However, it is actually the white count that turns the neupogen or neulasta off. Once the count starts to climb and reaches a certain level, the neulasta/neupogen no longer works. When the level comes down a new injection of neupogen starts the progress again. If you're on neulasta it stays in your body about 3 weeks so if the count drops after a week or so, it will start working again.
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.
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.
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.
I think most drs will let your own body have a try to make the blood cells after chemo. If it fails then neulasta will stimulate the production of white cells in the bonemarrow (that's where most blood cells come from and that's why you feel pain in the bone when you using neulasta). It has been report the neulasta maybe the cause of blood cell cancer( over production) from over using if there is no needs.
Hope it clearify a bit.
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.
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 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.
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.
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.
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.
Last week, 12-week lab work showed WBC of 1.6; since it was so low, doc wanted labs repeated this week. Repeat labs showed WBC at 1.7. They did absolute neutrophil count this time (not previously done) and it was 650. I did a little reading in old forum archives, and felt pretty comfortable that as long as ANC is above 500, I wouldn't need Neupogen. ARNP just called, however, and says doc likes to treat if ANC < 1000.
It took me over a month to use 30 vicodin and now he is saying he wants to stop the vicodin. He does not believe that neupogen could cause this debilitating pain. He says I need to be careful with the vicodin. He has me totally embarrassed to ask for pain meds. He is acting like I am an addict or something. My mother even told him the kind of pain I am in and he said that I needs to just get through the pain. My question is, what do I do? Who do I talk?
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