Treating low neutrophil counts with Neupogen during chemotherapy

Newkin (Filgrastim) is a drug given to some people undergoing chemotherapy to prevent or treat a condition called chemotherapy-induced neutropenia. Neutrophils are a type of white blood cell (WBC) that help prevent infection.

Neupogen increases the production of white blood cells by stimulating the bone marrow. After chemotherapy is given, the drug is given as a subcutaneous injection (in the tissue under the skin).

This article will explain what Neupogen is and its known side effects and benefits.

Neupogen vs Neulasta During Chemotherapy: Which Is Best?

Neupogen and Breast Cancer

Chemotherapy for breast cancer destroys rapidly dividing breast cancer cells. Unfortunately, chemotherapy also affects healthy cells such as white blood cells, red blood cells, and platelets. The loss of these healthy cells is known as chemotherapy-induced myelosuppression. When the number of white blood cells decreases, cancer patients are at increased risk of infection.

It is common for breast cancer patients to prescribe Neupogen, which helps the bone marrow produce circulating WBCs, which improve the body’s ability to fight bacteria.

How Neupogen Works

The body produces a protein called granulocyte-colony stimulating factor, which stimulates the production of neutrophils through a process called neutrophils. hematopoiesis. However, chemotherapy usually reduces the number of WBCs faster than the bone marrow can produce them. Therefore, Neupogen is used to help speed up the production of WBCs by the bone marrow.

A laboratory test called a complete blood count (CBC) is used to assess the absolute neutrophil count (ANC). If ANC is low, Neupogen can be given to help increase it. Preventing infection while undergoing chemotherapy is critical to maintaining health and well-being during cancer treatment.

Although Neupogen injections will boost your neutrophil production, it is important to report signs of infection, including fever (100.4 F or higher), to your oncology team immediately.


Neupogen is injected once a day until ANC rises. The number of injections needed depends on several factors, including CBC results, cancer type, chemotherapy regimen, and medical condition.

The injection is injected into the fatty tissue in the arm or abdomen. Your oncology nurse will rotate these sites daily. Neupogen can sometimes be used at home. In rare cases, Neupogen can be given intravenously (through a vein in the arm).

Neupogen side effects

As with most medicines, Neupogen injections can cause side effects. The following are the side effects associated with Neupogen:

  • Bone pain: Usually felt in the breastbone, buttocks, and leg bones, bone pain is caused by increased activity in the bone marrow.
  • Allergic reactions: You may need to get your first injection at the clinic to make sure you are not allergic to Neupogen.
  • Thrombocytopenia (decreased platelet count): Watch for signs of bleeding or petechiae (small red spots on the skin) while receiving Neupogen.
  • Leukocytosis (elevated WBC count): Too many white blood cells can cause other medical problems.
  • Ruptured spleen: If the spleen becomes too large, it can rupture, causing blood loss.
  • Acute Respiratory Distress Syndrome (ARDS): Notify your healthcare provider if you develop a fever or breathing problems while taking Neupogen.

relieve bone pain

Although nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be used to relieve bone pain, some studies suggest that taking the over-the-counter antihistamine Claritin (loratadine) along with Neupogen treatment can also help. Ask your oncology nurse for more information on how to reduce bone pain while using Neupogen.

Risks and Contraindications

Although Neupogen is relatively safe, medical conditions make it impossible for some people to accept it. Before starting Neupogen, tell your oncologist (cancer doctor) if you have any of the following:

  • Known hypersensitivity to granulocyte colony-stimulating factors such as Neupogen or Neulasta
  • blood cancers such as myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML)
  • glomerulus nephritis
  • sickle cell anemia
  • pregnant or breastfeeding

When to call your healthcare provider

Sometimes a reaction may occur. Call your healthcare provider right away if you have signs of an allergic reaction (hives, trouble breathing, swelling of your face, lips, tongue or throat, rash spreading to your body), abdominal pain, shoulder pain, chest pain, or severe symptoms of fatigue .

Neutropenia occurs when you have a fever and a low ANC. This condition is considered a medical emergency and requires immediate treatment. Report a fever of 100.4 F, chills, cough, shortness of breath, burning urination, or any other signs of infection to your oncology team immediately.

Before the first injection

Before your first injection of Neupogen, your healthcare provider will ask for a CBC to evaluate your healthy blood cells. After that, you will need to repeat the CBC to determine how well the Neupogen is working. If you are using Neupogen at home, your oncology nurse will schedule an educational session on how to inject yourself.

Other ways to reduce the risk of infection

Although Neupogen may reduce the risk of infection, here are other ways to be healthy during cancer treatment:

  • Practice good hand washing and hand disinfection.
  • Stay away from sick people.
  • Do not get live vaccines.
  • Ask your oncology nurse about a neutropenic diet.
  • Eat healthy and stay hydrated.
  • Report any signs of infection to your oncology team.

How to Reduce Your Risk of Infection During Chemotherapy


Chemotherapy destroys cancer cells and healthy white blood cells, such as neutrophils. If your neutrophil count is low, you may have an infection that requires hospitalization. Neupogen is an effective way to prevent and treat low neutrophil counts.

Although well tolerated, Neupogen can cause mild to moderate bone pain. Soak in a warm bath, stay hydrated, and use NSAIDs and Claritan to potentially relieve bone pain. Be sure to report any signs of infection to your oncology team immediately.

Frequently Asked Questions

  • How long does it take for Neupogen to work?

    An increase in neutrophil counts can be seen one to two days after starting Neupogen. Most patients will return to their pre-treatment neutrophil counts within 7 days of starting Neupogen.

    understand more:

    The role of neutrophils and white blood cells

  • How much do Neupogen injections cost?

    A single injection of Neupogen and similar colony-stimulating factors can cost $4,000. Depending on your insurance coverage, your out-of-pocket costs may be lower.

    understand more:

    Manage chemotherapy and low white blood cell counts

  • How long will bone pain last after taking Neupogen?

    Bone pain can last from one to four days after taking Neupogen. Nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve discomfort. Research has also shown that loratadine, the ingredient in Claritin, is effective in treating bone pain associated with Neupogen.

    understand more:

    side effects of chemotherapy