Health Alert:

Your health can’t wait. Learn how we’re making our facilities safer and schedule your care now.

Pegfilgrastim-xxxx (Neulasta, Neulasta Onpro, Fulphila, Udenyca)

About This Drug

Pegfilgrastim-xxxx belongs to a class of medicines called granulocyte colony-stimulating factor (G-CSF). G-CSF helps the body make more white blood cells. White blood cells help fight infection in your body. This drug is given as an injection under the skin (subcutaneously)

Possible Side Effects

  • Bone pain
  • Pain in your arms and/or legs

Note: Each of the side effects above was reported in 5% or greater of patients treated with pegfilgrastim-xxxx. Not all possible side effects are included above.

Warnings and Precautions

  • Enlargement and inflammation (swelling) of your spleen, which can very rarely rupture and be lifethreatening. Signs of enlargement may be left-sided pain in your abdomen and/or shoulder.
  • Trouble breathing because of fluid build-up around your lungs and/or inflammation (swelling) of the lungs.
  • Allergic reactions, including anaphylaxis are rare but may happen in some patients. Signs of allergic reaction to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, do not take another dose of this drug. You should get urgent medical treatment.
  • Sickle cell crisis in sickle cell patients treated with pegfilgrastim-xxxx
  • Changes in your kidney function
  • A rapid increase in your white blood cells may happen
  • A syndrome where fluid and protein can leak from your blood vessels into your tissues. This can cause a decrease in your blood protein level and blood pressure and fluid can accumulate in your tissues and/or lungs.
  • The on-body injector uses acrylic adhesive. Caution should be used if you have an allergy to acrylic adhesives.
  • Missed or partial doses of the medication have been reported from the on-body injector device not working properly. This could increase your risk of developing severely low white blood cells, which puts you at a risk of severe and life-threatening infections. If you have any problems with the onbody injector, contact your doctor and/or nurse right away.
  • Inflammation of the aorta- symptoms may include fever, abdominal pain, back pain and feeling tired.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

Important Information

For patients with the on-body-injector (OBI) only:

  • Avoid activities such as traveling, driving, or operating heavy machinery during hours 26-29 after it is placed.
  • Do not use any other materials to hold it in place that could cover the audio/visual indicators or could press down the injector against your skin. Avoid peeling off the adhesive before the full dose of pegfilgrastim has been delivered.
  • Keep your OBI dry for the last 3 hours before the dose should be delivered.
  • If your OBI comes off before the full dose is delivered, do not try to reapply it. Instead, call your nurse and/or doctor right away.
  • Notify your nurse and/or doctor right away if your OBI becomes saturated in fluid, or if there is dripping around the OBI. These could be signs of leaking and could increase the risk of a missed or incomplete dose of pegfilgrastim.
  • It is recommended to avoid using lotions, creams, or oils on your arms and abdomen to help keep the device on your skin, especially before your next scheduled dose of the OBI.
  • Keep the OBI at least 4 inches away from electrical equipment such as cell phones, cordless telephones, microwaves and other appliances as it could interfere with the operation of the OBI and cause a missed or incomplete dose of pegfilgrastim.
  • Do not expose the OBI to temperatures less than 41°F (5°C) or greater than 104°F (40°C).
  • Avoid bumping or knocking off your OBI off your body.
  • Do not expose your OBI to medical imaging studies such as an X-ray (including airport X-ray scans), MRI, CT scan or ultrasound. Avoid radiation treatments or oxygen rich places such as hyperbaric chambers. This could increase the risk of damage to your OBI or injury to yourself.
  • Avoid sleeping on your OBI.
  • Avoid using bathtubs, hot tubs, whirlpools or saunas and avoid exposing your OBI to direct sunlight as this may affect pegfilgrastim.

How to Take Your Medication

  • Talk to your doctor, nurse and/or pharmacist for proper preparation, dosing, administration. It is important that you follow the instructions and precautions closely. 

Treating Side Effects

  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.

Food and Drug Interactions

  • There are no known interactions of pegfilgrastim-xxxx with food.
  • Tell your doctor and pharmacist about all the prescription and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.4° F (38° C) or higher
  • Chills
  • Cough
  • Wheezing and/or trouble breathing
  • Feeling dizzy or lightheaded
  • Tiredness that interferes with your daily activities
  • Pain in the left side of the abdomen and/or shoulder pain
  • Back pain
  • Decreased urine, or very dark urine
  • Pain that does not go away or is not relieved by prescribed medicine
  • Swelling of legs, ankles, or feet
  • Signs of allergic reaction: swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, call 911 for emergency care.
  • Red flashing light on your OBI and/or any other signs of your OBI not working properly
  • If you think you may be pregnant

Reproduction Warnings

  • Pregnancy warning: It is not known if this drug may harm an unborn child. For this reason, be sure to talk with your doctor if you are pregnant or planning to become pregnant while receiving this drug. Let your doctor know right away if you think you may be pregnant.
  • Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breastfeeding during treatment with this drug because this drug may enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Revised January 2020

This patient information was developed by Via Oncology, LLC © 2020. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.