Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041


Your treatment is called pegfilgrastim (peg-fill-GRASS-tim) or Neulasta® (new-LAST-ah). It is commonly used to treat neutropenia (low white blood cells), which can be a side effect of chemotherapy treatment. White blood cells are the infection fighting cells of the body, and if their numbers become too low, it can put you at risk for developing infections. Pegfilgrastim works by causing your bone marrow to make more white blood cells.

What Do I Need to Know Before Starting Treatment?

Be sure to tell your healthcare provider about any prescription or over-the-counter products you are taking, including dietary supplements, vitamins, herbal medicines and homeopathic remedies. Use an effective birth control method while you are taking this medication. It is not known whether pegfilgrastim can cause harm to a fetus, so be sure to tell your healthcare provider right away if you or your partner become pregnant. Avoid breastfeeding during treatment. It is not known if pegfilgrastim passes into breast milk.

What Do I Need to Know Before Starting Pegfilgrastim?

If you have sickle cell disease, be sure to tell your healthcare provider before you start taking pegfilgrastim. It is important that you drink plenty of fluids while taking pegfilgrastim. In very rare cases, pegfilgrastim can cause an enlarged or ruptured spleen. Call your healthcare provider right away if you have pain in the upper left abdominal area or shoulder as these may be signs of an enlarged or ruptured spleen. Call your healthcare provider right away or seek emergency care if you have shortness of breath, difficulty breathing or have a fast rate of breathing. In rare cases, pegfilgrastim can cause a serious lung problem called acute respiratory distress syndrome (ARDS). Pegfilgrastim can cause an allergic reaction. Tell your healthcare provider right away if you have redness, swelling or itching at the site of the injection, skin rash or hives, shortness of breath, wheezing, swelling around the mouth or eyes, fast pulse or sweating. Your treatment can interact with other substances, including:
  • Lithium
  Please note this list is a summary and does not contain all possible drug interactions. Contact your healthcare provider if you are taking any medications that can interact with pegfilgrastim. You should not take this treatment if you are allergic to E coli-derived proteins‚ pegfilgrastim‚ filgrastim or any components of these drugs.

How Is the Treatment Given?

Pegfilgrastim is given by injection under the skin or into a vein. Your dose and treatment schedule will depend on your diagnosis and your response to pegfilgrastim. Your healthcare provider will determine your dose and the number of treatments you receive. If you are injecting pegfilgrastim at home, follow your healthcare provider’s instructions. Pegfilgrastim should be stored in the refrigerator at 36° to 46°F (2° to 8°C). Do not freeze or shake the vial and keep it out of direct sunlight. Pegfilgrastim left at room temperature for longer than 48 hours should be thrown away. Do NOT use any pegfilgrastim vial if the drug is expired or if you notice any discoloration or free-floating particles in the solution. If you are given any medicine to take at home, do not share it with others. Sharing this medication with anyone else could be harmful.

What Are the Possible Side Effects?

All drugs can cause side effects, but every person reacts differently to each drug. The following chart lists the possible side effects that can occur with your treatment, how to recognize and minimize symptoms and possible treatments. The side effects are grouped by how often the side effect occurs: Common (occurs in more than 25 percent of patients), Less Common (occurs in 5 to 25 percent of patients) or Rare (occurs in less than 5 percent of patients).
Side Effect How to Minimize Side Effect Possible Treatments
Bone pain (Common)
  • Generally mild to moderate severity
  • Is usually felt more in bones such as the pelvis, sternum or thigh bone
  • May be more frequent with intravenous (IV) administration and with higher doses of treatment
  • May be less frequent with subcutaneous (SC) administration and with lower doses of treatment
  • Plan rest periods throughout the day.
  • Ask your health care provider how to minimize your pain.
  • Your healthcare provider may provide you with a  non-narcotic pain medicine, such as acetaminophen (Tylenol®).
  • For severe bone pain you may receive a narcotic pain medicine such as hydrocodone (Vicodin®) or codeine.
  • Talk with your healthcare provider before taking any medications for bone pain.

What Are The Other Possible Side Effects?

The chart below lists additional side effects found with this treatment. It does not list all possible side effects. For more information, talk with your healthcare provider.  

Common Side Effects

  • Skin reaction at the site of injection
  • Bone pain

Less Common Side Effects

  • Constipation

Rare Side Effects

  • Spleen rupture
  • Lung problem (acute respiratory distress syndrome)
  • Allergic reaction