells that allow the blood to clot, and prevent bleeding.
• Oprelvekin may be given to decrease the need for platelet transfusions.
• Oprelvekin is not indicated for myeloid malignancies (diseases that start in the bone marrow such as leukemia).
• Oprelvekin is a support medication.  It does not treat cancer.

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 Oprelvekin Is Given:

• Oprelvekin is given by subcutaneous (the layer between the skin and muscle).
• Oprelvekin is usually given 6-24 hours after chemotherapy.
• Oprelvekin is generally given on a daily basis.  The number of days you receive oprevlekin will be prescribed by your doctor.
• You may be taught to give these shots to yourself once a day after chemotherapy, or they may be given to you by another healthcare provider.
• The amount of oprelvekin that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated.  Your doctor will determine your dose and schedule.

Side Effects:

Important things to remember about the side effects of oprelvekin:

• Most people do not experience all of the side effects listed.
• Side effects are often predictable in terms of their onset and duration. 
• Side effects are almost always reversible and will go away after treatment is complete.
• There are many options to help minimize or prevent side effects.
• There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
   

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

• Swelling (water retention - most common in the hands, feet and ankles)
• Nausea and vomiting
• Mouth sores
• Diarrhea
• Shortness of breath

These side effects are less common side effects (occurring in about 10-29%) of patients receiving oprelvekin:

• Headache
• Fever
• Rapid heartbeat/palpitations (see heart problems)
• Dizziness
• Insomnia (see sleep problems)
• Cough
• Rhinitis/pharyngitis (see cold symptoms)
• Rash
• Conjuctival infection (see eye problems)
• Bone or joint pain
• Temporary anemia (low red blood count - will resolve on it's own within a week after oprevelkin is discontinued).

A serious, but very uncommon side effect of oprelvekin is "capillary leak syndrome" or "vascular leak syndrome."  Capillary leak syndrome is a potentially serious disease in which fluids within the vascular system (veins and capillaries) leaks into the tissue outside the bloodstream. This results in low blood pressure and poor blood flow to the internal organs. Capillary leak syndrome is characterized by the presence of 2 or more of the following 3 symptoms; low blood pressure, swelling, and low levels of protein in the blood.  Your doctor will monitor these things carefully while you are taking oprelvekin.   You should notify your doctor immediately if you notice dizziness (especially when changing position), sudden swelling or rapid weight gain, little or no urine output (for 8-12 hours), shortness of breath, difficulty breathing, irregular heartbeats, or chest pain.

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Seek emergency help immediately and notify your health care provider, if you experience the following symptoms:

• Shortness of breath, wheezing, difficulty breathing, closing up of the throat, swelling of facial features, hives (possible allergic reaction).

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

• Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)
• Dizziness (especially when changing position), sudden swelling or rapid weight gain, little or no urine output (for 8-12 hours), shortness of breath, difficulty breathing, irregular heartbeats, or chest pain.

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:

• Nausea (interferes with ability to eat and unrelieved with prescribed medication)
• Vomiting (vomiting more than 4-5 times in a 24 hour period)
• Diarrhea (4-6 episodes in a 24-hour period)
• Unusual bleeding or bruising
• Black or tarry stools, or blood in your stools
• Blood in the urine
• Mouth sores (painful redness, swelling or ulcers)
• Swelling of the feet or ankles.  Sudden weight gain
• Signs of infection such as redness or swelling, pain on swallowing, coughing up mucous, or painful urination.

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

Precautions:

• Before starting oprelvekin 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, or 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 oprevelkin.
• 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: Do not conceive a child (get pregnant) while taking oprelvekin. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
• Do not breast feed while taking this medication.

Self-Care Tips:

• You may be at risk of infection so try to avoid crowds or people with colds and those not feeling well, and report fever or any other signs of infection immediately to your health care provider.
• Wash your hands often.
• You may be at risk of infection report fever or any other signs of infection immediately to your health care provider.
• To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.
• Use an electric razor and a soft toothbrush to minimize bleeding.
• Avoid contact sports or activities that could cause injury.
• To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
• You may experience drowsiness or dizziness; avoid driving or engaging in tasks that require alertness until your response to the drug is known.
• You may experience bone or joint pain as a result of this medication. Ask your healthcare provider if you may take a mild pain medicine to relieve this. Tylenol^® may help.
• The anemia you may experience as a result of this therapy should resolve within a few weeks of stopping the drug.
• Avoid sun exposure.  Wear SPF 15 (or higher) sunblock and protective clothing.
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely.  You should discuss this with your doctor.
• Get plenty of rest. 
• Maintain good nutrition.
• If you experience symptoms or side effects, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing:

You will be checked regularly by your health care professional while you are taking oprelvekin, to monitor side effects and check your response to therapy.  Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.   

How Oprelvekin 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 waste products from organs and tissues; and platelets, which enable the blood to clot.  Cancer treatments such as chemotherapy and radiation therapy can effect these cells which put a person at risk for developing infections, anemia and bleeding problems.  Colony-stimulating factors and growth 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 cancer treatment.

Oprelvekin is a cytokine that stimulates the production, maturation and activation of platelets. In patients receiving chemotherapy, oprelvekin can accelerate the return of platelets to normal levels, reducing the thrombocytopenic (low platelet) phase (the time in which people are most susceptible to bleeding), and decrease the need for platelet transfusions.

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.  

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