This leaflet contains information about pegfilgrastim. This leaflet is compiled by the department of medical oncology of the Amsterdam UMC - location VUmc. Each 0.6ml disposable syringe contains 6mg of pegfilgrastim. There are several brands such as Neulasta®, Pelgraz®, Pelmeg® and Ziextenzo®.

What does pegfilgrastim do?

Pegfilgrastim is administered to shorten the duration of neutropenia (low white blood cell count), caused by chemotherapy (drugs that destroy rapidly dividing cells). White blood cells are important because they help your body fight infections. White blood cells are very susceptive to the effects of chemotherapy, therefore your white blood cell count may drop to low levels. As a result, your body may temporarily have too few white blood cells to fight off bacteria and therefore you may be at greater risk of bacterial infections during this time. The doctor prescribes pegfilgrastim to stimulate the bone marrow (the inner part of the bone that makes blood cells) to produce more white blood cells, which helps your body restore the immune system in a shorter period of time allowing the body to fight infections.

Storage advice

Pegfilgrastim should be stored in the refrigerator. Therefore, you will not receive the disposable syringe until just before discharge. Once you are at home, you should put this disposable syringe back in the refrigerator as soon as possible. Remove the disposable syringe from the refrigerator half an hour before administration to allow it to come to room temperature. Do not heat the disposable syringe, it will become less effective.

Instructions for use

You will be given the pegfilgrastim disposable syringe by the oncology nurse in the medical oncology department before your discharge. The injection should be administered 24-48 hours after the (last drop of) chemotherapy has dripped in. The injection is administered under the skin (subcutaneous) using a pre-filled syringe for manual administration. The injection should be applied to clear, non-irritated skin in the upper leg or abdomen. The back of the upper arm can also be used, but should only be used if a caregiver or loved one is able to administer the injection.

  • Check the expiration date on the label first.
  • Remove the syringe from the package.
  • Feel if the injection is at room temperature.
  • Check the liquid: clear, colorless liquid.
  • Wash your hands.
  • Choose the injection site ( leg, abdomen or possibly arm if another person is administering).
  • Remove the rubber protective cap from the needle.
  • Grasp a skin fold between thumb and forefinger, without squeezing.
  • The pre-filled syringe is ready to inject.
  • Insert the needle completely into the skin.
  • Inject the fluid slowly and evenly, still holding the skin.
  • After all of the fluid has been injected, gently withdraw the needle with the plunger still fully depressed and release the skin. Keep pressure on the plunger while removing the needle from the skin.
  • Slowly release the plunger to allow the syringe to move upward automatically until the entire needle is covered by the needle guard. NOTE: The automatic needle guard is activated only when the pre-filled syringe is completely empty.
  • Deposit the syringe with needle in the needle container.

Other information

Do not use in case of:

Hypersensitivity to pegfilgrastim.

Caution recommended in:

A congenital red blood cell abnormality (sickle cell anemia).

Side effects

Transient bone pain (usually mild to moderate), headache, nausea, muscle pain, joint pain, pain at the injection site. For pain symptoms, you can take paracetamol. In case of liver function disorders, consult before taking paracetamol.

You may also experience sudden bruising, red dots on the skin, unexpected nosebleeds or wounds that are difficult to stop bleeding. If this happens, contact the medical oncology department. Rarely, hypersensitivity reactions may occur. These may include itching, rash, tightness of the chest, swelling (of the face, lips or tongue, for example) or rapid heartbeat. Even then, contact the medical oncology department.

This leaflet lists only the most common side effects. Besides these, there are other side effects that may occur. If in doubt, please contact the medical oncology department for these.

Contact information

If you have any concerns or other questions regarding the administration of pegfilgrastim, please contact the medical oncology department at Amsterdam UMC, location VUmc, telephone number: 020-4442130 (available 24 hours a day).