• 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

Questions For Your Doctor on Chemotherapy Side Effects and Treatment

As a patient with cancer, part of your fight against your disease is to take control of your cancer care. One way to do that is to keep your doctor informed about side effects from your chemo, including any symptoms of infection you may experience.

The questions below may help open communication between you and your doctor about your blood counts and risk of infection. These questions will help keep your doctor informed about your needs, allowing him or her to explore the best cancer treatment options for you. It may also help to print out these questions and take them with you on your next routine visit.

• What are blood counts?
• How can I keep track of my blood counts?
• Which people on chemo are most at risk for neutropenia and infections?
• Why does chemotherapy increase my risk of infection?
• What effect can a low white blood cell count or infection have on me?
• Is it important for my doctor to be able to administer chemotherapy according to their treatment schedule?
• How can the risk of neutropenia complications be minimized?
• What is Neulasta^®?
• Do I need Neulasta^®?
• What are some of the side effects associated with Neulasta^®?
• What else can I do to help protect against infection?
• What other resources offer information and support for chemo patients?

In addition to consulting your doctor, you may wish to explore other ways of finding support and resources.

Indication

Neulasta^® (pegfilgrastim) is a prescription medication 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^®?
Do not take Neulasta^® if you have had an allergic reaction to Neulasta^® (pegfilgrastim) or to NEUPOGEN^® (Filgrastim).

What should I tell my health care provider before taking Neulasta^®?
If you have a sickle cell disorder, make sure your doctor knows about it before using Neulasta^®.

• Spleen Rupture. Your spleen may become enlarged and can rupture while taking Neulasta^®. 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). Call your doctor or seek emergency care right away if you have shortness of breath, trouble breathing, or a fast rate of breathing.
• Serious Allergic Reactions. Neulasta^® 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 of Neulasta^®, stop the injection. Call your doctor right away.
• Sickle Cell Crises. You may have a serious sickle cell crisis if you have a sickle cell disorder and take Neulasta^®. Serious and sometimes fatal sickle cell crises can occur in patients with sickle cell disorders receiving Filgrastim, a medicine similar to Neulasta^®. 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^®?
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.

• Occasionally pain and redness may occur at the injection site. If there is a lump, swelling, or bruising at the injection site that does not go away, talk to the doctor.
• Neulasta^® should only be injected on the day the doctor has determined and should not be injected until approximately 24 hours after receiving chemotherapy.
• The needle cover on the single-use prefilled syringe contains dry natural rubber (latex), which should not be handled by persons sensitive to this substance.

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.

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