- Drugs List
- Therapeutic Indications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
Parenteral formulations of pegfilgrastim.
Reduced duration of neutropenia
Reduced incidence of febrile neutropenia
One 6mg dose of pegfilgrastim is recommended at least 24 hours after each chemotherapy cycle.
Administer subcutaneous injection into the thigh, abdomen or upper arm, a minimum of 24 hours after cytotoxic chemotherapy.
The on-body injector should be applied to intact, non-irritated skin on the back of the arm or abdomen.
The on-body injector delivers pegfilgrastim over approximately 45 minutes, around 27 hours after it is applied to the patient's skin.
The on-body injector must only be used with the co-packed pegfilgrastim pre-filled syringe.
Children under 18 years
Chronic myeloid leukaemia
Hereditary fructose intolerance
Secondary acute myeloid leukaemia
Precautions and Warnings
Hypersensitivity to latex
Acute myeloid leukaemia
History of pulmonary infiltrates
New onset acute myeloid leukaemia in patients below 55 years
Recent history of pneumonia
Sickle cell disease
Sickle cell trait
Incidence of thrombocytopenia and anaemia not reduced by treatment
Treatment to be initiated and supervised by a specialist
Needle cover contains a derivative of latex in some brands
On-body injector contains acrylic adhesive: may cause allergic reactions
Presentations with sorbitol unsuitable in hereditary fructose intolerance
Record name and batch number of administered product
Monitor full blood count and differential WBC before and during therapy
Consider splenic rupture if patient has abdominal or shoulder pain
Lung or breast cancer: Monitor for MDS and AML
Monitor for symptoms of Capillary Leak Syndrome
Monitor haematocrit values
Monitor patients with sickle cell anaemia
Monitor patients with sickle cell trait
Monitor spleen size
Perform regular urinalysis
Advise patient to seek medical advice if signs/symptoms of aortitis occur
Discontinue treatment if Stevens-Johnson syndrome is confirmed
Seek urgent medical attention if symptoms of Capillary Leak Syndrome occur
May affect bone imaging results
Discontinue if adult respiratory distress syndrome occurs
Discontinue if leucocyte count exceeds 50x10 to the power of 9/L
Discontinue if serious allergic or anaphylactic reaction occurs
Discontinue if severe hypersensitivity reactions occur
Discontinue or reduce dose if glomerulonephritis occurs
Concurrent cytotoxic drugs: Maintain established dose regime (no increase)
Female: Ensure adequate contraception during treatment
Patient alert card available for some brands
If aortitis is suspected it can usually be diagnosed by CT scan and generally resolves after withdrawal of pegfilgrastim.
If the patient develops Stevens-Johnson syndrome with the use of pegfilgrastim, treatment must not be restarted at any time.
Pregnancy and Lactation
Pegfilgrastim is contraindicated during pregnancy.
The manufacturer does not recommend using pegfilgrastim during pregnancy. Animal studies have shown reproductive toxicity. Human data is limited and as such a potential risk cannot be ruled out.
Pegfilgrastim is contraindicated during breastfeeding.
The manufacturer advises that the patient either discontinues pegfilgrastim or discontinues breastfeeding. The presence of pegfilgrastim in human breast milk and the effects on exposed infants are unknown.
Advise the patient that if they suspect a device failure or malfunction with the on-body injector they must immediately inform their healthcare provider.
On-body injector: Patient alert card available. Remind patient of the importance of carrying alert card with them at all times.
Acute febrile dermatosis (Sweet's syndrome)
Acute myeloid leukaemia
Adult respiratory distress syndrome
Altered liver function tests
Application site reaction
Capillary leak syndrome
Increase in alkaline phosphatase
Increase in lactate dehydrogenase
Increased uric acid level
Local pain (injection site)
Local reaction at injection site
Pulmonary reactions (acute)
Sickle cell crisis
Effects on Laboratory Tests
Positive bone imaging findings have been associated with growth factor therapy due to the increase in haematopoietic activity in the bone marrow.
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Last Full Review Date: March 2021
Summary of Product Characteristics: Neulasta pre-filled syringe. Amgen Ltd. Revised November 2020.
Summary of Product Characteristics: Neulasta on body injector. Amgen Ltd. Revised November 2020.
Summary of Product Characteristics: Pelgraz 6mg solution for injection in pre-filled injector. Accord Healthcare Ltd. Revised November 2019.
Summary of Product Characteristics: Pelgraz 6mg solution for injection in pre-filled syringe. Accord Healthcare Ltd. Revised November 2019.
Summary of Product Characteristics: Pelmeg 6mg solution for injection in pre-filled syringe. Napp Pharmaceuticals Ltd. Revised October 2020.
Summary of Product Characteristics: Ziextenzo 6mg solution for injection in pre-filled syringe. Sandoz Limited. Revised January 2020.
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Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.