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 your child for other reasons. Talk with the doctor.
On-body Injector:
- This drug is not approved for use in children. However, the doctor may decide the benefits of taking this drug outweigh the risks. If your child has been given this drug, ask the doctor for information about the benefits and risks. Talk with the doctor if you have questions about giving this drug to your child.
What do I need to tell the doctor BEFORE my child takes this drug?
- If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.
- If your child has a latex allergy, talk with the doctor. Some products have latex.
- If your child weighs less than 99 pounds (45 kilograms), talk with your child’s doctor.
This drug may interact with other drugs or health problems.
Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe to give this drug with all of your child’s other drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.
What are some things I need to know or do while my child takes this drug?
- Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
- Do not give this drug to your child within 14 days before or 24 hours after your child gets chemo.
- Have your child’s blood work and other lab tests checked as you have been told by the doctor.
- This drug may affect certain lab tests. Tell all of your child’s health care providers and lab workers that your child takes this drug.
- 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.
If your child is pregnant or breast-feeding a baby:
- Talk with the doctor if your child is pregnant, becomes pregnant, or is breast-feeding a baby. You will need to talk about the benefits and risks to your child and the baby.
What are some side effects that I need to call my child’s 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 child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:
- 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.
- Low platelet counts have rarely happened with this drug. This may lead to a higher chance of bleeding. Call your child’s doctor right away if your child has any unexplained bruising or bleeding.
- Enlarged and ruptured spleens have happened with this drug. Sometimes, ruptured spleens have been deadly. Call the doctor right away if your child has 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 child’s doctor right away if your child feels very tired or weak. Call your child’s doctor right away if your child has 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 child’s doctor right away if your child gets 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 your child has black, tarry, or bloody stools.
- 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 the doctor right away if your child has a fever, feels very tired, or has unexplained bruising or bleeding.
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 child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:
- Bone, joint, or muscle pain.
- Pain in arms or legs.
These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.
You may report side effects to your national health agency.
How is this drug best given?
Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.
- It is given as a shot into the fatty part of the skin.
- If you will be giving your child the shot, your child’s doctor or nurse will teach you how to give the shot.
- Keep giving this drug to your child as you have been told by your child’s doctor or other health care provider, even if your child feels 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.
What do I do if my child misses a dose?
- Call your child’s doctor to find out what to do.
How do I store and/or throw out this drug?
- 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.
- 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 child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
- Do not share your child’s drug with others and do not give anyone else’s drug to your child.
- Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s 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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