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What is Neulasta

Neulasta is a protein that stimulates production of white blood cells. White blood cells are important for protecting the body from infection.

Neulasta is used to increase white blood cells and therefore decrease the risk of infection in patients with non-myeloid (not bone marrow) cancers while receiving cancer chemotherapy (drugs).

Neulasta may also be used for purposes other than those listed in this medication guide.

General medical information about Neulasta

Do not administer an injection if you are unsure how to properly give the injection, how much to inject, or how often to inject the medication. Call your doctor, nurse, or pharmacist to go over the instructions with you.

Contact your doctor if you develop a fever; chills; sore throat; congestion; or redness, pain, or swelling around a wound or sore while using Neulasta. These may be signs of infection.

What you should discuss with your doctor before using Neulasta

Do not use Neulasta if you have an allergy to the bacterium E. coli or the drug filgrastim (Neupogen). You may also have an allergic reaction to Neulasta.

Before using this medication, tell your doctor if you:
- are undergoing radiation or chemotherapy;
- have sickle cell disease;
- have myeloid (bone marrow) cancer;
- have kidney disease; or
- have liver disease.

You may not be able to uses Neulasta or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Neulasta is in the FDA pregnancy category C. This means that it is not known whether Neulasta will be harmful to an unborn baby. Do not use Neulasta without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether Neulasta passes into breast milk. Do not use Neulasta without first talking to your doctor if you are breast-feeding a baby.

How should you use Neulasta

Use Neulasta exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Neulasta is administered by subcutaneous (SC) injection. If you are injecting the medication at home, your doctor, nurse, or pharmacist will give you specific instructions on how and

Where it should be injected. Do not administer an injection if you are unsure how to properly give the injection, how much to inject, or how often to inject the medication. Call your doctor, nurse, or pharmacist to go over the instructions with you.

Neulasta is supplied in prefilled syringes, each intended to administer a single dose.

Do not shake the syringes containing Neulasta.

Do not inject Neulasta that is discolored or that has particles in it.

Before injection, a prefilled syringe of Neulasta may be allowed to reach room temperature for a maximum of 48 hours but should be protected from light. Neulasta left at room temperature for more than 48 hours should be thrown away.

After injecting a dose of Neulasta, slide the needle guard into place until the needle is completely covered and the guard clicks into place. Throw away the syringe, with the needle guard in place, in a puncture resistant container.

Your doctor will want you to have periodic blood tests during treatment with Neulasta to monitor effectiveness and possible side effects of the medication.

Store Neulasta prefilled syringes in the refrigerator between 2 and 8 degrees Celsius (36 to 46 degrees Fahrenheit) in the original carton to protect from light. Do not allow the medication to freeze. If a vial of medication is accidentally frozen, it can be thawed in the refrigerator and used at a later time. If the vial is frozen a second time, do not use it at all. Discard all unused medication on the expiration date.

If you miss a dose:

Contact your doctor if you miss a dose of Neulasta.

What happens if you overdose:

Seek emergency medical attention if an overdose is suspected.

Symptoms of a Neulasta overdose are not known.

What should you avoid while using Neulasta

There are no restrictions regarding foods, beverages, or activities during treatment with Neulasta unless your doctor directs otherwise.

Possible side effects of Neulasta

If you experience any of the following serious side effects, seek emergency medical treatment or contact your doctor immediately:
- an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
- fever or chills;
- sore throat or congestion;
- redness, pain, or swelling around a wound or sore;
- difficulty breathing or shortness of breath; or
- left upper stomach or shoulder pain.

Other, less serious side effects may be more likely to occur. Continue to use Neulasta and talk to your doctor if you experience:
- muscle, joint, or bone pain;
- fatigue;
- headache;
- weakness;
- dizziness;
- sores in the mouth or throat; or
- nausea, vomiting, diarrhea, or constipation.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Neulasta

Before using this medication, tell your doctor if you
- are taking lithium (Eskalith, Lithobid, Lithane, others); or
- are undergoing radiation or chemotherapy.

You may not be able to use Neulasta or you may require special monitoring if you are taking any of the medications listed above.

Drugs other than those listed here may also interact with Neulasta. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

All prescription drugs:

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