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The following provides crucial safety information regarding the use of Neupogen (filgrastim). Please read carefully and discuss any concerns with your healthcare provider.

• Enlarged Spleen: In rare instances, Neupogen may cause an enlarged spleen, which can be life-threatening if it ruptures. Seek immediate medical attention if you experience pain in the upper left abdominal area or shoulder.

• Respiratory Distress: This medication has been associated with acute respiratory distress syndrome (ARDS), a severe condition that impairs oxygen exchange in the lungs. If you experience shortness of breath, rapid breathing, or fever, seek emergency medical help.

• Allergic Reactions: Severe allergic reactions may occur with Neupogen use. Avoid this medication if you have previously had an allergic reaction to it or similar drugs like Neulasta (pegfilgrastim). Keep your healthcare team informed of any known allergies. Immediate medical assistance is required if you notice a rash, breathing difficulties, or swelling of the lips, tongue, or throat.

• Sickle Cell Crisis: Neupogen may trigger painful episodes in patients with sickle cell anemia. If this occurs, your healthcare provider will discontinue the medication.

• Kidney Issues: Neupogen can lead to kidney damage. If kidney problems are suspected, blood tests may be necessary to assess kidney function, and dosage adjustments might be required.

• Capillary Leak Syndrome: This serious condition involves fluid leakage from small blood vessels, leading to symptoms such as low blood pressure, dizziness, fatigue, abdominal pain, extreme thirst, or sudden weight gain. Contact your provider if you experience these symptoms for further evaluation.

• Blood Vessel Damage: Long-term use of Neupogen may cause cutaneous vasculitis, characterized by skin lesions. Report any itchy, red spots, or bumps, feeling unwell, or muscle or joint pain to your healthcare provider, as treatment might need to be paused.

• Cancer Risk: While Neupogen stimulates neutrophil production, it may also promote tumor growth. Some users have developed blood-related cancers, particularly when used alongside chemotherapy or radiation for breast or lung cancer. Regular lab monitoring is essential, and treatment may be stopped if risks outweigh benefits.

Contraindications:

• Do not use Neupogen if you are allergic to pegfilgrastim products such as Neulasta.

Always consult with your healthcare provider before starting or stopping any medication.

When taking this medication, some individuals may experience common side effects such as fever, nausea, dizziness, cough, and rash. These are generally mild and may resolve on their own. If they persist or worsen, consult your healthcare provider. You may also notice feelings of weakness or tiredness, shortness of breath, and chest pain. Additionally, pain in the bones, joints, or a general sense of discomfort may occur. Using a non-aspirin pain reliever like acetaminophen could alleviate some of these symptoms.

Certain side effects, while less common, are more serious and require immediate medical attention. These include difficulty breathing, signs of a ruptured spleen such as pain in the left upper abdomen or shoulder, and symptoms of kidney damage like swelling of the face or ankles, dark urine, or reduced urination. Low platelet counts can lead to easy bruising, prolonged bleeding, or blood in the urine or stools. A severe allergic reaction is rare but serious, characterized by rash, facial swelling, severe dizziness, or difficulty breathing.

In very rare cases, the medication may increase the risk of developing cancer of the blood or bone marrow in certain individuals. If you notice any unusual symptoms, contact your healthcare provider immediately. Always remain vigilant about any changes in your health and seek medical advice as needed.

When using Neupogen (filgrastim), it's important to avoid using pegfilgrastim at the same time, as both medications are similar and should not be combined. Additionally, Neupogen can affect certain lab tests, such as bone imaging, potentially leading to inaccurate results. Therefore, inform lab personnel and all your healthcare providers that you are taking this medication.

Be aware that Neupogen might interact with other drugs or supplements. Always communicate with your doctor and pharmacist about any medications, including prescribed, over-the-counter, vitamins, and herbal supplements, you are taking. While not exhaustive, some medications like Vincristine and Vincristine Sulfate Liposome may require careful consideration if used alongside Neupogen. Your doctor might adjust dosages or usage frequency if both are necessary.