t know what the dosage requirements are for Neulasta but it is not taken as often as Neupogen. My experience with Neupogen was 1 injection per week initally, then 2 and several times I was reduced to half dosage or skipped several weeks because my WBC was high. It's a balancing act and usually those on Neupogen require more blood draws than those who are not taking it.
I thought it was some nasty stuff.
Neulasta is a peglated version of Neupogen which is also know as filgrastim. It's used to stimulate production of neutrophils, a component of whilte blood cells. It can be taken less often than regular 'ol Neupogen. I found it rougher than Neupgen in that it had some side effects, mainly bone pain. I found Neupogen to be side-less.
Aranesp is Darbepoetin Alfa which is like Procrit (epo). It is also taken less often than Procrit.
I recall that when I started the neulasta (pegylated form of neupogen that stays in system longer), I was required to come back next day for blood draws to see if I responded to it and how well I responded. Towards the end of TX, the effects (holding my neuts above danger level) lasted a shorter time, so I guess the blood helper drugs may get less effective but they did still work.
The neupogen (or neulasta) works overnight. Other posters (was it nygirl?
Considering the Neulasta shot within 24 hours of chemo. Seems to be a lot of side affects regarding bone pain.
Trying to decide if it's really necessary with the neupogen shot available later.
Your thoughts would be appreciated.
The primary reason for using growth factors such as Neupogen or Neulasta is to be able to maintain the full dose and schedule of the chemotherapy regimen. Some chemotherapy protocols are much more likely to result in low white blood cell counts that cause dose reductions or delays than others. In these cases, and for older frailer patients, there may be an argument for prophylactic Neupogen/Neulasta.
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.
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.
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.
Right now, the low neutrophils can be remedied with filgrastim (Neupogen, Neulasta), but nothing is prescribed for low platelets (whites involved in clotting) except for reducing the interferon. There is a drug (eltrombopag) that stimulates platelet formation but the FDA has not approved it to go with the HCV treament drugs, so insurance may not cover it.
It is always better to use the rescue drugs instead of reducing the peginterferon or riba, especially if you have not cleared yet.
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.
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.
I am not on chemotherapy but I have to take Neupogen 2x/week at 480mcg a shot. The bone pain I have is horrible, the weirdest pain I have ever had before. My bone marrow gets so swollen that I can actually feel my heart beat in my femur, pelvis and ribs. That happens if I get up too fast, or bend over. On top of that I have the "bone aches and sharp zings" of pain for a day and a half after a shot. The first night I woke up shaking, because of the pain my body was experiencing.
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