neupogen guidelines

Does your trial give your doctor leeway to determine what comes first, the neupogen or the dosage reduction? If yes, you can ask your doctor to go with the neupogen first, stating you don't want a dosage reduction. Adherence to dosages in the first 12 weeks are particularly important. If the trial does not allow your doctor that leeway and it strictly requires dosage reduction at 750 ANC and neupogen at 500 ANC, you'll have to follow trial mandates.

Maybe your lymphoctyes are low because of the infection? Not sure if one day is going to make much of a difference in numbers. If you ANC is OK -- above 500 -- why take Neupogen? You've mentioned that your trial guidelines appear somewhat flexible. Use that to your advantage and present your tx team with studies and arguments to continue tx on full dosage and without Neupogen. Isn't that what Dr. D. suggested in the professional forum?

Do you have the option of using Neupogen? If not, and you doctor insists, you might have no option but to further reduce the Inf dose. I never liked dose reductions, but you need to do what is needed to get through trt. Good luck.

My doctor feels that although my ANC went from 670 to 840 between Monday and Friday, that we need to be prepared for Neupogen in the event that it drops again. The insurance company has denied coverage for this because HCV treatment is not on their inclusion list for medical conditions approved for neupogen usage. WTF? I know that a lot of members have had issues with their insurance companies but was wondering if anyone ran across this situation and if so, how they dealt with it.

Related, is the question -- Was it really necessary to reduce to the Peg in the first place, as many inexperienced doctors pull (or reduce) the Peg much too early instead of either using more relaxed ANC (fraction of his white cells) guidelines, or starting Neupogen right away. Also, in many cases only the Peg is stopped (or reduced with low WBC and not the Riba.

Table 3, Table 4, Table 5, and Table 6 provide guidelines for dose modifications and discontinuation of PEGASYS/COPEGUS based on laboratory abnormalities, patient’s depression status, and cardiac status. Adult Patients When dose modification of PEGASYS is required for adverse reactions (clinical and/or laboratory), initial dose reduction to 135 mcg (which is 0.75 mL for the vials or adjustment to the corresponding graduation mark for the prefilled syringes) is recommended.

My treatment coordinator said they can add neupogen, but that there were study results that indicated that low WBC and neutrophils that occurred during tx did not cause infection. If that's true, why prescribe the neupogen? Thanks for your input!

This has been the first and the last time when I had neupogen to help the increase in number. This neupogen kept me in bed for 2 days = terrible!!! thrombocytes = 77 (200 - 400) hemoglobin = 11 (12,1 - 17,2) I was worried about interferon dose reduction but fortunately it was not the case.

org/posts/Hepatitis-C/Does-neuprogen-lower-platelets/show/1786217#post_8219349 I am wondering (in the case of cirrhotics) since your doctors did not prescribe Neupogen and opted for an antibiotic if any of you had to lower your dose of Peg? I understand I cannot apply the circumstances in your situations to mine but my ANC is only .6 and I am supposed to lower my Peg (not sure the amount but there is a notation on my labs) & start the Neupogen when it arrives.

Ok so I've been on cephalaxin for 10 days, went off for 1 day, and now infection is back so skin doctor wants me to do another 10 days. Just got blood test results, neutophils are around 600, so doc doesn't want me to take shot until I have more blood work done. I am ten weeks into treatment, and I don't understand why neupogen isn't an option. I go for my twelve week test in two weeks and am already nervous about that.

Do any of you have information about any long term side effects if you had Neupogen for 40 weeks?

I just read that a lot of people try NOT to take Neupogen unless it is a necessity due to sx. I am on Neupogen and I take it 3 times a week and have been taking it for 8 mos. now. Does anyone know exactly why people/anyone would want to NOT take Neupogen? Your answers may provide some insight for me and my sx's.

The Hematologist said he was going to start him on Neupogen is anyone else taking this and is it working for them. He also said that he may need a transfusion , which is freaking my husband out because that is how we suspect he contracted the Hep c orignally (back in the 80s). I told him that they screen the blood much differently now then they did back then , but he is still freaking out. Anyone who is taling Neupogen please let me know if it is helping.

low blood count started neupogen injections to build up white blood cell count so I can have chemotherapy, can I drink beer with this?

Just got the call this morning that my doctor wants to put me on Neupogen for 4 weeks because my white blood cells are so low. I'm so disappointed, I really wanted to be done shooting into myself!! Anyone else out there on this drug? I don't know a thing about it.

So the doc finally agreed to a neupogen shot, after many delayed shots of pegasys. I was supposed to do a shot tuesday, however got bloodwork done today and anc is 620, Doc says to take neupogen tonight (I did, the neupogen is 300mcg, im ~130lbs) and get more bloodwork done on thursday, and then he'll call friday with whether or not to take the shot or not. So here I am, waiting, again. Arggg!

I am supposed to receive Neupogen tomorrow. Did my peg shot this morning. I'm sure I will get instructions with the med but it's good to get some input from those who are currently treating with it. Are we supposed to wait 24 hrs after the peg shot to inject Neup? Should I inject more slowly than I do with Peg? Docs office told me to reduce peg today to 135 mcg but I didn't (me not listen - what a revelation) because I knew I was getting the Neup tomorrow.

HI ALL,HOPING U CAN HELP ME OUT WITH WHERE TO FIND/BUY MEDS LIKE NEUPOGEN FOR LOW WBC,IV HAD LOTS OF TROUBLE WITH LOW WBC AND MY DOC SAID AUSTRALIA HAS NOT APPROVED IT. IM AN AUSSIE AND HOPING SOME1 KNOWS OF WHERE TO GET THIS STUFF,OR ANYTHING THAT WILL HELP.IV HAD MY DOSE LOWERED AND IT SHATTERS ME COS MY CHANCES WOULD BE MUCH HIGHER WITH FULL DOSE OF INTERFERON. I DONT CARE WHAT IT COSTS I JUST WANT TO BRING MY WBC UP COS IV HAD SO MANY INFECTIONS AND FLUES ETC.

Have been trying to cost what a ceiling amount might be for a 12 week period to see if I can organise sufficient funds. Neupogen in prepared syringes are sold in packs of 10 - $1504 for 3000mcg/.5ml shots and $2407 for 480mcg/.5ml shots. I realise that amount required is case dependant but wouldnt mind any info which might assist me to at least get some idea of the range which may generally apply.

http://pi.amgen.com/united_states/neupogen/neupogen_ppi_pt_english.pdf Among other things: "Serious Allergic Reactions. NEUPOGEN can cause serious allergic reactions. These reactions can cause a rash over the whole body, shortness of breath, wheezing, dizziness, swelling around the mouth or eyes, fast pulse, and sweating. If you or your child starts to have any of these symptoms, stop using NEUPOGEN and call your doctor or seek emergency care right away.

It has been one week since the last treatment and my WBC count is 900 (ninehundred) Can they now give me a neupogen shot. I would think they should take a count daily. and give Neupogen if it till it corrects.

Anyone get any help with bone pain and seems like a migraine after neupogen ? I am on my second shot and it's 4:30 am and I have been up all nite with a horriable headache and severe nausea. Will call docs today and ask for something.

I am currently ordered to take one neupogen shot a week and that seems to be keeping the number between .92 and 1.2 which is lower than the recommended 1.5(per the Dr.) So if I teach preschool and I am exposed to 18 little ones on a daily basis, what are the odds that I am going to get something? I have been off work for the summer, but I return next week (how I am going to work 8 hrs. a day again?) I have to if I don't want to lose my benefits. The Dr.

Next time I try treatment I'm going to suggest to my doctor to prescribe neupogen and procrit before I start to get the counts up. Mine have always dropped into the low range. I found especially the neupogen made me feel rough after I was already well into treatment and didn't do a whole lot. Why don't doctors prescribe it before treatment? Would there be a downside to that?

Neupogen guidelines

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