Neupogen (Filgrastim, GCSF)

OVERVIEW -- Your doctor has advised you to receive chemotherapy.  As your doctor or nurse has explained, chemotherapy drugs destroy rapidly growing cells, such as cancer cells.  However, these drugs can also harm certain normal cells, such as blood cells, hair follicles, and the cells lining your mouth, throat, stomach, and intestines.  One type of blood cell that is very sensitive to the effects of chemotherapy drugs is the white blood cell, also called a neutrophil.  Neutrophils are responsible for helping your body fight off infections.  If your neutrophils fall to a low level after receiving chemotherapy, you are at increased risk of developing a fever and/or serious infection.

USE -- To help reduce the chances of developing a serious infection after receiving chemotherapy, your doctor has prescribed a medication called Neupogen (filgrastim).  You may also hear it called growth factor or GCSF.  Neupogen works by increasing the number of infection-fighting cells (neutrophils) in your blood.  It does not help to increase other blood cells, such as red cells or platelets.

ADMINISTRATION -- Neupogen is given by an injection in the fat pad under the skin (subcutaneously) or by intravenous infusion if you are in the hospital.  If you are to get this medicine while at home, a nurse will instruct you or a support person on the proper injection technique.  (It is best to take Neupogen at the same time every day.) 

You should not receive Neupogen for the 24-hour period before of following a chemotherapy treatment.  If Neupogen is given within 24 hours of receiving chemotherapy, there is a risk of increased damage to your neutrophils.

You should have a Complete Blood Count (CBC) or "counts" performed 2 times a week while receiving Neupogen.  This will help the doctor decide how effective Neupogen therapy is and when it can be stopped.

SIDE EFFECTS -- Generally, Neupogen causes few side effects.  The most common side effect is mild to moderate bone pain.  This pain may be felt in the chest, legs, lower back, and/or pelvis.  Mild pain relievers, such as Tylenol, will help decrease this pain.  Check with your doctor or nurse before taking any medication.  When Neupogen is injected under the skin, you will feel a burning sensation that will go away within a minute.  There may be redness or slight bruising at the site.  Side effects are similar in adults and children.

STORAGE -- Neupogen should be kept in the refrigerator - do not freeze.  It may be removed 1/2 hour before injection time to allow it to get to room temperature.  Do not shake.

If Neupogen is left unrefrigerated for 6 hours or more, throw it away. 

Also, do not leave the medication in direct sunlight.  Always check the solution before injecting it.  It should be clear and colorless.  If it is discolored or cloudy, throw it away.

SIGNS TO REPORT -- Signs of infection you should watch for and report to your doctor or nurse include:

• a temperature (fever) over 100 deg. F

• shaking chills

• cough

• sore throat

• burning feeling when passing urine

• loose bowel movements

• sweating, especially at night

• flu-like symptoms