change in protocol

[cutey]

My wife is in the midst of a cycle of six chemo treatments.  She gets Taxotare and Carboplatin once every three weeks.  Because we went on vacation she made arrangements to receive her fourth treatment at a different practice/location than the first three.  The new practice was surprised to learn that her first practice gives her a shot of Neulasta at the same time as she's given her chemo.  The new practice said that's not advised and had her come back 24 hours after chemo to receive her Neulasta shot.  Dr Goodman - do you have an opinion on this topic?  We want to make sure she is getting the very safest and best care, obviously.

[Jan214]

I begged my chemo nurse to just let me have it after chemo because usually by the next day I don't want to go anywhere.  I did wonder why I had to wait exactly 24 hrs after my chemo drip finished to come in.  They don't give me an appt for my shot until my chemo is finished and at first they would tell me to come back the next day at 12:23 or whatever it was to the MINUTE that I finished chemo.  They were THAT exact, now they give me a little more leeway but NEVER earlier than 24 hrs.  They'll say between 12-1 or something.  I have had to wait until the monday after my thursday chemo because I was to sick on Friday, but they said that was better than to early.  I hope this helps.  It seems most everyone on here is getting it at 24 hrs and those of you who aren't should ask your drs to explain why they think it is alright to give it before 24 hrs considering the manufactuer doesn't advise that.  I would love to hear their answers.  
I guess by now you know you didn't get the Drs forum, but I hope your wife is doing well.  If she can travel in between chemos I guess she is doing pretty well.  Good luck to both of you.

[marie3B]

I just looked up info on this. Everything said it is not to be given until 24 hrs after chemo. I am sure going to ask why my clinic gives it the second they take the chemo needle out. Luckily I didn't have a blood count problem, but many other patients out there do. Marie

[vegas2cr]

I took neupogen which is the same as neulesta different drug company.   I was given 3 injectons to take home with me.  The first one was to NOT be given less than 24 hours after my chemo ended... I was also told if given early it could cause complications...then I gave myself the next 2 again 24 hours after each one.

[PF_PVD]

I also had to have a Neulasta injection on Thanksgiving day, but my onc wasn't quite as nice.  Instead, they showed my how to give it to myself.  I can tell you I was nervous--not about the pain, but about the possibility of wasting a $3,000 injjection!

[JC145]

Neulasta is given to increase the white cells that get depleted during chemotherapy and therefore, ward off infection.  It should be given 24 hrs. after the last day of chemo per round.  My GYN/ONC actually came to the office on Thanksgiving Day to give me the shot personally so his staff didn't have to come in.  Great guy!  

This is the actual protocol for this drug.  It worked amazingly well for me.

Judy

[SimplyStar]

Leslee went in the next day, Mayo told her that 24 hours were necessary for correct absorbtion.

[marie3B]

I was given my shot right when my chemo was done dripping. I will look into this further before I have any more chemo. This is something I have not heard discussed before now. Thank you for bringing up this topic. Marie

[PF_PVD]

I got the following from the Amgen website:

"Neulasta® helps provide protection against these complications with just 1 injection per cycle of chemotherapy. It is given 24 hours after chemotherapy is administered.
  
Be sure to ask your doctor about white cell boosters and if Neulasta® is right for you—given one day after the start of your chemo."

[Conquerer]

i recieved my shot on the same day.  i am a year out of chemo stage 3  and still in remission  i don't think it is that critical  but keep looking

[PF_PVD]

I''m not Dr. Goodman, but I can tell you that Neulasta is not supposed to be given before 24 hours after your chemo treatment.  I just had this discussion with my hospital pharmacist on Saturday after my in-patient chemo Friday. She said that although it is made to stimulate WBC's, it can also stimulate active cancer cells through the same mechanism. She said that 24 hours after the EP is administered, pretty much all the cancer cells that are in the stage of development that would be most likely to be "supercharged" by the Neulasta have been killed by the chemo. You can further research this, but I've always received mine 24 hours after treatment.  You can write Dr. Goodman on the other forum. Good luck. Paula