Neulasta (pegfilgrastim) is a colony-stimulating factor, a man-made form of a protein that stimulates the growth of white blood cells, used to decrease the incidence of infection, by treating neutropenia, a lack of certain white blood cells caused by receiving cancer chemotherapy.

What is it used for?

  • Reducing the duration of low white blood cell counts (neutropenia) and risk of infection in people treated with chemotherapy for cancer (with the exception of chronic myeloid leukaemia and myelodysplastic syndromes).

How does it work?

  • Neulasta injection contains the active ingredient pegfilgrastim, which is a type of medicine called a recombinant human granulocyte-colony stimulating factor (G-CSF).
  • G-CSF is a substance produced naturally by the body that stimulates the bone marrow to produce white blood cells known as neutrophils. Filgrastim is a man-made version of G-CSF. Pegfilgrastim is a 'pegylated' form of filgrastim, which means it is attached to a substance called polyethylene glycol. This increases the length of time that the filgrastim works for.
  • Neutrophils, like all blood cells, are produced naturally by the bone marrow.
They play a central role in the body's immune system because they help defend the body from infections. A low level of neutrophils in the blood (neutropenia) leaves a person very susceptible to life threatening infections.
  • Neutropenia can be caused by a number of factors, including cancer chemotherapy, which often kills normal healthy cells such as blood cells as well as the cancer cells.
  • Filgrastim is used to stimulate the bone marrow to produce neutrophils and thus correct low neutrophil levels in the blood. This reduces the duration and severity of neutropenia caused by chemotherapy. As a result, filgrastim minimises the need for antibiotic treatment, the risk of complications due to infections and length of time spent in hospital.
  • Neulasta is given once for every cycle of chemotherapy. It is given as an injection under the skin (subcutaneous injection), approximately 24 hours after the chemotherapy.
  • Neulasta should be stored in a refrigerator at 2 to 8°C.
    You will need to have regular blood tests to monitor the numbers of blood cells in your blood while you are receiving treatment with this medicine.

    Use with caution in

    • Acute myeloid leukaemia (AML).
    • People who have recently had pneumonia.
    • Sickle cell disease.
    • Not to be used in
    • Allergy to filgrastim or E coli derived proteins.
    • Chronic myeloid leukaemia (CML).
    • Myelodysplastic syndromes.
    • Secondary acute myeloid leukaemia (AML).
    • Breastfeeding.

    This medicine is not recommended for children and adolescents under 18 years of age.
    This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

    If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

    Pregnancy and breastfeeding

    • Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
    • The safety of this medicine during pregnancy has not been established. It should not be used during pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.
    • There is no information available about the safety of this medicine during breastfeeding. For this reason it should not be given to women who are breastfeeding. Seek medical advice from your doctor.

    Side effects

    Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

    • Pain in the bones or muscles (musculoskeletal pain).
    • Chest pain.
    • Injection site pain.
    • Headache.
    • Enlargement of the spleen.
    • Nausea.
    • Allergic reactions, such as anaphylaxis, blistering skin rash, difficulty breathing, low blood pressure or swelling of the face, lips, throat or tongue.
    • Fluid on the lungs (pulmonary oedema).
    • Pneumonia.
    • A sudden inability to breath (adult respiratory distress syndrome, ARDS).
    • Decrease in the number of platelets in the blood (thrombocytopenia).
    • Abnormally high numbers of white blood cells in the blood (leukocytosis).

    The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

    For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

    How can this medicine affect other medicines?

    • This medicine is not known to affect other medicines. However, it is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, always check with your doctor or pharmacist before taking any new medicines while you are having treatment with this one, to ensure that the combination is safe.

    This medicine should be administered approximately 24 hours after chemotherapy for cancer. If it is given before this, the chemotherapy medicine may also affect any new blood cells produced by the filgrastim.



    Health Reference: Cancer