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
Granix; Neupogen; Nivestym; Releuko; Zarxio
Brand Names: Canada
Grastofil; Neupogen; Nivestym; Nypozi
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 to raise the number of white blood cells in certain patients.
- 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 are breast-feeding or plan to breast-feed. You may need to avoid breast-feeding.
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?
- Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
- If you have a latex allergy, talk with your doctor. Some products have latex.
- Do not get this drug at the same time or within 24 hours before or after chemo or radiation treatment. Talk with your doctor.
- 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.
- 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.
- 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.
- Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this drug while you are pregnant.
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:
- 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.
- A fast heartbeat.
- Dizziness or passing out.
- Sweating a lot.
- Fast breathing.
- Coughing up blood.
- Purple spots or redness of the skin.
- Swelling.
- Numbness or tingling.
- 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.
- 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.
- A bone marrow problem called myelodysplastic syndrome (MDS) and a type of leukemia have happened with this drug in people who were born with low white blood cell counts. This has also happened 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.
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:
- Bone, joint, or muscle pain.
- Pain in arms or legs.
- Headache.
- Diarrhea, upset stomach, or throwing up.
- Feeling tired or weak.
- Hair loss.
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.
All products:
- It is given as a shot into the fatty part of the skin on the top of the thigh or the belly area.
- This drug may be given into the buttocks or the outer area of the upper arm if given by someone else.
- Some products may be given as an infusion into a vein over a period of time. Talk with the doctor if you have questions.
- Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
- If you will be giving yourself the shot, your doctor or nurse will teach you how to give the shot.
- Before using this drug, take it out of the refrigerator and leave it at room temperature for 30 minutes.
- Do not use if the solution is cloudy, leaking, or has particles.
- Do not use if solution changes color.
- Do not shake the solution.
- Wash your hands before and after you give the shot.
- Do not give into skin that is irritated, tender, bruised, red, scaly, hard, scarred, or has stretch marks.
- 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.
- Each prefilled syringe or vial is for one use only. Throw away any part left over after the dose is given.
- 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.
- If you get this drug on the skin, wash it off right away with soap and water.
- If you get this drug in the eyes, flush right away with cool water and get medical help.
Prefilled syringes:
- Do not use this drug if it has been dropped or if it is broken.
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?
All products:
- 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 put back in the refrigerator after being stored at room temperature. If you are not sure, talk with the pharmacist.
- 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.
Neupogen, Grastofil, Nivestym, and Zarxio:
- If this drug freezes, let it thaw in the refrigerator before use.
- Do not use if this drug has been frozen more than 1 time.
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
2024-02-16
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