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• About Low White
  Blood Cell Counts
  • Who is Most at Risk?
  • Understanding Your Blood Counts
• How Neulasta^®
  Can Help
  • Neulasta^® and NEUPOGEN^®
• Helping to Protect
  Against Infection
• Questions to Ask
  Your Doctor
• Support and
  Resources
  • Information on
    Neutropenia and
    Cancer
• Glossary of Terms
• Important Safety
  Information

Help for Infection Protection and Reducing the Risk of Infection During Chemotherapy

As a cancer patient taking chemotherapy (this is sometimes called chemo), you may be aware how some chemo increases your chance of infection. While this may be true, there are steps you can take to help protect against infection.

At every step of your chemo, it's important to help protect yourself against infections. Taking a white cell booster such as Neulasta^® (pegfilgrastim) or NEUPOGEN^® (filgrastim) is one way to help protect yourself, but there are other everyday precautions that are also helpful, such as the following:^1,2

• Always wash your hands with soap and plenty of water to avoid transmission of infection through things that you touch.
• Avoid people with colds or the flu.
• Avoid large crowds to avoid coming into contact with sick people.
• Bathe daily and gently dry your skin.
• Use lotion to help prevent cracks in your skin.
• Prevent cuts or scrapes, which can provide places for infection to enter your body.
  • Use an electric razor instead of a blade to prevent cuts.
  • Handle sharp objects with caution.
  • Wear protective gloves when appropriate.
• If you get a cut or scrape, cover it with a clean bandage until it heals.
• Cook food thoroughly to kill infection-causing bacteria that may be in raw food.

Watch for signs of infection

Be sure to report any of the following signs of infection immediately to your doctor:^2-4

• Fever higher than 100.5°F (38°C)
• Chills
• Cough or sore throat
• Loose stools/diarrhea over 24 hours
• Changes in urination
• Mouth ulcers or sores in the throat or around the rectum
• Unusual vaginal discharge or itching
• Redness, swelling, or sores on the skin

Are there any tests that can help monitor for risk of infection?

Your doctor determines what kinds of tests are needed. If you are receiving chemotherapy, you may have blood work done anywhere from the day of or up to 7 days before your scheduled treatment. This blood work will include a complete blood count (CBC). A blood sample for a complete blood count (CBC) will also be collected 7 to 14 days following your chemotherapy. The CBC measures counts of different cells in your body, including the white blood cell (WBC) counts. Patients with a low WBC count are at increased risk of infection and may benefit from treatment with a low white blood cell booster such as Neulasta^®.

If you are concerned or unsure about your condition, it may help to make a list of questions to ask your doctor.

What are Neulasta^® and NEUPOGEN^®?

Neulasta^® (pegfilgrastim) and NEUPOGEN^® (Filgrastim) are prescription medications used to reduce the risk of infection (initially marked by fever) in patients with some tumors receiving strong chemotherapy that decreases the number of infection-fighting white blood cells.

Important Safety Information

Who should not take Neulasta^® or NEUPOGEN^®?
Do not take Neulasta^® or NEUPOGEN^® if you have had an allergic reaction to Neulasta^® (pegfilgrastim) or to NEUPOGEN^® (Filgrastim).

Do Neulasta^® and NEUPOGEN^® prevent all infections?
Neulasta^® or NEUPOGEN^® may reduce your chance of getting an infection, but it does not prevent all infections. An infection can happen anytime your neutrophil counts are low. Look for signs of infection, such as fever, chills, rash, sore throat, diarrhea, or redness, swelling, or pain around a cut or sore. If you have any of these signs, contact your health care professional immediately.

What are possible serious side effects of Neulasta^® and NEUPOGEN^®?
Your spleen may become enlarged and can rupture while taking Neulasta^® or NEUPOGEN. A ruptured spleen can cause death. The spleen is located in the upper left section of your stomach area. Call your doctor right away if you have pain in the left upper stomach area or left shoulder tip area. This pain could mean your spleen is enlarged or ruptured.

A serious lung problem called acute respiratory distress syndrome (ARDS) has been reported with Neulasta^® and NEUPOGEN use. Call your doctor or seek emergency care right away if you have shortness of breath, trouble breathing, or a fast rate of breathing.

Neulasta^® and NEUPOGEN can cause serious allergic reactions. These reactions can cause shortness of breath, wheezing, dizziness, swelling around the mouth or eyes, fast pulse, sweating, and hives. If you start to have any of these symptoms, call your doctor or seek emergency care right away. If you have an allergic reaction during the injection, stop the injection. Call your doctor right away.

You may have a serious sickle cell crisis if you have a sickle cell disorder and take Neulasta^® or NEUPOGEN. Serious and sometimes fatal sickle cell crises can occur in patients with sickle cell disorders receiving NEUPOGEN. Call your doctor right away if you have symptoms of sickle cell crisis such as pain or difficulty breathing.

What are the most common side effects of Neulasta^® and NEUPOGEN^®?
The most common side effect you may experience is aching in the bones and muscles. If this happens, it can usually be relieved with a nonaspirin pain reliever, such as acetaminophen.

Some people experience redness, swelling, or itching at the site of injection. If you notice any signs of a local reaction, call your doctor.

If you have any questions about this information, be sure to discuss them with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Next: Questions to Ask Your Doctor >>