Considerations before starting neulasta

Your doctor will take you through the things you need to consider when preparing to take Neulasta®. Further information is also available in the Neulasta® Patient Information Leaflet.

Things to consider when starting on Neulasta®1

Do not use Neulasta®:

  • if you are allergic to pegfilgrastim, filgrastim, or any of the other ingredients of this medicine (Sodium acetate, Sorbitol (E420), Polysorbate 20, Water for injections).

Talk to your doctor, pharmacist or nurse before using Neulasta®:

  • if you experience an allergic reaction including weakness, drop in blood pressure, difficulty breathing, swelling of the face (anaphylaxis), redness and flushing, skin rash and areas of the skin that itch.
  • if you have an allergy to latex. The needle cap on the pre-filled syringe contains a derivative of latex and may cause severe allergic reactions.
  • if you have an allergy to acrylic adhesives. The on-body injector uses acrylic adhesive and may result in an allergic reaction.
  • if you experience a cough, fever and difficulty breathing. This can be a sign of Acute Respiratory Distress Syndrome (ARDS).
  • if you have any of the following or combination of the following side effects: swelling or puffiness, which may be associated with passing water less frequently, difficulty breathing, abdominal swelling and feeling of fullness, and a general feeling of tiredness. These could be symptoms of a condition called “Capillary Leak Syndrome” which causes blood to leak from the small blood vessels into your body.
  • if you get left upper abdominal pain or pain at the tip of your shoulder. This may be a sign of a problem with your spleen (splenomegaly).
  • if you have recently had a serious lung infection (pneumonia), fluid in the lungs (pulmonary oedema), inflammation of the lungs (interstitial lung disease) or an abnormal chest x-ray (lung infiltration).
  • if you are aware of any altered blood cell counts (e.g. increase in white blood cells or anaemia) or decreased blood platelet counts, which reduces the ability of your blood to clot (thrombocytopenia). Your doctor may want to monitor you more closely.
  • if you have sickle cell anaemia. Your doctor may monitor your condition more closely.
  • if you are a patient with breast cancer or lung cancer, Neulasta® in combination with chemotherapy and/or radiation therapy may increase your risk of a precancerous blood condition called myelodysplastic syndrome (MDS) or a blood cancer called acute myeloid leukaemia (AML). Symptoms may include tiredness, fever, and easy bruising or bleeding.
  • if you have sudden signs of allergy such as rash, itching or hives on the skin, swelling of the face, lips, tongue or other parts of the body, shortness of breath, wheezing or trouble breathing these could be signs of a severe allergic reaction.
  • if you have symptoms of inflammation of aorta (the large blood vessel which transports blood from the heart to the body), this has been reported rarely in cancer patients and healthy donors. The symptoms can include fever, abdominal pain, malaise, back pain and increased inflammatory markers. Tell your doctor if you experience those symptoms.

Other medicines and Neulasta®

  • Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

Pregnancy and breast-feeding

Ask your doctor or pharmacist for advice before taking any medicine. Neulasta® has not been tested in pregnant women. It is important to tell your doctor if you:
  • are pregnant;
  • think you may be pregnant; or
  • are planning to have a baby.
Unless your doctor directs you otherwise, you must stop breast-feeding if you use Neulasta®

Driving and using machines

Neulasta® has no or negligible effect on the ability to drive or use machines.


  1. Neulasta® (pegfilgrastim). Patient Information Leaflet. [Available at:]