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This document outlines important safety and warning information concerning the use of Neulasta (pegfilgrastim). It is crucial to closely review these details and discuss any concerns with your healthcare provider.

• Enlarged Spleen: There have been rare instances where Neulasta has led to an enlarged spleen, which can result in a life-threatening rupture. Seek medical attention if you experience pain in the upper left abdomen or shoulder area.
• Breathing Issues: Neulasta can cause acute respiratory distress syndrome (ARDS), a severe condition that involves fluid leakage into the lungs, obstructing oxygen flow. Urgent medical care is needed if you encounter symptoms like shortness of breath, rapid breathing, or fever.
• Allergic Reactions: Serious allergic reactions to Neulasta can occur and may be life-threatening. Avoid using this medication if you have a history of allergies to it or similar drugs like Neupogen. Additionally, inform your provider if you have latex or acrylic allergies, as Neulasta devices may contain these materials. Immediate medical help is necessary if you develop a rash, difficulty breathing, or swelling of the lips, tongue, or throat.
• Sickle Cell Crisis: Individuals with sickle cell anemia may experience a painful sickle cell crisis while on Neulasta. If this occurs, the medication will be discontinued.
• Kidney Issues: Neulasta may cause kidney damage, which typically improves once the medication is adjusted or paused. Blood tests may be required to monitor kidney function if issues are suspected.
• Capillary Leak Syndrome (CLS): This serious condition involves fluid leakage from small blood vessels. Symptoms include low blood pressure, dizziness, fatigue, abdominal pain, excessive thirst, or sudden weight gain. If you notice these signs, consult your healthcare provider.
• Cancer Risk: Although Neulasta stimulates neutrophil production, it may also promote the growth of other tumors. Some patients have reported blood-related cancers when used in conjunction with other cancer treatments. Regular lab monitoring will determine if the medication remains appropriate.
• Blood Vessel Inflammation: Neulasta has been associated with a condition known as aortitis, involving inflammation of blood vessels. Symptoms can emerge within the first week of treatment. Report any fever, abdominal pain, back pain, or general malaise to your provider.

Contraindications: Do not use Neulasta if you have allergies to filgrastim products like Neupogen, as it may pose serious health risks. Always consult your healthcare provider before starting this medication.

When using this medication, some common side effects may include bone pain and discomfort in the arms or legs. These symptoms are generally mild and manageable with non-aspirin pain relievers like acetaminophen. Additionally, you might notice redness, swelling, itching, or bruising at the injection site. If these effects persist or worsen, it is advisable to consult your healthcare provider for further guidance.

Occasionally, individuals may experience more serious side effects, which require prompt medical attention. These include pink or bloody urine, easy bleeding or bruising, fever, rapid heartbeat, purple or red spots on the skin, and back pain. Very serious side effects, such as breathing difficulties, unusual tiredness, or a noticeable decrease in urination, should be addressed immediately by seeking medical help. Rarely, there can be severe complications like a ruptured spleen, indicated by stomach or shoulder pain, or an increased risk of bone marrow disorders or blood cancers in patients undergoing chemotherapy or radiation.

If you encounter symptoms of a serious allergic reaction, such as a rash, severe dizziness, swelling of the face, tongue, or throat, or trouble breathing, it is crucial to seek urgent medical care. While these severe reactions are rare, being aware of them ensures prompt action, thereby safeguarding your health. Always stay vigilant for any unusual symptoms and consult your healthcare provider if you have concerns.