Neulasta (pegfilgrastim) is a prescription drug that’s used to prevent serious infection from chemotherapy for certain cancers and treat radiation sickness. The drug comes as a liquid solution for injection. It’s usually given based on the condition it’s being used to manage.
Neulasta is used to lower the risk of serious infection in adults and children.
It is used to help:
- prevent febrile neutropenia (fever in a person who has very low neutrophil counts) from types of chemotherapy treatment
- treat radiation sickness
The active ingredient in Neulasta is pegfilgrastim. (An active ingredient is what makes a drug work.) Neulasta is a type of biologic drug, which means it’s made from living cells. It belongs to a group of drugs called granulocyte-colony stimulating factors (G-CSFs), which help neutrophils to grow in your bone marrow.
This article describes the dosages of Neulasta, as well as its strength and how it’s given. To learn more about Neulasta, see this in-depth article.
This section describes the usual dosages of Neulasta. Keep reading to learn more.
What are Neulasta’s forms?
Neulasta is available in two different forms:
- as a liquid solution in single-dose prefilled syringes for manual injection under your skin by a healthcare professional, yourself, or your caregiver at home
- a liquid solution that comes as Neulasta Onpro Kit with a single-dose prefilled syringe and Neulasta as part of an on-body injector (OBI) system for injection under the skin
What strength does Neulasta come in?
Neulasta comes in one strength of 6 milligrams (mg) per 0.6 milliliters (mL).
What are the usual dosages of Neulasta?
Your dosage and how often you receive Neulasta depends on the condition it’s being used to manage.
In children, the dosage of Neulasta also depends on their body weight.
The information below describes dosages that are commonly used or recommended. Your doctor will determine the best dosage and frequency of your Neulasta injections based on your condition.
Dosage for preventing infections during chemotherapy
The typical Neulasta dosage for adults to lower the risk of serious infection from febrile neutropenia during treatment with certain types of chemotherapy is one 6-mg injection given under the skin per chemotherapy cycle. (A cycle consists of chemotherapy treatment followed by a period of rest to allow your body to recover from chemotherapy.)
You may be given Neulasta injection under your skin by a healthcare professional, or you may administer the dose yourself at home.
You may also receive Neulasta by the on-body injector (OBI) system as an injection under your skin. Your doctor or other healthcare professional will fill the on-body injector with Neulasta, and you’ll receive the medication about 27 hours after the OBI is attached to your skin. Neulasta is delivered over about 45 minutes.
Note: You will not receive Neulasta injection to prevent serious infection from chemotherapy within 14 days before or 24 hours after your chemotherapy treatment.
If you have questions about how often you’ll receive Neulasta, talk with your doctor.
Dosage for radiation sickness
Neulasta is approved in adults to treat a type of radiation sickness called hematopoietic subsyndrome from a high level of radiation exposure.
Neulasta’s dosage for this use is two 6-mg injections under your skin. You’ll receive one 6-mg injection under the skin as soon as possible after your radiation exposure and the second dose 1 week after the first dose.
Note: The Neulasta OBI system is not used in people with radiation sickness.
What’s the dosage of Neulasta for children?
Similar to with adults, Neulasta is approved to prevent infection in children during chemotherapy. It’s also approved to treat radiation sickness in children.
The dosage used in children who weigh more than 45 kilograms (kg), or about 99 pounds (lbs), is the same as the dosage for adults. For reference, 1 kg equals about 2.2 lbs.
To learn more about the dosage in children weighing more than 45 kg, see the “What are the usual dosages of Neulasta?” section above.
The dosage for children who weigh less than 45 kg is based on their body weight. They’ll receive their Neulasta dosage as an injection under the skin by a healthcare professional. See the table below for a breakdown of dosage by weight.
| Weight in kilograms | Approximate weight in pounds | Neulasta dosage |
|---|---|---|
| less than 10 kg | less than 22 lbs | 0.1 mg per kg |
| 10–20 kg | 22–45 lbs | 1.5 mg |
| 21–30 kg | 46–67 lbs | 2.5 mg |
| 31–44 kg | 68–98 lbs | 4 mg |
For more information about Neulasta’s dosage for children, talk with your child’s doctor or a pharmacist.
Note: The Neulasta OBI system is not used in children.
Is Neulasta used long term?
Yes, this is possible. You’ll likely receive Neulasta as long as you’re on certain types of chemotherapy treatment that increase your risk of serious infection from febrile neutropenia. For this use, if you and your doctor determine that it’s safe and effective for your condition, you’ll likely be given Neulasta long term.
For radiation sickness, Nuelasta is only given as two doses: one dose immediately after exposure and another 1 week after the first dose.
If you have questions about how long you’ll be on Neulasta treatment, talk with your doctor.
The dosage of Neulasta you’re prescribed may depend on several factors. These include:
- the type and severity of the condition you’re using the drug to treat
- body weight (in children)
Neulasta is available in two dosage forms: as a liquid solution in single-dose prefilled syringes for manual injection and as Neulasta Onpro kit.
For Neulasta single-dose manual injections
Neulasta is given as an injection under your skin. You’ll receive your dose from a healthcare professional at a clinic or doctor’s office, or — if you’re taking it long term — they’ll show you or your caregiver how to give your doses at home. Keep in mind that Neulasta is only given as two single doses under the skin for radiation sickness. You will not receive Neulasta injections 14 days before or 24 hours after your chemotherapy treatment.
For Neulasta Onpro kit
Your doctor or another healthcare professional will fill the on-body injector (OBI) with Neulasta and attach the system to the skin of your abdomen, back, or arm. The Neulasta Onpro OBI is only attached to the back of the arm if a caregiver can monitor the OBI medication dosage delivery. You’ll receive your dosage of Neulasta about 27 hours after the Onpro OBI is attached to your skin.
Neulasta will be injected slowly under your skin from the OBI over about 45 minutes. You will not receive Neulasta injections 14 days before or 24 hours after your chemotherapy treatment.
Note: Neulasta Onpro OBI is not used for radiation sickness or in children.
For information on the expiration, storage, and disposal of Neulasta, talk with your doctor or pharmacist.
Accessible drug containers and labels
Some pharmacies provide medication labels that:
- have large print
- use braille
- feature a code you can scan with a smartphone to change the text to audio
Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.
If you miss a dose of Neulasta, call your doctor’s office. They can advise you on whether you need to reschedule an appointment to receive a missed dose of Neulasta.
In some cases, it’s possible to miss a dose from the Neulasta Onpro OBI system. Sometimes, the on-body injector can fail or leak. If you or a caregiver notices that the Neulasta Onpro system didn’t deliver the medication or leaked, call your doctor’s office right away. They can schedule a time for you to receive your full dose of Neulasta injection.
If you need help remembering to give your dose of Neulasta on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.
If you receive Neulasta at a doctor’s office or clinic and need help remembering your appointments to receive Neulasta by a healthcare professional, try downloading a reminder app on your phone.
Do not use more Neulasta than your doctor prescribes, as this can lead to harmful effects.
Symptoms of overdose
Symptoms caused by an overdose can include:
- trouble breathing
- bone pain
- water buildup around your lungs
- edema (swelling)
What to do in case you use too much Neulasta
Call your doctor right away if you think you’ve given yourself too much Neulasta. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.
Below are answers to some commonly asked questions about Neulasta’s dosage.
Is Neulasta’s dosage similar to the dosages of filgrastim (Neupogen)?
No, it is not. Both Neulasta (pegfilgrastim) and Neupogen (filgrastim) are approved to prevent the risk of serious infection from febrile neutropenia and treat radiation sickness. But they have different strengths and dosages. Neupogen is also approved for other uses, and it comes in several dosages and dosage forms. Your dosage for Neupogen depends on the condition the drug is being used to treat and other individual factors.
Neupogen comes as a liquid solution in single-dose vials and as prefilled syringes.
The medication can be given as an injection under the skin by a healthcare professional, or you or a caregiver can give doses yourself at home. It can also be given intravenously into a vein by a healthcare professional.
See the “What is Neulasta’s dosage?” section above for more information on Neulasta’s dosages.
Your doctor will prescribe the drug and the dosage that’s right for you. To learn more about how these drugs compare, talk with your doctor.
How long does it take for Neulasta to start working?
Neulasta starts to work soon after you receive your first dose. Studies show it takes around 1–2 weeks for your neutrophil levels to normalize after Neulasta treatment. (Neutrophils are a type of white blood cell that works to fight off infections.)
For radiation sickness, it may take several days for Neulasta to help your body build back the white blood cells that were destroyed by radiation.
Because of how the drug works, you likely won’t feel the drug working in your body. But your doctor will monitor you during treatment to check whether the drug is working to improve your white blood cell count.
If you have other questions about what to expect from your Neulasta treatment, talk with your doctor.
The sections above describe the usual dosages provided by the manufacturer. If your doctor recommends Neulasta for you, they’ll prescribe the dosage that’s right for you.
Remember, you should not change your dosage of Neulasta without your doctor’s recommendation. Only give Neulasta exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.
Here are some examples of questions you may want to ask your doctor:
- Would I need a different dosage of Neulasta if my chemotherapy treatment regimen changes?
- Will I need a dosage adjustment if I’m taking other medications with Neulasta?
- Can I stop my Neulasta dosage injections if my cancer is in remission?
To learn more about Neulasta, see these articles:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.