Pegfilgrastim injection products come as a solution (liquid) in prefilled injection syringes to inject subcutaneously (under the skin), and in a prefilled automatic injection device (on-body injector) to apply to the skin. If you are using a pegfilgrastim injection product to decrease the risk of infection during chemotherapy, it is usually given as a single dose for each chemotherapy cycle, no sooner than 24 hours after the last dose of chemotherapy of the cycle is given and more than 14 days before beginning the next chemotherapy cycle. If you are using pegfilgrastim injection because you have been exposed to harmful amounts of radiation, it is usually given as 2 single doses, 1 week apart. Your doctor will tell you exactly when you should use pegfilgrastim injection products.
Pegfilgrastim injection products may be given to you by a nurse or other healthcare provider, you may be told to inject the medication yourself at home, or you may receive a prefilled automatic injection device by the nurse or healthcare provider that will inject the medication automatically for you at home. If you will be injecting pegfilgrastim injection products yourself at home, or if you receive the prefilled automatic injection device, a healthcare provider will show you how to inject the medication, or how to manage the device. Your healthcare provider will also give you the manufacturer's information for the patient. Ask your healthcare provider to explain any part that you do not understand. Use a pegfilgrastim injection product exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Do not shake syringes containing pegfilgrastim solution. Always look at pegfilgrastim solution before injecting. Do not use if the expiration date has passed, or if the pegfilgrastim solution has particles or looks cloudy or discolored.
If your pegfilgrastim solution comes in a prefilled automatic injection device , the device will usually be applied to your abdomen or the back of your arm by a nurse or other healthcare provider the day before you will receive the dose of pegfilgrastim. The next day (approximately 27 hours after the prefilled automatic injection device was applied to your skin), the dose of pegfilgrastim solution will be automatically injected subcutaneously over 45 minutes.
When you have the pegfilgrastim prefilled automatic injection device in place;
- you should have a caregiver with you the first time you receive a dose of pegfilgrastim or anytime the prefilled automatic injection device is applied to the back of your arm.
- you will need to monitor the prefilled automatic injection device while the entire dose of pegfilgrastim is injected in your body, so you should avoid activities and being in places that may interfere with monitoring while you are receiving the dose of filgrastim and for 1 hour afterwards.
- you should not travel, drive a car, or operate machinery 1 hour before and 2 hours after you receive your dose of pegfilgrastim with the prefilled automatic injection device (about 26 to 29 hours after the it was applied).
- you should make sure that you keep the prefilled automatic injection device at least 4 inches away from electric appliances and equipment including cell phones, cordless telephones, and microwave ovens.
- you should avoid airport x-rays and request a manual pat down if you have to travel after the prefilled automatic injection device is applied to your body and before you receive your dose of pegfilgrastim.
- you should immediately remove the prefilled automatic injection device if you have an allergic reaction while you are receiving your dose of pegfilgrastim by grabbing the edge of the adhesive pad and peeling it off. Call your doctor immediately and get emergency medical treatment.
- you should call your doctor immediately if the prefilled automatic injection device comes off of your skin, if the adhesive becomes noticeably wet, if you see dripping from the device, or if the status light flashes red. You should keep the prefilled automatic injection device dry for 3 hours before you receive your dose of pegfilgrastim to help you notice if your device starts to leak while you are receiving your dose.
- you should avoid being exposed to medical imaging studies (X-ray scan, MRI, CT scan, ultrasound) or oxygen rich environments (hyperbaric chambers).
- you should avoid sleeping or applying pressure on the prefilled automatic injection device.
- you should avoid hot tubs, whirlpools, saunas, and direct sunlight.
- you should avoid using lotions, oils, creams, and cleansers on your skin near the prefilled automatic injection device.
If the prefilled automatic injection device flashes red, if the device comes off before the full dose is delivered, or if the adhesive on the device becomes wet or there is leaking, call your doctor right away. You may not have received the full dose of pegfilgrastim, and may need an additional dose.
Dispose of used needles, syringes, and devices in a puncture-resistant container. Talk to your doctor or pharmacist about how to dispose of the puncture-resistant container.