Care During Chemotherapy and Beyond
(peg fil GRA stim)
Trade names: NeulastaTM
Other names: G-CSF, granlocyte - colony stimulating
Chemocare.com uses generic names in all descriptions of drugs. Neulasta is the trade
name for pegfilgrastim. G-CSF is another name for pegfilgrastim. In some cases,
health care professionals may use the trade name neulasta or other names G-CSF when
referring to the generic drug name pegfilgrastim.
Drug type: Pegfilgrastim is a biologic response modifier.
It is classified as a colony stimulating factor. (For more detail, see "How
this drug works" section below).
What Pegfilgrastim Is Use 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 not be given within 14 days prior to chemotherapy.
- Pegfilgrastim is given as a single injection.
Note: If a drug has been approved for one use, physicians
sometimes elect to use this same drug for other problems if they believe it might
How Pegfilgrastim Is Given:
- This medicine can be given as a shot underneath the skin (subcutaneous [SQ]), in
pre-filled syringes. The dose of pegfilgrastim depends upon why you are receiving
- The amount of this medication you will receive also depends on many other factors,
including your height and weight, your general health or other health problems,
and the type of cancer you have. Your doctor will determine your dose and
Important things to remember about the side effects of pegfilgrastim:
- 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.
- Pegfilgrastim is a support medication. The following list includes side effects
attributed to pegfilgrastim. Other side effects experienced were attributed
to the chemotherapy and/or the disease.
The following side effects are common (occurring in greater than 30%) for
patients taking pegfilgrastim:
- Note: There are no common side effects of pegfilgrastim
These side effects are less common side effects (occurring in about 10-29%)
of patients receiving pegfilgrastim:
- Pain (bone pain)
- Blood test abnormalities (temporary elevation in lactate dehydrogenase)
- These will return to normal once treatment is discontinued
- Tenderness at the site of injection
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:
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), chills, sore throat (possible signs of infection)
- Shortness of breath
- Rapid heart beat
- Bleeding that does not stop after a few minutes
- Any new rashes on your skin
The following symptoms require medical attention, but are not emergency situations.
Contact your health care provider within 24 hours of noticing any of the
- Bone pain that does not go away despite taking recommended pain reliever
Always inform your health care provider if you experience any unusual symptoms.
- Before starting pegfilgrastim 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.
- The manufacturer recommends that the first dose of pegfilgrastim be given no sooner
than 24 hours after chemotherapy. Your doctor will discontinue therapy with
pegfilgrastim when your white blood cell count has reached acceptable levels.
- Pegfilgrastim may be inadvisable if you have had a hypersensitivity (allergic) reaction
to filgrastim, pegfilgrastim or E. coli-derived proteins.
- Do not receive any kind of immunization or vaccination without your doctor's approval
while taking pegfilgrastim.
- 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 pegfilgrastim.
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.
- Pegfilgrastim should be used with caution in people taking lithium.
- If you are performing your own subcutaneous self-injections, remove the syringe
from the refrigerator 30 minutes prior to injection. This will reduce local
stinging at the injection site.
- 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. Acetaminophen
(Tylenol®) may help.
- Apply a warm compress if you have any pain, redness or swelling at the injection
site, and notify your doctor.
- You may be at risk of infection so try to avoid crowds or people with colds, and
report fever or any other signs of infection immediately to your health care provider.
- Wash your hands often.
- Avoid contact sports or activities that could cause injury.
- This medication causes little nausea. But if you should experience nausea, take
anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
Sucking on lozenges, and chewing gum may also help.
- 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 doctor while you are taking pegfilgrastim
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 Pegfilgrastim 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 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.
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 (the filgrastim) to stay in the body longer before they are broken down
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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