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Wow Neulasta?

kmenurse's picture
kmenurse
Posts: 223
Joined: Apr 2013

I received the Neulasta injection on Thurs. the 27th I started having pain on Friday and I am still unable to sleep, because of the pain. I have been taking 800mg Ibuprofen every 6 hrs and receive little relief. So I tried 400mg every 4 hrs and still not getting mush relief. Any suggestions? I can't take this much longer….

TraciInLA's picture
TraciInLA
Posts: 1836
Joined: Jul 2009

I'm so sorry the Neulasta is causing you so much pain.

Many women here have found that Claritin helps a great deal with Neulasta pain -- some doctors recommend it beforehand, others don't seem to know about it.  

I was fortunate that ibuprofen was enough for me, so I don't know the details about taking it (whether you have to start it before the pain starts, dosage, etc.).  But, if you're still suffering so much after several days, you should definitely call your doctor's emergency line right now and ask what they recommend.  There's no reason you have to suffer, your oncologist has lots of resources for you to take advantage of.

Traci

 

 

CypressCynthia's picture
CypressCynthia
Posts: 3926
Joined: Oct 2009

I did take the claritin for a couple of days.  I haven't had much pain-nothing thta ibuprofen didn't take care of handily.  I am so sorry that you are having this side effect.  My nurses did warn me about it.  The good news is that it means the drug is working and stimulating those cells in the bones.  I hope it gets better soon!!!

kmenurse's picture
kmenurse
Posts: 223
Joined: Apr 2013

Thanks CC I tried the Benedryl with ibuprofin the other day but I give it another chance tonight.. If nothing else maybe it will help me sleep longer then 20-30min at a time.... I'll let you know tomorrow how I did...  I have also been taking the ibuprofen 600mg every 4 hrs witch takes the edge off for a while... 

CypressCynthia's picture
CypressCynthia
Posts: 3926
Joined: Oct 2009

One nurse said to take claritin every day for about 5 days.  She said it may decrease the inflammatory response.  I took it 2 days and then forgot...Lol. 

"Do Antihistamines Relieve Drug-Induced Bone Pain?

The granulocyte colony-stimulating factor (G-CSF) medications filgrastim (Neupogen) and pegfilgrastim (Neulasta) are used to decrease infection risk associated with febrile neutropenia in patients receiving myelosuppressive chemotherapy.[1,2] However, bone pain is a common adverse effect of these drugs, occurring in 20% to 50% of patients; the incidence is similar for both filgrastim and pegfilgrastim.[3]

While G-CSF-associated bone pain is usually mild to moderate, severe pain may occur. Pain medications commonly prescribed for bone pain include acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and narcotics.

The exact mechanisms of bone pain have yet to be elucidated, but possible causes include change in bone marrow pressure and inflammation.[4] Histamine has been suggested as a chemical mediator causing pain associated with bone marrow edema.[5] Although the role of G-CSF in histamine release is unclear, this concept could be the basis for anecdotal use of antihistamines to treat G-CSF-induced bone pain. Furthermore, second-generation antihistamines (eg, cetirizine and fexofenadine) may have anti-inflammatory properties.[6] This finding may also contribute to anecdotal use of antihistamines for G-CSF-associated bone pain.

To date, no known clinical trials have evaluated the use of antihistamines for treatment of G-CSF-associated bone pain; even published case reports suggesting the usefulness of antihistamines are sparse. Gudi and colleagues[7] described a case in which astemizole (since withdrawn from the US market) was given to relieve G-CSF-associated bone pain refractory to acetaminophen. In addition, Ogata and colleagues[8] described the use of hydroxyzine in 4 patients with G-CSF-associated bone pain refractory to NSAIDs. They found that hydroxyzine was not only effective but also prevented bone pain with the next cycle of G-CSF.

Despite the lack of evidence, some clinicians prescribe antihistamines for relief of G-CSF-associated bone pain when conventional methods of pain relief provide unsatisfactory results. Clinical trials are needed to determine the mechanism, safety, and efficacy of antihistamines in reducing bone pain caused by G-CSF before this practice can be recommended."

http://www.medscape.com/viewarticle/566300

 

kmenurse's picture
kmenurse
Posts: 223
Joined: Apr 2013

I actually slept last night... I don't know if was because of the Benedryl or because I'm in the 5th day after the Neulasta and the drug is almost out of my body... But I slept.  I actually got 5 hrs stright.  I will take the Benedrly from now on... I took 50mg last night anyone know what the dose should be for benedryl. When I am able to do some shopping again, I will get a long acting antihystimine but for now all I have is benedryl...

camul's picture
camul
Posts: 2017
Joined: Dec 2010

and it helped a lot.  I didn't realize how much, until I didn't use it.  My nurse had me take it before the shot and for 3-5 days after, I usually did 3.  For some reason, Benedryl did not have the same effect.  I used the generic for Claritan.

If you have to have another Neulasta shot, I would ask the nurse about it. 

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