Pegfilgrastim is a white blood cell growth factor known as granulocyte colony-stimulating factor (G-CSF). Growth factors are substances which are produced naturally in the body but can also be made using technology for it to be used as a medicine.
This medicine stimulates the growth of neutrophils, a type of white blood cell that helps your body to fight infections. It is used to increase the neutrophil counts which helps reduce the risk of infection when undergoing chemotherapy for certain cancers.
Pegfilgrastim may be used to treat other conditions as decided by your doctor.
Pegfilgrastim is to be injected subcutaneously (into the fatty layer under the skin, usually in the thigh, upper arm, or abdomen area).
Your doctor or nurse will administer the injection for you. If you or your caregiver had been given the proper training on the preparation and injection techniques of this medicine, you or your caregiver may do the administration.
This medicine is available in a pre-filled syringe for manual subcutaneous administration or as a kit for use with the on-body injector.
To use this medicine, follow these steps:
- Ensure that you have received all the supplies that you need (e.g. pre-filled syringe, alcohol wipes, cotton balls or gauze pad, adhesive bandage, puncture-resistant sharps container).
- Remove Pegfilgrastim from the refrigerator and allow it to reach room temperature for 30 minutes.
- Wash your hands with soap and water.
- Prepare the injection. Hold the syringe barrel and gently take the cap from the needle. Pull straight. Do not touch the needle or push the plunger. Do not shake the pre-filled syringe or remove the cap until you are ready to inject.
- Clean the injection site with alcohol wipes and allow it to dry.
- Gently pinch the skin of the injection site with one hand and pick up the syringe with the other hand. Insert the needle in the pinched area of the skin. Release the pinched skin after the needle is completely inserted. To deliver a full dose, push the plunger with slow and constant pressure until you feel or hear a "snap".
- Slowly release the needle and gently pull it out of the skin. Press a cotton ball or gauze pad over the area. If needed, you may cover it with an adhesive bandage. Do not rub the injection site.
- If you are using the manual subcutaneous injection, activate needle guard to prevent accidental needlestick. Contact your doctor or nurse immediately if the on-body injector comes away from your skin at any time before your full dose has been delivered. Do not re-apply it. There is a small cannula which sits just under your skin. If the on-body injector has been knocked or pulled, the cannula may become dislodged. If this happens, you may not receive your dose.
- Dispose of your used syringe and needle in the sharps container or according to your doctor or pharmacist's instructions. Do not throw away in household trash.
Make sure you know how to use the specific device you have been given. If you have problems or do not understand the instructions, ask your doctor or pharmacist.
The dose and schedule of administration of this medicine will be decided by your doctor. Your doctor will advise you on the course of treatment depending on your condition and response to the medication.
Ensure that you keep all appointments with your doctor so that you do not miss any doses. Your doctor also needs to regularly monitor your response to Pegfilgrastim.
If you miss an appointment or miss an injection, alert your doctor or nurse. A replacement appointment or injection should be given as soon as possible.
If you or a caregiver had been trained to administer this medicine and missed a dose, inject the missed dose as soon as you remember and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
Inform your doctor or pharmacist immediately if you forgot to administer your dose.
Do not use Pegfilgrastim if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine or similar medicines such as filgrastim.
Inform your doctor if you have the following conditions:
- sickle cell disease (an inherited condition in which the haemoglobin in red blood cells is damaged and unable to carry oxygen throughout your body)
- cancer of the bone marrow or blood
- recent history of pneumonia (an infection that causes inflammation of one or both lungs)
Let your doctor know if you are pregnant or breastfeeding.
Do not switch between different brands unless advised by your doctor.
If you are going to undergo certain medical procedures or tests (e.g. bone imaging), inform your doctor that you are being treated with Pegfilgrastim.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. complete blood count) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring for signs and symptoms of allergic reactions may also be needed.
Pegfilgrastim may cause any of the following side effects: headache, nausea, bone pain, muscle pain, and pain at the injection site.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes, breathlessness, swelling of the face, eyes or mouth
- rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
- extreme tiredness, fever, fast heartbeat, chest pain, blue fingernails or blueish skin or lips, cough which may contain blood
- unusual bleeding or bruising
- pain or difficulty in passing urine, change in how much urine is passed, blood in the urine
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking or using other medicines for cancer such as fluorouracil or methotrexate.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Store in the refrigerator, between 2-8°C.
Do not freeze Pegfilgrastim otherwise, it will no longer be effective and should not be used.
Keep the pre-filled syringes in their original carton to protect them from light.
If you notice that the injection has changed colour or has become cloudy, do not use it. Throw it away and use a new injection.
Medicines must not be used past the expiry date.
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