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For most patients with cancer, facing diagnosis is the first step before they embark on a treatment journey requiring the support of a cancer team including doctors, nurses, family and caregivers.
According to Natalie, a mom to two children, a wife, yoga instructor and photographer who was diagnosed with breast cancer in October 2015, that first step can be jarring. “The diagnosis was terrifying and unbelievable. However, once I came to terms with it, I began to see my cancer experience as my cancer journey – a very personal healing journey.”
Following her diagnosis, Natalie underwent six rounds of strong chemotherapy involving infusions every 21 days. However, she did not initially know that strong chemotherapy can lead to a weakened immune system that may leave patients like her at a higher risk for infection.
After identifying Natalie as at high risk for infection as a result of receiving strong chemotherapy, her oncologist determined that she was an appropriate patient for Neulasta® (pegfilgrastim), which he recommended to help reduce her risk of infection.
Neulasta® is a prescription medicine used to help reduce the chance of infection due to a low white blood cell count, in people with certain types of cancer (non-myeloid), who receive anti-cancer medicines (chemotherapy) that can cause fever and low blood cell count.
Important Safety Information
Who should not take Neulasta®?
Do not take Neulasta® if you have had a serious allergic reaction to Neulasta® (pegfilgrastim) or NEUPOGEN® (filgrastim).
What should I tell my health care provider before taking Neulasta®? Tell your healthcare provider if you:
- Have sickle cell trait or sickle cell disease
- Have had severe skin reactions to acrylic adhesives
- Are allergic to latex Have problems with your kidneys
- Have any other medical problems
- Are pregnant or plan to become pregnant. It is not known if Neulasta® may harm your unborn baby.
- Are breastfeeding or plan to breastfeed. It is not known if Neulasta® passes into your breast milk.
Tell your healthcare provider about all the medicines you take, including prescription and over the counter medicines, vitamins, and herbal supplements.
“Three things that helped me as I went through my experience with cancer were: taking a deep breath and calming down; gathering my people – my support network; and doing my research so I could find the right team and know when to advocate for myself.”
- Natalie, Breast Cancer Patient
Due to Natalie’s schedule, she received her chemotherapy treatments on Fridays. As her clinic was closed over the weekend, after her first chemotherapy, Natalie had to return to the clinic again on Monday just for her Neulasta® shot.
When discussing options for Neulasta® delivery with her nurse, Linda Buck, MSN, ANP-C, OCN, she recommended that Natalie try Neulasta® Onpro® because it could be applied the same day as her chemotherapy treatment and was designed to automatically deliver her dose of Neulasta® the next day.
The Neulasta® Onpro® kit is comprised of a single dose of Neulasta® and a single-use On-body Injector. The On-body Injector (a delivery system for Neulasta®) is filled with the co-packaged Neulasta® prefilled syringe and applied to the skin (arm or abdomen) by a healthcare provider during the chemotherapy appointment – designed to allow people who are undergoing strong chemotherapy treatment for certain types of cancer to receive Neulasta® without having to return to the clinic just for their Neulasta® shot. However, patients may need to return to the office if there is a concern that they missed or received a partial dose of Neulasta®.
Working with her cancer care team to determine the best treatment plan for her was an important part of Natalie’s cancer journey. “Neulasta® Onpro® was a good option for me because of the scheduling flexibility, it allowed me to receive Neulasta® at home the next day,” Natalie commented.
If you are undergoing strong chemotherapy, talking to your doctor may help you to better understand your treatment plan as well as the potential risks of infection during treatment. Questions for your next doctor’s visit that may help start a discussion about low white blood cell counts and risk of infection during strong chemotherapy include:
- What type of chemotherapy am I receiving?
- Am I at risk for infection?
- What could happen if I get a serious infection?
- Should Neulasta® be part of my treatment plan?
- Is Neulasta® Onpro® an option for me?
To download a printable list of these questions and more, click here.
Learn more about how the Neulasta® Onpro® kit may offer the possibility of fewer doctor visits. For information about the Neulasta® Onpro® kit, and patient support tools such as:
- Questions for the doctor
- Patient brochure
- Patient video
To provide additional support, patients and caregivers can download the companion app. The On-body Injector (OBI) Digital Companion app (Apple® and Android™ available) is an optional resource for patients who have been prescribed the Neulasta® Onpro® kit. The app:
- Generates optional notifications to guide the patient through the Neulasta® dose delivery process;
- Provides easy access to Patient Instructions for Use, and Neulasta® Patient Prescribing Information and Important Safety Information;
- Has the ability to share the Neulasta® dose delivery process by “connecting” the app with a friend or family member; and
- Includes one-touch phone access to Neulasta® Patient Support Services.
Important Safety Information, continued
What are possible serious side effects of Neulasta®?
- Spleen Rupture. Your spleen may become enlarged and can rupture while taking Neulasta®. A ruptured spleen can cause death. Call your doctor right away if you have pain in the left upper stomach area or left shoulder tip area. This pain could mean your spleen is enlarged or ruptured.
- A serious lung problem called Acute Respiratory Distress Syndrome (ARDS). Call your healthcare provider or get emergency medical help right away if you get any of these symptoms of ARDS: fever, shortness of breath, trouble breathing, or a fast rate of breathing.
- Serious Allergic Reactions. Get emergency medical help right away if you get any of these symptoms of a serious allergic reaction with Neulasta®: shortness of breath, wheezing, dizziness, swelling around the mouth or eyes, fast pulse, sweating, and hives.
If you have an allergic reaction during the delivery of Neulasta®, remove the On-body Injector for Neulasta® by grabbing the edge of the adhesive pad and peeling off the On-body Injector. Get emergency medical help right away.
- Sickle Cell Crises. Severe sickle cell crises, and sometimes death, can happen in people with sickle cell trait or disease who receive filgrastim, a medicine similar to Neulasta®.
- Kidney injury (glomerulonephritis). Kidney injury has been seen in patients who received Neulasta®. You should notify your healthcare provider right away if you experience puffiness in your face or ankles, blood in your urine or brown colored urine or you notice you urinate less than usual.
- Increased white blood cell count (leukocytosis). Your doctor will check your blood during treatment with Neulasta®.
- Capillary Leak Syndrome. Neulasta® can cause fluid to leak from blood vessels into your body’s tissues. This condition is called "Capillary Leak Syndrome” (CLS). CLS can quickly cause you to have symptoms that may become life-threatening. Get emergency medical help right away if you develop any of the following symptoms:
- swelling or puffiness and are urinating less often
- trouble breathing
- swelling of your stomach area (abdomen) and feeling of fullness
- dizziness or feeling faint
- a general feeling of tiredness
The most common side effect of Neulasta® is pain in the bones and in your arms and legs.
Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of Neulasta®. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1.800.FDA.1088 (1.800.332.1088).
For more information about Neulasta®, talk with your healthcare provider or pharmacist; go to www.neulasta.com, or call 1.844.696.3852 (1.844.MYNEULASTA).
Please see Neulasta® Patient Information.