Neupogen

Nurse Kyles, BSN, RN · Nov 8, 2011

Simultaneous use with antineoplastic drugs will have an adverse effect on the rapidly proliferating neutrophils. That is why it should be avoided for 24 hours before and 24 hours after chemo. (Davis Drug Guide 201) In chemo you are killing the cells... so you wouldn't want to stimulate the cells to grow because they would just die anyway.

Editorial Team / Admin · Nov 8, 2011

If Neupogen is taken anytime within 24 hours before or after chemotherapy, the risk of infection is actually increased.

emmanewgrad · Nov 8, 2011

Interesting :)

Tsatalstrana · Nov 8, 2011

OK, makes sense, but I still don't understand the "24" hours thing. Why choose 24hours as opposed to 48 etc...Does this have to do with the chemotherapy's drug half life?

Biffbradford · Nov 8, 2011

Sounds like a great chance to test one of those high payed pharmacists! :)

Tsatalstrana · Nov 8, 2011

I hear ya...i would really like to...I got my RN is March from 6 years of LPN and wanted to try something new. Just got hired about 2 months ago into this Oncology clinic as a sort of "get foot in door" with hospital and it is sink or swim with it. Not very many friendly and helpful people...pharmacists and techs just don't have any time for me and they are soooo snobby. Nurses also say don't ask doctors any "stupid" questions. That is why I have to research day and night for my own answers. Please tell me it gets better in nursing? Thanks for all the great replies. :lol2:

Esme12, ASN, BSN, RN · Nov 8, 2011

neutropenia - a low neutrophil count (i.e. an absolute neutrophil count below 1.0 x 103); a short period of neutropenia is a common side effect of most chemotherapy, it tends to occur about 10 days after chemotherapy and lasts several days (these days are known as the nadir); the nadir can be shortened with daily subcutaneous injections of neupogen starting 24 hours after the last chemotherapy drug and continuing for at least 7 days or until the wbc comes up; antibiotic prophylaxis is sometimes necessary to prevent infections during periods of neutropenia; many precautions must be taken when neutropenic: patients can't be near fresh flowers or plants, they have to eat a low-microbial diet meaning no fresh uncooked foods or foods with active cultures like cheese or yogurt, also have to wash hands so often that they get all dry even when i use lotion; there are several other terms you will hear in conjunction with neutropenia like "immunosuppressed" and "immunocompromised" all of which basically suggest that a person has a weak immune system and little defense against infection.

the safety and efficacy of neupogen has not been established....because of the rapidly dividing cells to cytotoxic chemotherapy and neupogen is made from e coli.......the risk of severe infection is greater during this period and actually it's 24 hours prior to and after chemo.

http://www.rxlist.com/neupogen-drug.htm

http://pi.amgen.com/united_states/neupogen/neupogen_pi_hcp_english.pdf

mandtsmom · Nov 8, 2011

hi there. not much help however, i do know that if given within 24 hrs in can actually increase the risk of infection. i don't know why this is i just remember a doc telling me that.:)

Mommy&RN, BSN, RN · Nov 8, 2011

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000912/

xtxrn, ASN, RN · Nov 9, 2011

IDK if this matters or not- BUT I got Neupogen (or Neulasta) only on the weekends, since I had to resume chemo on Mondays. The doc wanted the Neupogen in long enough to "work" so I'd have enough WBCs to keep getting the chemo.

Another side: both hurt like h***. Like no kidding. The onc. explained it as the bone marrow having so much pressure inside because of the production of WBCs, that it caused the bone to feel like it was being blown up from the inside. It was BAD. So don't forget that when doing teaching or expecting side effects :)

Toto7891 · Nov 9, 2011

The sooner the better? chemotherapy reduces your neutrophil count (causing neutropenia), thus weakening your immune system. since it's a colony stimulating factor, it'll help with production of neutrophil and will "decrease" your chance of getting an infection after chemotherapy. It's not uncommon to see these administered every day for at least a week until the pt.'s neutrophil count goes back to accepted levels. As a side note, these things are $300 a pop =)