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173975 tn?1216257775

Neupogen injections

Hi all.

I have to start injecting neupogen, 480, 2x per month.

My Dr. says it's ok to do the injection Fridays, same day as pegasys but the pharmacist says I should wait until Sunday.

Does it make any difference?
16 Responses
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173975 tn?1216257775
How womderful that you're through treatment and, clearly, SVR!

And how nice of you to stop by.

I chickened out, btw.  Didn't do the neupogen last night and will do it later this evening, instead.

How are you doing, post TX?  And how long has it been?
Helpful - 0
Avatar universal
Thanks, don't mind if I do (chime in any time).  I have been enjoying some of your posts, but just don't get on here as frequently as when I was treating. I never heard of the needle (stick?) test.  Sounds cool.  My arms were pretty beat up after my weekly CBCs and other assorted blood tests.  I am glad you are seeing a hemotologist.  I think that was the best thing my GI did for me was put me in contact with one right away.  My whites dropped about as fast as yours, and they wanted to do Neupogen but I begged off, giving them studies, and went without until about week 11 when ANC got to .4.  I never noticed any side effects but after I was done with the treatment, I took about 4 more Neup shots to bring the counts up, and then - when it was all by itself -- I could feel the bone pain that others spoke about.  I think I started every two weeks too, but that didn't last too long.
frijole
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173975 tn?1216257775
test
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173975 tn?1216257775
"was told when I started Neupoggen that I couldn't take the shot within 24 hours of taking the peg as the working ingredients in the neupogen might kill off the working ingredients in the peg.

Brian Fog has been visiting for some time now, sure wish I could just kick him out


Ohhhhhh.  Painter lady!  You're the one who introduced BRIAN to the forum!  Ya know, when i first met him I thought he was amusing and basically harmless.  Now I'm wondering what I have ta do to get rid of him, too.  He sure knows how to wear out his welcome, doesn't he?

Seriously, thanks for the neup info.

friole
"It is my understanding that the Neupogen and Pegasys counteract each other. My hemotologist told me to do them 48 hours apart. Others doctors here have said to wait at least 24 hours between."

Thanks.  My Doctor said it doesn't matter but the pharmacist says the same thing you said.
I've had 2 shots of neupogen so far, both at the hematologist's office.  The second shot was the same day I did the pegasys and I had no problem.  As a matter o fact, I (think) I remember feeling really good that weekend.

But My doc gave me a script for self injectable meds to save me a trip to the hemo.  He had already informed me that, based on his interpretation of my weekly labs, I was gonna need the neup every two weeks coz of dropping wbc and anc counts.  I guess at this point he thinks I only need a boost twice a month instead of twice a week.  I'm at week 9 (today)

I'm just trying to make things easier and make sure I don't forget to take any of the meds at the right time.  It's more convenient for me to do them all together.  I think I may try the neup tonight and if I feel really lousy, well, I know the next time to do the injections separately.

Sounds so simple, right?  (duhhhhhh).  I just get so paranoid sometimes.  I guess it's probably a good thing my doc is so laid back.  I keep telling myself, he's seen hundreds if not thousands of people like me.

Thanks friole, for your advice and please chime in with any more words of wisdom.

BTW - since i get weekly bloodwork the doctor has been able to monitor my reaction to the neup.  WBC and ANC have both risen above alert status after injections.  And when I did go to the hemo, he was able to do a finger ***** test that gave immediate readings on my blood.  

My wbc dropped from 2.7 to 1.7 between 1/22 and 1/29 and my ANC dropped from 1.6 to 0.8.

I don't have the copy of my last labs, from 2/9, but the doc had them when I saw him 2/14.  I guess if he'd thought I should start taking the neup more frequently he would have told me then.  I will (eventually) get copies from Labcorp and of course I'll compare the readings.

Thanks Friole

"goofydad had to take it twice a week. His hemotologist told him to take in 24 hours before the interferon -- to boost the bone marrow -- and 48 hours after the interferon -- to help build up what the interferon just destroyed."

Good info.

"Vicious cycyle, isn't it."

That's one way of putting it!  
Helpful - 0
173975 tn?1216257775
test
Helpful - 0
Avatar universal
It is my understanding that the Neupogen and Pegasys counteract each other.  My hemotologist told me to do them 48 hours apart.  Others doctors here have said to wait at least 24 hours between.  I think it is good advice not to do them at the same time.  I think if you do the shots on the same day, you should try to get a CBC maybe the next day to see if the Neupogen helped.  Neupogen is fast acting -- not like the Procrit that takes a couple of weeks to work -- and doesn't last real long.  So I am also surprised that you are only going to do it every 2 weeks.

What is your ANC?

goofydad had to take it twice a week.  His hemotologist told him to take in 24 hours before the interferon -- to boost the bone marrow -- and 48 hours after the interferon -- to help build up what the interferon just destroyed. Vicious cycyle, isn't it.

frijole
Helpful - 0
137539 tn?1344379928
I was told when I started Neupoggen that I couldn't take the shot within 24 hours of taking the peg as the working ingredients in the neupogen might kill off the working ingredients in the peg. Or at least that is the jist of it.
Sorry I can't explain it like he did but Brian Fog has been visiting for some time now, sure wish I could just kick him out lol
HAGD  Nicki
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179355 tn?1207407251
I do the Peg myself. Left side stomach one week, right the next week. Haven't got up the courage to do my thighs. Was getting the rash at the injection site the first 10 or 12 weeks but it wasn't bad enough to tempt looking for another place to punture myself.  
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179355 tn?1207407251
The reason I didn't do it myself is I don't like needles...Actually, the schedule I have set up is bloodwork every Thursday, and since I was there and needed the Neupogen, they'd stick me. Besides,that was their justification for charging $500. He never mentioned doing them on the same day though. Although he didn't want to do a flu shot on Thursday because of the Peg shot on Friday. My hats off to those that have to do their own Neupogen AND Peg AND allergy!  It's confusing enough with just the Peg. Maybe your Pharmacist reasoning is the Peg starts to wear you down, and by Sunday the Neup brings you back up? Hang in there. Better days are coming.
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Avatar universal
I took neuprogen weekly and was told to take it 24 hours before or after the INF. I personally took it the day before and my neutrophils were always pretty good
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173975 tn?1216257775
Thanks for the input.

Teufel
"Maybe your Pharmacist reasoning is the Peg starts to wear you down, and by Sunday the Neup brings you back up? "

Actually, it was just the opposite.  He said that the neupogen can cause 'malaise' (only people who have never really felt that way use that term -haha)

I guess his reasoning is either that he wants me to be malaised longer (as peg does the same thing) or . . .who the h*** knows?

Needles never bothered me much.. Even if they did, the thought of going to the DR 3X a week for 3 different injections is so unappealing.  I'd rather do it myself.

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173975 tn?1216257775
one other thing . . .

How come you weren't injecting yourself?

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173975 tn?1216257775
So the doctor didn't want you to take the peg and the neupogen on the same day?

Do you know why?
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173975 tn?1216257775
"I have no clue, just can't stand to see a post with no comments!"

You're so nice.  :)

I'm just asking coz I got conflicting advice (as usual).

It would be easier to do both injections the same day, in terms of keeping track, and I'd rather get sx all at once.

Then there's the matter of fitting in the allergy shots, though the Dr. told me the same thing posters on the forum said, that over reaction at injection sites could be coz the pegasys is affecting/enhancing/increasing the immune system and that's what allergy shots are, immunotherapy.

Sigh :-(

I'm very confused and trying-not-to-get-depressed.  It's so overwhelming.
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179355 tn?1207407251
When I was doing Neupogen, it was weekly. Every Thursday. On Friday I do my Peg. The Dr. would read my WBC and anything below 5 he'd stick me(weekly 2.7, 2.6, 3.9). The nurses felt sorry for me (or taking bets, haven't figured which one), knowing I'd be below 5.  Then he started reading my ANC and  said anything below 1.0. I've been above that threshold since the end of Nov so no Neupogen. My WBC is still low (2.5 today, ANC 1.3) but I guess since he's the doctor...Funny thing about the Neupogen though, I started dreading it more than the Peg. Thursday night, all day Friday I was wiped out. At least I don't see the money coming out when I go into the office anymore.
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146021 tn?1237204887
I have no clue, just can't stand to see a post with no comments! Did the neupogen come with a pharmaceutical sheet that can tell you more. Do you have a Be-in-charge program that can tell you anything? I don't know if the B-I-C program is just for the peg-intron. Aren't you on the other one?
Bug
Helpful - 0
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