Patients undergoing chemotherapy usually experience bone marrow suppression. Our bone marrow is actively dividing, just like cancer cells, thus are prone to be affected by chemotherapy. As a results, low white blood cells (neutropenia), low red blood cells (anemia) and low platelets (thrombocytopenia) are common in patients on chemo. When your white blood cells are too low, you may get severe infection. Your doctor may prescribe you Neulasta (Pegfilgrastim) or Neupogen (Filgrastrim) injection in between of your chemo sessions.
Neulasta/ Neupogen induces your bone marrow to work harder to produce white blood cells. Commonly, patients would complain of muscle and bone aches after Neulasta/ Neupogen injection. One patient complained in her blog "My stomach felt like I did a hundred sit ups, without the flat abs to show for it" :-).
Bone pain has been reported in approximately 22% of patients.
One of rare complications of Neulasta/ Neupogen is it may cause your spleen to enlarged and can rupture. A ruptured spleen can cause death. The spleen is located in the upper left section of your stomach area. Call your doctor right away if you have pain in the left upper stomach area or left shoulder tip area. This pain could mean your spleen is enlarged or ruptured. There are other serious risks that you could review from the website below.
For the common aches, taking acetominophen (Tylenol) before and after the injection usually help. Sometimes, your doctor may have to give a stronger pain medication such as hydrocodone or oxycodone. Reducing the dose of neulasta also may reduce the pain while still giving you the benefit of white blood cell production. Some patients reported that claritin also help reducing the bone pain. But I could not find a study confirming it.
Reference:
- http://www.neulasta.com/starting-chemo-with-neulasta/white-blood-cell-counts.html?src=ppc&WT.srch=1&SRC=2
Neulasta/ Neupogen induces your bone marrow to work harder to produce white blood cells. Commonly, patients would complain of muscle and bone aches after Neulasta/ Neupogen injection. One patient complained in her blog "My stomach felt like I did a hundred sit ups, without the flat abs to show for it" :-).
Bone pain has been reported in approximately 22% of patients.
One of rare complications of Neulasta/ Neupogen is it may cause your spleen to enlarged and can rupture. A ruptured spleen can cause death. The spleen is located in the upper left section of your stomach area. Call your doctor right away if you have pain in the left upper stomach area or left shoulder tip area. This pain could mean your spleen is enlarged or ruptured. There are other serious risks that you could review from the website below.
For the common aches, taking acetominophen (Tylenol) before and after the injection usually help. Sometimes, your doctor may have to give a stronger pain medication such as hydrocodone or oxycodone. Reducing the dose of neulasta also may reduce the pain while still giving you the benefit of white blood cell production. Some patients reported that claritin also help reducing the bone pain. But I could not find a study confirming it.
Reference:
- http://www.neulasta.com/starting-chemo-with-neulasta/white-blood-cell-counts.html?src=ppc&WT.srch=1&SRC=2
- Kubista E,et
al; Pegfilgrastim
Study Group.Bone pain associated with once-per-cycle pegfilgrastim is similar to
daily filgrastim in patients with breast cancer. Clin Breast Cancer. 2003 Feb;3(6):391-8
I tried both Claritin and Zyrtec (different treatments) with Tylanol (per nurses' recommendation) as well as trying only Tylenol. In my case, Tylenol alone worked best as the allergy meds actually made the pain increase along with making the Tylenol take longer to take effect (with 8 hour Tylenol, it would be a minimum of 90 min. before the pain started reducing -- and only worked for 5 hours).
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