What is Neulasta?

Neulasta Dosage, forms & strengths

Medically reviewed by Jamie Winn, PharmD

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Neulasta (pegfilgrastim) is an injectable leukocyte growth factor manufactured by Amgen. It is approved by the FDA to decrease the risk of serious infections if you have certain types of malignancies such as breast cancer and are receiving chemotherapy that can cause a clinically significant incidence of febrile neutropenia (fever with low white blood cells). It is also used to increase survival if you have been administered high doses of radiation. Neulasta is not approved as preparation for blood collection for your own stem cell transplant.

What is Neulasta’s mechanism of action?

Granulocyte-colony stimulating factor (G-CSF) stimulates your bone marrow to produce neutrophils, which is a type of white blood cell (WBC). Neulasta is a recombinant G-CSF that works exactly as your natural G-CSF does. By causing your bone marrow to make more neutrophils, Neulasta helps you fight infections and febrile neutropenia.

Neulasta dosage forms and strengths

Neulasta injection: 6 mg/0.6 ml single-dose prefilled syringe

Neulasta Onpro: 6 mg/0.6 ml single-dose prefilled syringe along with an on-body injector (OBI)

Neulasta dosage

Patients with malignancies who are receiving myelosuppressive chemotherapy:

Neulasta 6mg is given as a single subcutaneous injection (under the skin) once per chemotherapy cycle for adults and pediatric patients weighing more than 45kg. You should not receive Neulasta between 14 days before and 24 hours after the administration of cytotoxic chemotherapy.

Patients with hematopoietic subsyndrome of acute radiation syndrome (radiation sickness):

Neulasta is given in 2 doses of 6mg injected under the skin 1 week apart. You should be given your first dose as soon as possible after a suspected or confirmed exposure to levels of radiation greater than 2 gray (Gy).

For dosing in pediatric patients with a body weight of less than 45 kg:

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Neulasta dosage restrictions

There are no guidelines or dose reduction recommendations available for patients with hepatic (liver) or renal (kidney) impairment.

How to take Neulasta

Read the Full Prescribing Information, Instructions for Use, and Medication Guide that comes with this medication.
Neulasta can be given as a subcutaneous injection by your doctor or at home by you or a caregiver. Your doctor will show you and your caregiver how to give Neulasta before you administer your first dose.
Neulasta prefilled syringes should not be used to measure doses less than 0.6mg (0.6ml) as they may not be accurate.
Store Neulasta in its original carton in the refrigerator between 36°F to 46°F (2 °C to 8°C). Take the prefilled syringe out of the refrigerator about 30 minutes before administering a dose so it can reach room temperature. Dispose of any Neulasta that was left out at room temperature for more than 48 hours.

Neulasta dosage FAQs

What are some side effects of Neulasta?

Some common side effects of Neulasta that were seen in clinical trials when compared to placebo include:

Stomach, back, and bone pain
Injection site reactions
Pain in your arms and legs
Fatigue

Neulasta can sometimes cause more serious side effects, including:

Severe, life-threatening allergic reactions, including anaphylaxis (hives, swelling of your face or throat, shortness of breath, or trouble breathing
Sickle cell crisis in patients with sickle cell disorders
Thrombocytopenia (decreased platelet count)
Increased risk of splenic rupture
Kidney toxicity and glomerulonephritis
Aortitis (inflammation of your aorta)
Increased neutrophil count, which may be a sign of acute respiratory distress syndrome (ARDS)
Leukocytosis (increased white blood cell count)
Capillary leak syndrome (CLS)
Myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) in patients with breast cancer or lung cancer

Contact your healthcare professional for medical advice about any adverse reactions you experience while taking Neulasta. You can report your adverse effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What are some drug interactions with Neulasta?

The concomitant use of Neulasta with other drugs can change how they work or increase the frequency and severity of side effects. You should ask your healthcare professional if any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication.

Are there any contraindications for Neulasta?

Neulasta should not be used if you have had a serious allergic reaction to granulocyte colony-stimulating factors (G-CSF) such as pegfilgrastim or filgrastim or any inactive ingredients in its formulation. The on-body injector (OBI) for the Neulasta Onpro kit uses an acrylic adhesive and can cause significant hypersensitivity reactions in patients allergic to acrylic adhesives.

Is it safe to use Neulasta while pregnant or breastfeeding?

There is no adequate information on the use of Neulasta in pregnant women. Filgrastim products have not been associated with major birth defects, miscarriages, or adverse outcomes for the mom or baby. It is not known whether Neulasta is found in breast milk during lactation and should be used with caution in nursing females. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.

Where can you inject Neulasta?

You can inject Neulasta in your thigh, stomach (not around your belly button), buttocks, or the outer area of your upper arm.

When should you not give Neulasta?

You should not receive Neulasta between 14 days before and 24 hours after the administration of cytotoxic chemotherapy.

Why does Neulasta cause bone pain?

The exact reason is not known, but it may be due to Neulasta’s effects on histamine, which can cause inflammation and swelling in your bone marrow and result in pain.

What is the maximum daily dose of Neulasta?

Your dose of Neulasta will depend on the condition being treated. For adults receiving myelosuppressive chemotherapy, the maximum dose is a single subcutaneous injection of 6 mg administered once per chemotherapy cycle. For adults receiving high doses of radiation, the maximum dose is 2 doses of Neulasta 6 mg given 1 week apart.

What is the average price of Neulasta?

There is no generic for Neulasta but there are biosimilars available. You would need a new prescription from your doctor to change medications as they cannot be substituted for Neulasta. The average cost of 1 syringe of Neulasta 6mg/0.6ml is around $8,800.

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The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.