Pegfilgrastim is a long-acting form of the drug, filgrastim. These drugs, called colony-stimulating factors, are used to help stimulate the bone marrow to make white blood cells in patients who are not able to produce enough white blood cells on their own.
White blood cells help the body fight infections. Certain medical conditions (e.g., cancer) and/or medications (e.g., cancer chemotherapy) may reduce the body\'s ability to make normal white blood cells.

How to use Neulasta SubQ
Read the Patient Information Leaflet provided by your pharmacist before you start using pegfilgrastim and each time you get a refill. If you have any questions regarding the information, consult your doctor or pharmacist.
Avoid shaking this medication; doing so may make the drug ineffective.
Remove the medication from the refrigerator 30 minutes before you inject it to allow it to reach room temperature.
Inject this medication under the skin (subcutaneously) usually once during each chemotherapy cycle, or as directed by your doctor. The dosage is usually one 6 milligram injection, but it may be adjusted for children or small adults (weighing less than 100 pounds or 45 kilograms).
Do not give this drug during the period 14 days before to 1 day after your chemotherapy. Giving this drug during this time may increase your risk of certain side effects. Consult your doctor for details.
If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.
Choose a new injection site each time you give yourself a dose. This will help prevent soreness. Never inject pegfilgrastim into skin that is tender, red, bruised, and hard, or has scars or stretch marks.

Bone pain may occur. Taking a non-aspirin pain reliever such as acetaminophen may help with this pain. Ask your doctor or pharmacist for more details. Injection site reactions such as redness, swelling, itching, lumps, or bruising may also occur. If any of these effects persist or worsen, notify your doctor promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Get medical help right away if any of these rare but very serious side effects occur: breathing problems (e.g., trouble breathing, shortness of breath, fast breathing).
Rarely, possibly fatal damage to the spleen may occur. Get medical help right away if you experience the following side effects: stomach/abdominal pain and/or shoulder pain.
A very serious allergic reaction to this drug is unlikely, but get medical help right away if it occurs. Symptoms of a serious allergic reaction may include: rash, fast heartbeat, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before using pegfilgrastim, tell your doctor or pharmacist if you are allergic to it or to filgrastim; or to other medications made in a similar way (biotechnology-produced proteins using E. coli); or if you have any other allergies. This product may contain inactive ingredients (such as dry natural rubber/latex in the needle cover on the prefilled syringe), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: sickle cell disease, spleen problems.
If you are scheduled only for radiation therapy, pegfilgrastim may still help your body fight off infections. Discuss the risks and benefits with your doctor.
This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.
It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor\'s approval.
Some products that may interact with this drug include: lithium.
This medication may interfere with certain laboratory tests (e.g., bone tests such as bone imaging). Make sure laboratory personnel and all your doctors know you use this drug.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly.

NOTES:
Do not share this medication with others.
This medication must be taken under close medical supervision so that your blood counts can be monitored. Laboratory and/or medical tests (e.g., blood and platelet counts) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
It is very important to keep all scheduled medical and laboratory appointments.

MISSED DOSE:
For the best possible benefit, it is important to receive each scheduled dose of this medication as directed. If you miss a dose, contact your doctor or pharmacist immediately to establish a new dosing schedule. Do not double the dose to catch up.

STORAGE:
Store in the refrigerator between 36-46 degrees F (2-8 degrees C) away from light. Do not freeze. However, if frozen, thaw in the refrigerator before use. Discard syringe if frozen more than once. Keep all medications away from children and pets.
This medication may be kept out of the refrigerator for up to 48 to 72 hours, depending on your brand. After that time, if the medication is left unused, discard it. Consult your product instructions or pharmacist for details.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA), or 1-800-668-1507 (Canada).
Information last revised May 2012. Copyright(c) 2012 First Databank, Inc.