Neupogen: Treatment for Low Neutrophil Count

A syringe and two vials of chemotherapy drugs
Khuong Hoang / Getty Images

What is Neupogen?:

Neupogen (filgrastim) is a drug given to chemotherapy patients who have neutropenia (low neutrophil count). An injection of Neupogen stimulates white blood cell production. It is a clear liquid that is usually given as a shot (injection).

Use For Breast Cancer:

Chemotherapy for breast cancer affects all the rapidly dividing cells in your body, including bone marrow cells, which produce white and red blood cells and platelets.

Fewer bone marrow cells means fewer blood cells overall. If your CBC shows that your neutrophil count is low, you may be neutropenic. Injections of Neupogen can boost production of your neutrophils, a special type of white blood cell that helps your body fight infection.

How Neupogen Works:

Usually, your body produces a protein that stimulates the production of neutrophils. But during chemo for breast cancer, your body may not make enough of this protein. Your CBC may reveal that your neutrophil blood counts are low, and that you are neutropenic. Neupogen injections will boost production of your neutrophils. You may feel aches and some bone pain while this drug is working, but it may help to imagine your immune system rebuilding itself and becoming stronger at protecting your health.

How Neupogen is Given:

You will have injections of Neupogen once daily, until your white blood cell counts return to normal levels.

When properly given, these injections will not hurt. This drug can also be given through an intravenous infusion (IV).

Some Common Side Effects of Neupogen:

Not everyone has side effects from Neupogen, but here are the most common:

  • bone pain
  • fever

Self-Care Tips:

  • Soak in a warm bath to help reduce bone pain.
  • Take Tylenol (acetaminophen) to help lower mild fever and reduce pain.

Call Your Doctor if You Have These Symptoms:

  • unusual fatigue and lethargy
  • chest pain
  • heart palpitations
  • mouth sores

Urgent Symptoms include:

  • allergic reaction (hives; problems breathing; swelling of the face, lips, tongue or throat; rash spreading over your body)
  • abdominal pain
  • shoulder pain

Possible Risks of Using Neupogen:

Neupogen is a very safe drug used for many types of neutropenia. There are usually no ill or permanent effects from this drug. Any side effects you experience will taper off and cease when you stop receiving Neupogen shots. There have been cases of spleen rupture resulting in death, though this is rare.

Who Should Avoid This Drug:

Do not take this drug if:

  • you are pregnant or breastfeeding
  • you are allergic to Neupogen

Recommendations During Treatment:

Before your first injection of Neupogen, your doctor will order regular CBCs to get the levels of your platelets, red and white blood cells, and neutrophils. As treatment progresses, keep up with the recommended follow-up blood tests. These are important as they check the effectiveness of Neupogen and that you are getting the right dose.

If you are nursing or pregnant, discuss this with your doctor before taking Neupogen.

There have not been enough studies done to determine the effect of this drug on breast milk or the human fetus.

FDA. Drug Information. Filgrastim. Updated: 06/12/2012

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