This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.
Brand Names: US
Fulphila; Fylnetra; Neulasta; Neulasta Onpro; Nyvepria; Stimufend; Udenyca; Udenyca Onbody; Ziextenzo
Brand Names: Canada
Fulphila; Lapelga; Neulasta; Nyvepria; Ziextenzo
What is this drug used for?
- It is used to lower the chance of getting an infection in people with bone marrow problems caused by chemo.
- It is used in patients who have been exposed to certain doses of radiation.
- It may be given to you for other reasons. Talk with the doctor.
What do I need to tell my doctor BEFORE I take this drug?
- If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
- If you have a latex allergy, talk with your doctor. Some products have latex.
- If you weigh less than 99 pounds (45 kilograms), talk with your doctor.
This drug may interact with other drugs or health problems.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
What are some things I need to know or do while I take this drug?
All products:
- Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
- Do not take this drug within 14 days before or 24 hours after you get chemo.
- Have your blood work and other lab tests checked as you have been told by your doctor.
- This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
- Low platelet counts have rarely happened with this drug. This may lead to a higher chance of bleeding. Call your doctor right away if you have any unexplained bruising or bleeding.
- Some people with sickle cell disease have had times where the sickle cell disease has gotten worse when taking this drug. Sometimes, this has been deadly. Talk with the doctor.
- A bone marrow problem called myelodysplastic syndrome (MDS) and a type of leukemia have happened with this drug in people with breast or lung cancer who are getting chemo or radiation. Call your doctor right away if you have a fever, feel very tired, or have unexplained bruising or bleeding.
- Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.
On-body Injector:
- If you are allergic to acrylics, talk with your doctor.
- If you are using the On-Body Injector: Do not travel, drive, or do other tasks or actions that require alertness during hours 26 through 29 after the Injector is put on. Be sure you understand how the Injector works, what tasks and actions to avoid, and when to avoid them. Be sure you know how to tell if all of the drug has been given or if there has been a problem with the Injector. Talk with your doctor.
- You will need to avoid some things while using the On-body Injector like airport X-ray scans, sleeping on or putting pressure on it, bumping it, and getting skin products near it. Keep the On-body Injector at least 4 inches away from electrical equipment like phones and microwaves. Do not peel off the sticky part before your dose has been given.
- Tell your doctor you have this drug on before you have certain exams like MRIs, X-rays, CT-scans, and ultrasounds.
- Before the next on-body injector dose, avoid using creams, oils, lotions, or other skin products on areas where the on-body injector will be used.
- Avoid use of heat sources (such as sunlamps, tanning beds, heating pads, electric blankets, heat lamps, saunas, hot tubs, heated waterbeds). Avoid long, hot baths or sunbathing. Your temperature may rise and cause too much drug to pass into your body.
What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
All products:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
- Signs of lung or breathing problems like shortness of breath or other trouble breathing, cough, or fever.
- Dark urine.
- Sweating a lot.
- Fast breathing.
- Swelling of belly.
- Feeling full.
- Enlarged and ruptured spleens have happened with this drug. Sometimes, ruptured spleens have been deadly. Call your doctor right away if you have left upper stomach pain or left shoulder pain.
- Swelling of the main blood vessel that comes out of the heart (aorta) has happened with this drug. Call your doctor right away if you feel very tired or weak. Call your doctor if you have fever, stomach pain, or back pain.
- Capillary leak syndrome (CLS) is a very bad health problem that has happened with this drug. Sometimes, CLS can be deadly. Tell your doctor right away if you get signs of CLS like change in how much urine is passed; not able to pass urine; blood in the urine; a fast or abnormal heartbeat; chest pain or pressure; dizziness or passing out; shortness of breath; a big weight gain; swelling; throwing up blood or throw up that looks like coffee grounds; or if you have black, tarry, or bloody stools.
On-body Injector:
- Pain or bleeding where this drug goes into your body.
What are some other side effects of this drug?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
All products:
- Bone, joint, or muscle pain.
- Pain in arms or legs.
On-body Injector:
- Irritation, redness, or bruising where this drug goes into your body.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.
You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.
How is this drug best taken?
Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
Prefilled syringes and auto-injectors:
- It is given as a shot into the fatty part of the skin.
- If you will be giving yourself the shot, your doctor or nurse will teach you how to give the shot.
- Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
- If stored in a refrigerator, let this drug come to room temperature before using it. Leave it at room temperature for at least 30 minutes. Do not heat this drug.
- Do not remove the cap or cover until ready to use.
- Do not use if the solution is cloudy, leaking, or has particles.
- Different brands of this drug may be clear or have a slight color. Be sure you know what your brand needs to look like when ready to use. Do not use if the solution changes color. If you are not sure, talk with the pharmacist.
- Do not shake.
- Wash your hands before and after use.
- Do not give into skin that is irritated, bruised, red, infected, hard, or scarred.
- Do not give into skin within 2 inches (5 cm) of the belly button.
- Move the site where you give the shot with each shot.
- Throw away any part left over after the dose is given.
- Throw away after using. Do not use the device more than 1 time.
- Throw away needles in a needle/sharp disposal box. Do not reuse needles or other items. When the box is full, follow all local rules for getting rid of it. Talk with a doctor or pharmacist if you have any questions.
On-body Injector:
- Your doctor or other healthcare provider will put on the skin.
- Do not use other ways of holding the On-body Injector in place.
- Call the doctor right away if you think that the device may not have worked the right way. Call the doctor right away if the On-body Injector comes off before or during a dose, if it is leaking, or if the sticky part is wet. Call the doctor right away if the light on the On-body Injector flashes red.
What do I do if I miss a dose?
- Call your doctor to find out what to do.
How do I store and/or throw out this drug?
Prefilled syringes and auto-injectors:
- Store in a refrigerator. Do not freeze.
- Store in the original container to protect from light.
- If needed, this drug can be left out at room temperature for some time. Be sure you know how long you can leave this drug at room temperature before you need to throw it away.
- Some products may be used if they have been frozen. Some products are not for use if they have been frozen. If this drug freezes, be sure you know what to do.
- Do not use this drug if it has been dropped or if it is broken.
On-body Injector:
- If you need to store this drug at home, talk with your doctor, nurse, or pharmacist about how to store it.
All products:
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
General drug facts
- If your symptoms or health problems do not get better or if they become worse, call your doctor.
- Do not share your drugs with others and do not take anyone else’s drugs.
- Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
- Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
- If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
Consumer Information Use and Disclaimer
This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.
Last Reviewed Date
2024-01-12
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