Brand Name(s):

  • Neulasta®

WHY is this medicine prescribed?

Pegfilgrastim is used to reduce the chance of infection in people who have certain types of cancer and are receiving chemotherapy medications that may decrease the number of neutrophils (a type of blood cell needed to fight infection). Pegfilgrastim is in a class of medications called colony stimulating factors. It works by helping the body make more neutrophils.

HOW should this medicine be used?

Pegfilgrastim comes as a solution (liquid) to inject subcutaneously (under the skin). It is usually given as a single dose for each chemotherapy cycle, no sooner than 24 hours after the last dose of chemotherapy of the cycle is given and more than 14 days before beginning the next chemotherapy cycle. Your doctor will tell you exactly when you should use pegfilgrastim.

Pegfilgrastim may be given to you by a nurse or other healthcare provider, or you may be told to inject the medication at home. If you will be injecting pegfilgrastim at home, follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use pegfilgrastim exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

If you will be injecting pegfilgrastim yourself, a healthcare provider will show you how to inject the medication. Be sure that you understand these directions. Ask your healthcare provider if you have any questions about where on your body you should inject pegfilgrastim, how to give the injection, or how to dispose of used needles and syringes after you inject the medication.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before using pegfilgrastim,

  • tell your doctor and pharmacist if you are allergic to pegfilgrastim, filgrastim (Neupogen), medications that are made using the bacteria E. coli, or any other medications. Ask your pharmacist if you do not know if a medication you are allergic to is made using E. coli. Also tell your doctor if you or the person who will be injecting pegfilgrastim for you is allergic to latex.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention lithium (Eskalith, Lithobid). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you are being treated with radiation therapy and if you have or have ever had cancer of the blood or bone marrow or sickle cell disease (a blood disease that may cause painful crises, a low number of red blood cells, infection, and damage to the internal organs). If you have sickle cell disease, you may be more likely to have a crisis during your treatment with pegfilgrastim. Call your doctor right away if you have a sickle cell crisis during your treatment.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using pegfilgrastim, call your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are using pegfilgrastim.
  • you should know that pegfilgrastim decreases the risk of infection, but does not prevent all infections that may develop during or after chemotherapy. Call your doctor if you develop signs of infection such as fever; chills; rash; sore throat; diarrhea; or redness, swelling, or pain around a cut or sore.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

If you will be injecting pegfilgrastim at home, talk to your doctor about what you should do if you forget to inject the medication on schedule.

What SIDE EFFECTS can this medicine cause?

Pegfilgrastim may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • redness, swelling, bruising, itching or a lump in the area where the medication was injected
  • bone, joint, or muscle pain
  • headache
  • weakness
  • constipation
  • vomiting
  • swelling of the arms, hands, feet, ankles, or lower legs

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

  • pain in the left upper part of the stomach or the tip of your left shoulder
  • fever
  • shortness of breath
  • trouble breathing
  • fast breathing
  • wheezing
  • dizziness
  • sweating
  • hives
  • rash
  • itching
  • swelling around the mouth or eyes

Pegfilgrastim may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the carton it came in, tightly closed, and out of reach of children. Store pegfilgrastim in the refrigerator but do not freeze it. If you accidentally freeze the medication, you may allow it to thaw in the refrigerator. However, if you freeze the same syringe of medication a second time, you should throw away that syringe. Pegfilgrastim may be kept at room temperature for up to 48 hours but should be kept away from direct sunlight. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

What should I do in case of OVERDOSE?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to pegfilgrastim.

Before having a bone imaging study, tell your doctor and the technician that you are using pegfilgrastim. Pegfilgrastim may affect the results of this type of study.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

AHFS® Consumer Medication Information. © Copyright, The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Last Reviewed: September 1, 2010.