Pegfilgrastim helps increase the number of neutrophils, a type of white blood cell which is important in your body’s fight against infection after chemotherapy.
Your doctor or nurse will administer the injection for you. If you or a caregiver had been given the proper training on the preparation and injection techniques, you or your caregiver may do the administration.
Pegfilgrastim is available in pre-filled syringe for manual subcutaneous administration or as a kit for use with the on-body injector.
How to use this medicine:
- Ensure that you receive all the supplies that you need (e.g. pre-filled syringe, alcohol wipes, cotton balls or gauze pad, adhesive bandage, puncture-resistant sharps container).
- Remove Pegfilgrastim from the refrigerator and allow to reach room temperature for 30 minutes.
- Wash your hands with soap and water.
- Prepare the injection. Hold the syringe barrel and gently take the cap from the needle. Pull straight. Do not touch the needle or push the plunger. Do not shake the pre-filled syringe or remove the cap until you are ready to inject.
- This medicine is to be injected subcutaneously (into the fatty layer under the skin, usually in the abdomen, thigh, or upper arm). Remember to rotate the injection sites. Do not inject into the same area all the time. New injection sites should be at least 1 inch away from the previous injection site. Do not inject onto areas of your skin that are red, bruised, tender, hard or not intact.
- Clean the injection site with alcohol wipes and let it dry.
- Gently pinch the skin at the injection site with one hand and pick up the syringe with the other hand. Insert the needle in the pinched area of the skin. Release the pinched skin after the needle is completely inserted. To deliver a full dose, push the plunger with slow and constant pressure until you feel or hear a “snap”.
- Slowly release the needle and gently pull it out of the skin. If there is bleeding on the injection site, press a cotton ball or gauze pad over the area. If needed, you may cover it with an adhesive bandage.
- If you are using the manual subcutaneous injection, activate needle guard to prevent accidental needlestick. Contact your doctor or nurse immediately if the on-body injector comes away from your skin at any time before your full dose has been delivered. Do not re-apply it. There is a small cannula which sits just under your skin. If the on-body injector has been knocked or pulled, the cannula may become dislodged. If this happens, you may not receive your dose.
- Dispose your used syringe and needle in the sharps container or according to your doctor or pharmacist’s instructions. Do not throw away in household trash.
If you have problems or do not understand the instructions, ask your doctor or pharmacist.
The dose of Pegfilgrastim will be decided by your doctor. Your doctor will advise you on the dose and course of the treatment depending on your condition.
Ensure that you keep all appointments with your doctor so that you do not miss any dose. Your doctor also needs to regularly monitor your response to Pegfilgrastim.
If you miss an appointment or miss an injection, alert your doctor or nurse. A replacement appointment or injection should be given as soon as possible.
If you or a caregiver had been trained to administer this medicine and missed a dose, DO NOT double a dose under any circumstances.
If you often forget to administer your medicine, let your doctor and pharmacist know.
Inform your doctor if you have blood or bone marrow disorder e.g. sickle cell disease and acute myeloid leukemia.
Let your doctor know if you are pregnant or breastfeeding.
Do not use pre-filled syringe intended for manual injection to fill the on-body injector (or the other way around) as this may not deliver the full prescribed dose of Pegfilgrastim.
On-body injector is only for use with Pegfilgrastim. Do not use it to deliver other medication.
Do not expose the on-body injector to oxygen-rich environment (e.g. MRI, x-ray, CT-scan, ultrasound).
Avoid airport x-ray scans and request for a manual pat down. Use care during a manual pat down to help prevent the on-body injector from being accidentally removed.
Keep the on-body injector at least 4 inches away from electrical equipment such as cell phones, cordless telephones, microwaves and other common appliances. If the on-body injector is too close to electrical equipment, it may not work correctly and can lead to a missed or incomplete dose.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine blood tests (e.g. complete blood count, platelet count) may be needed. Your doctor will advise you about how often you will need to have these tests.
- If you are using an on-body injector, monitor for any evidence of device malfunction while you are being treated with this medicine.
Pegfilgrastim may cause any of the following side effects: bone pain, muscle pain, pain in the extremities and injection site pain or irritation.
If you develop rashes, breathlessness, swollen mouth or eyes, stop using Pegfilgrastim and inform your doctor quickly. These could be signs of an allergic reaction.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- abnormal heartbeat, trouble breathing, swelling or puffiness and are urinating less than usual, swelling of stomach, dizziness or a general feeling of tiredness. These could be symptoms of a condition called “capillary leak syndrome” which causes the blood to leak from the small blood vessels into your body.
- signs of a serious lung problem e.g. shortness of breath with or without a fever, trouble breathing, or a fast rate of breathing
- signs of an enlarged or ruptured spleen e.g. left upper stomach or left shoulder pain
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Store in the refrigerator, between 2-8°C. Do not allow to freeze. If frozen, this medicine will become ineffective and should not be used.
Protect from light.
Medicines must not be used past the expiry date.