Neupogen (filgrastim) is a man-made form of a protein that stimulates the growth of white blood cells in your body. White blood cells help your body fight against infection.
Neupogen is used to treat neutropenia, a lack of certain white blood cells caused by cancer, bone marrow transplant, receiving chemotherapy, or by other conditions.
Neupogen may also be used for purposes not listed in this medication guide.
Important information
You should not use Neupogen if you are allergic to filgrastim or to other medicines that contain the E. coli bacteria.
Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.
Before using Neupogen, tell your doctor if you have a blood cell disorder (such as sickle cell anemia), chronic myeloid leukemia, myelodysplasia (also called "preleukemia"), or if you are receiving chemotherapy or radiation treatment.
Stop using Neupogen and call your doctor at once if you have a serious side effect such as sudden or severe pain in your left upper stomach spreading up to your shoulder, rapid breathing or feeling short of breath, or signs of infection (fever, chills, sore throat, flu symptoms, easy bruising or bleeding, loss of appetite, nausea and vomiting, mouth sores, or unusual weakness).
Before taking this medicine
You should not use Neupogen if you are allergic to filgrastim or to other medicines that contain the E. coli bacteria.
To make sure Neupogen is safe for you, tell your doctor if you have:
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a blood cell disorder, such as sickle cell anemia;
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chronic myeloid leukemia;
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myelodysplasia (also called "preleukemia"); or
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if you are receiving chemotherapy or radiation treatment.
FDA pregnancy category C. It is not known whether Neupogen will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.
See also: Pregnancy and breastfeeding warnings (in more detail)
It is not known whether filgrastim passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
How should I use Neupogen?
Neupogen should not be given within the 24-hour period before or after you receive chemotherapy.
Neupogen is injected into a vein or under the skin. You may be shown how to use an IV at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, syringes, IV tubing, and other items used to inject the medicine.
Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.
This medicine comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
Do not shake the medication bottle or you may ruin the medicine. Prepare your dose only when you are ready to give an injection. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.
Use a different place on your arms, stomach, hips, or legs each time you give the injection. Your care provider will show you the best places on your body to inject the medication. Do not inject into the same place two times in a row.
Each single-use vial (bottle) of this medicine is for one use only. Throw away after one use, even if there is still some medicine left in it after injecting your dose. Do not use Neupogen if the expiration date on the label has passed. Call your pharmacist for a new prescription.
Use a disposable needle only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.
You may need frequent medical tests to help your doctor determine how long to treat you with Neupogen. Your liver function will also need to be tested, and you may need bone density scans.
Store this medication in the refrigerator and do not allow it to freeze. You may allow the medication to reach room temperature for 24 hours before measuring your dose in a syringe. Then place the vial back in the refrigerator. Throw away any Neupogen that has been left out at room temperature for longer than 24 hours.
What happens if I miss a dose?
Use the missed dose as soon as you remember, but not within the 24-hour period before or after you receive chemotherapy treatment. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while using Neupogen?
Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.
Neupogen side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Neupogen: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using Neupogen and call your doctor at once if you have:
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sudden or severe pain in your left upper stomach spreading up to your shoulder;
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rapid breathing or feeling short of breath; or
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signs of infection such as fever, chills, sore throat, flu symptoms, easy bruising or bleeding (nosebleeds, bleeding gums), loss of appetite, nausea and vomiting, mouth sores, unusual weakness.
Common Neupogen side effects may include:
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nausea, vomiting;
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muscle or joint pain;
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bone pain; or
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headache.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Neupogen?
Other drugs may interact with filgrastim, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
