The text I give the web address for was the best thing I found and it has to do with cancer chemotherapy drugs and the use of neulasta (similar but longer lasting than neupogen) . It is a good article -- they wanted to know if it was more effective to do the neulasta the day after the chemo which was protocol when it meant having the patient - on the day he feels the worst, the day after chemo - come back to the hospital for the shot. There was a difference but it was not significant.
In these cases, and for older frailer patients, there may be an argument for prophylactic Neupogen/Neulasta. On the other hand, if the white blood cells continue to be adequate for continuation of therapy, then there is no role for Neupogen/Neulasta. It would simply add cost (to you and or your insurance company) and provide no real benefit.
Jan are you getting neulesta neupogen, or Epogen and or procrit... big difference.. as you know one is for white blood cells..( neulesta neupogen) and the other that is for red blood cells.. Epogen and or procrrit...
My oncologist gives me neupogen for white blood cells but would not touch the other at all.. She believes that is causes more problems than it is worth including faster tumor growth...
d have to start the weekly shots and climb again. Same with the neulasta; when my levels jumped up to safety, neulasta would be stopped and I'd have to wait until they crashed before I was okayed to use it again and get that big overnight resolution. Your doctor should be able to fine-tune your helper drug dosing schedules to keep you in the safety zone.
Using the helper drugs means lots of extra blood draws but you get pretty accustomed to being a human pincushion on TX.
For me, Neupogen was significantly milder. As Linda pointed out, Neulasta is longer lasting, Neupogen requires more shots. Neulasta is much more expensive, if that's a consideration. Even with the more frequent Neupogen, I found that that Neupogen at $400 each is a better bargain than Neulasta at $3000 each. (these amounts are based on what hematologist billed insurance, not my out of pocket). Your mileage may vary.
The most common are injectable meds Neupogen and Neulasta. Neulasta is the pegylated version of Neupogen. Referred to as colony stimulating factors they are both effective in raising the absolute neutrophil count, which is the usually the focus component of the white cell count. Generally speaking, these meds will temporarily raise the counts and then the treament meds effects will usually repeat. So, the use of Neup and Neu will probably not be one-time events.
Neulasta® (pegfilgrastim) or NEUPOGEN® (Filgrastim) may reduce your chance of getting an infection, but it does not prevent all infections. An infection can happen anytime your neutrophil counts are low. Look for signs of infection, such as fever, chills, rash, sore throat, diarrhea, or redness, swelling, or pain around a cut or sore. If you have any of these signs, contact your health care professional immediately.
http://www.neulasta.com/starting-chemo-with-neulasta/about-neulasta-neupogen.
My doctor used the 500 neutrophill count as a cut-off, so every time I got down around 500 I used Neulasta. The interferon drops neutrophils and platelets. Some people can do okay with low neutrophils but just as many end up with kidney and sinus infections, etc., that make you even more miserable. You may want to start the approval process with your insurance company now, to avoid any delay if you need to add the rescue drug at your next visit.
My doctor is concerned because my ANC went to 700 after 4 weeks and then down to 550 two weeks later. Neulasta didn't work and he wanted me to have a bone marrow biopsy. One suggestion was to add nuprogen 3x a week before having that invasive procedure. Anyone have experience with this?
In her opinion I should hold off all Neupogen/Neulasta injections until my next MD appointment…I did offer to give my own Neupogen.
She is filing a continuance of service with Medicare to place my port. I hope they let her after the awful experience I had with my give me your co-pay plus more money; this chemo costs me too much and Medicare doesn't pay me enough doc.
Stopping or reducing the peg is the only way (it's what's killing them in the first place). Neulasta or neupogen are commonly accepted to bring neutrophils up; he must have his reasons to refuse to use it but I don't know what they are. You are so far along that skipping a shot will probably not make a difference. Hopefully your neuts will be up high enough next week to let you finish those last 2 shots, for peace of mind if nothing else.
As mentioned, there are drugs to encourage the development of red (Procrit)and white - ANCs (Neupogen - Neulasta) cells. However, there is nothing at this time for hcv treatment thrombocytopenia (means a shortage of platelets). The platelet situation is probably why the doc stopped treatment. Many docs reduce or stop in the neighborhood of 30. That they bounced back to 60 is not that unusual, especially if you've been off the treatment for a few weeks.
Neulasta (also called Neupogen) will immediately correct low neutrophils. The rescue drugs are quite expensive (neulasta in the $1000's) but can keep you from dose reduction of the riba or interferon. However, if your platelets go below 50,000 there is no other way to recover them but to reduce the interferon (no rescue drugs for platelets are approved yet).
I cleared the virus extremely early so it's not as anxious for me to reduce.
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