Neupogen questions for anyone taking it ?

[orphanedhawk]

Okay, I'm over my panic.
I need some specifics before taking my first neup. shot. Do you take it with or without food, at night or not,etc.
Did it knock you out, take away your energy or add to it?
Please~ any advice would be helpful.

BTW:A gripe:
My nurse is young, sweet, overworked, and has messed up on occasion.
She's the one I have to deal with so it's important I keep things pleasant with her. I phoned asking her these questionson her voice mail. She hasn't returned my call but then she's the one who called me and said," Dr. says start taking neupogen now! Do you have any at home?"
Geeze, I told her several times to phone in a script before I began tx.
How the heck am I supposed to have any sitting around the house?

[orphanedhawk]

Thanks for the advice though a little late for this time.
I just did it.

There I was ready to inject when I read " don't inject into stretch marks" geeze, I had two kids, I'm tiny and don't have much extra fat. So, I though WTF and did the shot anyway.

Thanks again for all the food for thought.

[hcvJames]

Took neup for 48 weeks out of 60 something weeks. I took one shot a week, though could have stood two. The interferon shot was on Wens. 23:00, and the Neup shot on Sun., @23:00 also. Then CBC's on Tue, around noon. The reasoning was, interferon lowers WBC so it wouldn't be prudent to take neup right after the interferon was at it's most potent. Besides I'd been taken off tx 3 times for low WBC, each a traumatizing event, so after realizing my WBC would be below cutoff any day from Wens. to Fri. I simply started coming on a Tue. for a CBC no matter when they had scheduled it.
I actually got a boost from the Neup shots but I think it was because of the insane difficulty in convincing them I needed it (based on the superb guidance received here.) No doubt the 'boost' was really an emotional response of thanks and relief for finally getting the stuff and being able to continue tx. Otherwise I may have been injecting distilled water for all the difference it made in the way I felt. It did work within hours but wore off after about three days. In short put your neup shot(s) as far away from inf shots as possible but close enough to your CBC's to give a good showing. :)

All the very best.

[orphanedhawk]

Thanks everyone for the responses. It helps.

Well, my nurse said usually it should be taken before interferon.
She just phoned me after consulting with the nurse practitioner who said interferon and neupogen shouldn't be taken too close together, though she didn't think there was a specific amount of hours.

The consensus is do it now, which I will rather than fret away the day.
Its been over 12 hours since my shot.

My ANC is 500, wbc are 1.6
I do feel tired, have for the last few days which hasn't stopped me from walking a mile or so daily, going to S.F.on Wed. for my labs and taking the train home.

BTW: I am very encouraged at how well I'm feeling. I woke last night after shot 2 with a slightly sore hip and thought, that's it? No achy everything?
Keeping my fingers crossed that it all stays this smooth

[flcyclist]

As mentioned above, no special dietary requirements and time of day doesn't matter.  I've heard some people experience the bone pain or achy bones, but I've never felt that at all.   Following is some further reading.  

http://www.neupogen.com/pi.html

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

Some people only require one shot per week, while some require three to keep the ANC levels in a "comfortable" range.  That range might vary depending on the interpretation of your doctor.  In most people the ANC responds very quickly to the neupogen, but will taper back down during the following days.  Frequent CBC checks might be needed to determine the amount needed per week .  Although I've read on this forum to avoid the neupogen with 24 hrs of the interferon shot, I don't know if I've ever seen a reference to confirm that.  

[redsurfer]

hi .. i have done nup 4 times when i was on chemo ..always did it in the day but hindsight i would probably do it right before bed cause for me the bone pain was very bad for me.. i had to take vicodin each time .. but it only lasted a day.. and the nup worked very quickly ...if you need it get it and yeah ive heard wait 48 hours too... i do that with my interferon and procrit now ....good luck ..sorry your nurse is being stupid ... but i admire you for getting along with her... it does help relieve stress at dr visits...

[frijole]

Hey OH
I think the only important thing is that you should not do it within 24 hours either side of your interferon.  Aren't you doing your INF on Thursday?:  If so, I would wait 24 hours after the shot.  If you are really in need (what is the ANC) then do it anyway.  It is just that the neupogen and Interferon counteract each other . -- they duke it out for those white cells.  The INF is trying to destroy at the same time the Neup is trying to build.

My hemo last time said wait 48 hours, but I remember at the time, a lot of folks on thr forum said their docs said 24 hours was okay.

frijole

[SusieS2010]

I spent quite a bit of time on neupogen. At first I had some bone pain and after the first couple of shots, it never came back. There are no special things you have to do regarding food, etc. I didn't find a change in my fastigue levels. Good luck and I hope your counts come back quickly.

[sandysf]

I have taken it daytime, night time, hasn't mattered.  The only side effect I have heard is bone pain.. I had it first time only and since then nothing.  

[mikesimon]

I don't think it matters what you eat or when you take it.
I'd just stick it in and be done with it - if you have the drug, that is.

Good luck,
Mike