Indication

Neulasta® is a prescription medication used to help reduce the chance of infection due to a low white blood cell count, in people with certain types of
cancer (non-myeloid), who receive anti-cancer medicines (chemotherapy) that can cause fever and low blood cell count.

Neulasta® is a prescription medication used to help reduce the chance of infection due to a low white blood cell count, in people with certain types of cancer (non-myeloid), who receive anti-cancer medicines (chemotherapy) that can cause fever and low blood cell count.

Neulasta® is a prescription medication used to help reduce the chance of infection due to a low white blood cell count, in people with certain types of cancer (non-myeloid), who receive anti-cancer medicines (chemotherapy) that can cause fever and low blood cell count.

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Strong chemotherapy fights cancer.
But it can also put you at risk of infection.

Strong Chemo and Your White Blood Cells

Strong chemotherapy works by killing the fast-growing cancer cells in your body. At the same time, it can decrease the number of white blood cells in your body. Having a low white blood cell count can weaken your immune system, which increases your risk of infection during your strong chemotherapy treatment.

About Febrile Neutropenia

A low white blood cell count is called neutropenia. When combined with a fever, it’s called febrile neutropenia – and it may be a sign that you have an infection, which is one of the most serious side effects of strong chemotherapy. In fact, based on a study from 2010, more than 80% of U.S. patients with febrile neutropenia require hospitalization.*

Reducing Your Risk of Infection

A key clinical study of 928 patients showed that infection can happen through all cycles of strong chemo, but happened most often in the first cycle. So your doctor may recommend a white blood cell booster like Neulasta® to help reduce your risk of infection during every cycle of strong chemo. These medications work by helping your body produce more infection-fighting white blood cells called neutrophils.

FAQs about Chemotherapy

  • What is chemotherapy?

    Chemotherapy (chemo) is a type of treatment that includes a medication or combination of medications to treat cancer. The goal of chemo is to stop or slow the growth of cancer cells. Chemo is considered a systemic therapy. This means it may affect your entire body.

    Chemo medications attack fast-growing cancer cells, but they can also affect healthy cells that grow rapidly. The effect of these medications on normal cells often causes chemo side effects. For example:

    • A number of blood cells that divide rapidly can be damaged along with cancer cells during chemo:
      • White blood cells help protect the body from infection. A low white blood cell count is known as neutropenia. If your white blood cell count gets too low, you could get an infection.
      • Red blood cells carry oxygen throughout your body. A low red blood cell count is known as anemia. Anemia can lead to fatigue, chest pain, and more serious complications.
      • Platelets are structures in the blood that help stop bleeding. A low platelet cell count is known as thrombocytopenia. A low platelet count can cause bruising and bleeding.
    • Hair follicles have cells that can be affected by chemo, leading to hair loss, also called alopecia.
    • Cells lining your stomach can also be affected by chemo. This can cause vomiting and diarrhea, and may be associated with nausea.
  • How does chemotherapy work?

    The goal of chemotherapy (chemo) is to kill cancer cells or slow the growth of cancer over time. Chemo is often given several times over weeks or months in what is known as a course of treatment. A course of treatment is made up of a series of treatment periods, called cycles. During a cycle, you may get chemo every day for one or more days. Since chemo also kills normal cells, these chemo days are followed by periods of rest when you receive no treatment. This rest lets your body recover and produce new healthy cells.

  • What is a chemo regimen?

    Your doctor will create a plan, or regimen, that includes the type of chemo medications you will receive. The regimen also includes the medication dose and how often you will receive it. Your doctor will choose certain medications that can best fight your cancer.

  • How is chemo given?

    Chemotherapy (chemo) treatment plans may use a single medication or a combination (or "cocktail") of medications that can be delivered in more than one way. You may receive chemo in one or more of the following forms:

    • Injection. Types of injection include:
      • Subcutaneous (SQ): Chemo given as a shot just under the skin
      • Intramuscular (IM): Chemo given as a shot directly into a muscle
      • Intravenous (IV): Chemo given as a shot directly into a vein
    • IV infusion: Chemo medications are dripped through a tube that is attached to a needle and put into a vein
    • Oral: Chemo taken by mouth as a pill or liquid
    • Topical: A cream containing the chemo medication that is rubbed into the skin
    • Intra-arterial (IA): Chemo delivered into an artery that is connected to the tumor
    • Intraperitoneal (IP): Chemo given directly into the area that contains the intestines, stomach, liver, ovaries, etc. This area is called the peritoneal cavity
  • What are the most common side effects of chemo?

    Most people undergoing chemotherapy (chemo) will have chemo side effects. These can vary from person to person. Common chemo side effects include:

    • Hair loss, also called alopecia
    • Nausea and vomiting
    • Fatigue
    • Neutropenia, a low number of white blood cells. White blood cells help you fight infections.
    • Anemia, caused by a low number of red blood cells. Red blood cells carry oxygen throughout the body.
    • Thrombocytopenia, a low number of platelets. Platelets help the blood to clot to stop bleeding.
    • Trouble with memory
    • Mouth sores
  • What are the most serious side effects of chemotherapy?

    Some chemo side effects can be serious. These may include febrile neutropenia, anemia, thrombocytopenia, fatigue, and nausea and vomiting. You can learn more about these serious chemo side effects by talking to your doctor.

  • What can happen to white blood cells during strong chemotherapy?

    White blood cells are a key part of your immune system. At natural levels, white blood cells help protect your body against infection. Strong chemotherapy can lower the number of infection-fighting white blood cells in your body, which may weaken your immune system and increase your risk for infection.

  • How will I know if my white blood cell counts are low?

    Your doctor may routinely use a test called a complete blood count (a CBC) before and during your chemotherapy treatment. A CBC can help tell if a patient is at increased risk of or has an infection.

  • What are the signs of an infection?

    If you’re getting strong chemo, watch for these signs of infection. It’s very important to tell your doctor or nurse if you experience the following:

    • Fever
    • Chills, cough or sore throat
    • Constipation, loose stools or diarrhea
    • Painful or frequent urination
    • Mouth ulcers or sores in the throat
    • Unusual vaginal discharge or itching
    • Redness, swelling or soreness in the skin around an implanted port
    • Shortness of breath, chest pain
    • Irregular or rapid heartbeat
    • Blood in urine or stool
  • What can I do to avoid getting an infection during strong chemo?

    During strong chemo, you may be at risk for infection. There may be ways you can help protect yourself. Here are some things you can do:

    • Wash your hands frequently with soap and water. This is especially important after you use the toilet and before cooking and eating.
    • Avoid people who have diseases—such as colds or the flu—that you can catch.
    • Clean cuts and scrapes right away with warm water and soap. Cover with a bandage. Ask your doctor and care team if using antibiotic creams is right for you.
    • Avoid crowds where germs can be rampant.
    • Be careful not to cut or nick yourself. Use an electric shaver instead of a razor. Wear protective gloves when gardening or cleaning to avoid cuts and scrapes.

Important Safety Information

Who should not take Neulasta®?

Do not take Neulasta® if you have had a serious allergic reaction to Neulasta® (pegfilgrastim) or to NEUPOGEN® (filgrastim).

What should I tell my health care provider before taking Neulasta®? Tell your healthcare provider if you:

  • Have sickle cell trait or sickle cell disease
  • Have had severe skin reactions to acrylic adhesives
  • Are allergic to latex
  • Have problems with your kidneys
  • Have any other medical problems
  • Are pregnant or plan to become pregnant. It is not known if Neulasta® may harm your unborn baby.
  • Are breastfeeding or plan to breastfeed. It is not known if Neulasta® passes into your breast milk.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

What are possible serious side effects of Neulasta®?

  • Spleen Rupture. Your spleen may become enlarged and can rupture while taking Neulasta®. A ruptured spleen can cause death. 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 healthcare provider or get emergency medical help right away if you get any of these symptoms of ARDS: fever, shortness of breath, trouble breathing, or a fast rate of breathing.
  • Serious Allergic Reactions. Get emergency medical help right away if you get any of these symptoms of a serious allergic reaction with Neulasta®: shortness of breath, wheezing, dizziness, swelling around the mouth or eyes, fast pulse, sweating, and hives.

If you have an allergic reaction during the delivery of Neulasta®, remove the On-body Injector for Neulasta® by grabbing the edge of the adhesive pad and peeling off the On-body Injector. Get emergency medical help right away.

  • Sickle Cell Crises. Severe sickle cell crises, and sometimes death, can happen in people with sickle cell trait or disease who receive filgrastim, a medicine similar to Neulasta®.
  • Kidney injury (glomerulonephritis). Kidney injury has been seen in patients who received Neulasta®. You should notify your healthcare provider right away if you experience puffiness in your face or ankles, blood in your urine or brown colored urine or you notice you urinate less than usual.
  • Increased white blood cell count (leukocytosis). Your doctor will check your blood during treatment with Neulasta ®.
  • Capillary Leak Syndrome. Neulasta® can cause fluid to leak from blood vessels into your body’s tissues. This condition is called "Capillary Leak Syndrome" (CLS). CLS can quickly cause you to have symptoms that may become life-threatening. Get emergency medical help right away if you develop any of the following symptoms:
    • swelling or puffiness and are urinating less often
    • trouble breathing
    • swelling of your stomach area (abdomen) and feeling of fullness
    • dizziness or feeling faint
    • a general feeling of tiredness
    • The most common side effect of Neulasta® is pain in the bones and in your arms and legs.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of Neulasta®. Call your doctor for medical advice about side effects. You may report negative side effects to the FDA at 1-800-FDA-1088.

For more information about Neulasta®, talk with your healthcare provider or pharmacist; go to www.neulasta.com, or call 1-844-696-3852 (1-844-MYNEULASTA).

Please see Neulasta® Patient Information.

Important Safety Information
Who should not take Neulasta®?
Do not take Neulasta® if you have had a serious allergic reaction to Neulasta® (pegfilgrastim) or to NEUPOGEN® (filgrastim).
What should I tell my health care provider before taking Neulasta®? Tell your healthcare provider if you:
• Have sickle cell trait or sickle cell disease

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