Pegfilgrastim (By injection)

Pegfilgrastim (peg-fil-GRA-stim)

Helps your body make white blood cells after you receive cancer medicine. Also used to improve survival in people who have been exposed to radiation.

Brand Name(s):

Fulphila, Neulasta, Neulasta Onpro, Udenyca, Ziextenzo

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

This medicine is not right for everyone. Do not use it if you had an allergic reaction to pegfilgrastim or filgrastim.

How to Use This Medicine:


  • Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin.
  • A nurse or other health provider will give you this medicine.
  • You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
  • Start using the medicine 24 hours or more after you finish your chemotherapy. However, do not use it within 24 hours before you begin another chemotherapy treatment.
  • Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
  • Allow this medicine to warm to room temperature for 30 minutes before you use it.
  • Do not shake the syringe. Use the syringe only once. Do not save leftover medicine.
  • Missed dose: This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.
  • Neulasta® single-use prefilled syringe: If you store this medicine at home, keep it in the refrigerator. Do not freeze. If the medicine is accidentally frozen, let it thaw out in the refrigerator before you use it. If the medicine freezes a second time, do not use it. Keep the medicine in the carton and away from heat or direct light. The medicine can stay out of the refrigerator for up to 48 hours. Throw away any medicine that has been out of the refrigerator for more than 48 hours.
  • Neulasta® Onpro™ kit: Keep the medicine in the carton and away from heat or direct light. The medicine can stay out of the refrigerator for up to 12 hours. Throw away any medicine that has been out of the refrigerator for more than 12 hours.
  • Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Warnings While Using This Medicine:

  • Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, lung disease, breathing problems, or sickle cell disease. Tell your doctor if you have an allergy to acrylic adhesives or latex.
  • This medicine may cause the following problems:
    • Spleen problems
    • Lung problems (including acute respiratory distress syndrome)
    • Kidney problems
    • Capillary leak syndrome
    • Aortitis (inflammation of the aorta, the largest artery in the body)
  • On-body Injector (OBI) for Neulasta®:
    • Keep the injector at least 4 inches away from electrical equipment, including cell or cordless phones, microwaves, and other appliances.
    • Do not use hot tubs or saunas while you are wearing the injector. Do not expose the injector to sunlight. Do not sleep on the injector. Call your doctor if the injector comes off before or during a dose.
    • Keep the injector dry at least 3 hours before the dose is scheduled to start. This will help you notice any leaks. Call your doctor if the bandage becomes wet or the medicine is dripping.
    • The injector is programmed to deliver your dose about 27 hours after it is placed on your skin. It will take about 45 minutes for the dose to be given. Avoid activities, including driving and traveling, that may interfere with the injector 1 hour before the dose starts, while it is being given, and for at least 1 hour afterward.
    • You should avoid airport X-ray scans and request a manual pat down instead.
    • You should avoid sleeping on the OBI for Neulasta® or applying pressure on the OBI for Neulasta®. Doing so may prevent the OBI from working properly.
    • You should avoid getting body lotions, creams, oils, and cleaning agents near the OBI for Neulasta® as these products may loosen the adhesive that holds the OBI into your body.
  • Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
  • Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Decrease in how much or how often you urinate, red or dark brown urine, lower back or side pain
  • Fever, chills, cough, sore throat, body aches, back or stomach pain
  • Lightheadedness, dizziness, fainting
  • Pain in your left side or shoulder, or feeling unusually full
  • Skin redness, blisters, or sores, red or purple spots on your skin
  • Swelling in your face, ankles, or feet
  • Trouble breathing or fast breathing
  • Unusual bleeding, bruising, tiredness, or weakness

If you notice these less serious side effects, talk with your doctor:

  • Bone, arm, or leg pain
  • Pain, redness, or swelling where the shot was given

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 11/6/2020

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