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.
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.
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.
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...
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.
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.
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.
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.
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.
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.
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.
Trinity: Glad I could help. Neulasta is kind of like a pegylated version of neupogen. It was very strange that I didn't respond to neualsta but did to neupogen. Thank goodness I had an excellent hematologist who didn't give up on me. The first one refused me trying neupogen cause she said if the neulasta didn't work neither would neupogen. She was dead wrong.
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