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Neulasta Onpro ??

RainbowRita's picture
RainbowRita
Posts: 51
Joined: May 2021

I’ve had my 5th cycle of carbo/Taxol delayed 3 times now due to low blood counts. The first time it was cancelled I had low platelets and low WBCs, but specifically too low of neutrophils along with my platelets being too low for chemo. I was told to come back a week later. 2nd trip showed my neutrophils had increased some and were right on the border to proceed, but my platelets had dropped some more. Chemo cancelled again and to told to come back a week later.  So last week I went back thinking, “Third time’s the charm, right?” Wrong. Platelets had rebounded from 79 up to 157, but my neutrophils dropped back down too low for chemo. So I am will be back again on Thursday for yet another attempt and this time I’m supposed to get Neulasta On Pro after chemo and my carbo dose will be reduced as well.

I did some reading online (I know, beware of Dr. Google) and boy this Neulasta stuff sounds scary!  I realize most side effects are remote, but almost a 1/3 of people getting it report bone pain. And some pretty significant pain for a lot of people. Not looking forward to that, but I only have two cycles left of chemo, so I tell myself, “This too shall pass.” What concerns me more (though scares me less) is the potential for thrombocytopenia (low platelets), especially since my platelets have been really slow to recover from the last round of chemo 6 weeks ago. Have any of you ever taken Neulasta, and if so did you ever experience really low platelets because of it?

Fridays Child
Posts: 216
Joined: Jul 2019

When my recurrence/metastasis was diagnosed, I had low dose Taxol/Carbo every week while I was having radiation.  After that they started full dose chemo every three weeks, and at that point they did the Neulasta OnPro. The nurse told us that it's recommended to take Claritin, starting a couple of days before the infusion, to help avoid bone pain.  The Neulasta stimulates the bone marrow and a byproduct of this is histamines, so an antihistamine can help with the side effects.  Taxol/Carbo can also cause bone pain so it can be a double attack.  I did have pretty bad bone pain the first time, so I got permission to switch to benadryl and that worked better for me.  A friend of mine is currently going through chemo and has had the Neulasta with no side effects.  For me, the bone pain started about 24 hours after the Neulasta injected itself and was gone in 24-36 hours.

Oh, and the OnPro blinks this little green light the whole time it's on, and then beeps at you when it's getting ready to inject.  Really strange!

Good luck! 

cmb's picture
cmb
Posts: 730
Joined: Jan 2018

I had bone pain with Carboplatin/Taxol. My doctor okayed me to take prescription level amounts of Aleve, which has always been a reliable pain reliever for me. I did not take Neulasta during this phase.

In chemo phase two, I gave myself the Neulasta shot after each cycle. This chemo combination (Ifosfamide/Doxorubicin) made me pretty miserable, but I did not have any side effects like bone pain that I could attribute to the Neulasta. I did, however, know about Claritin by then and took it before I had the shot.

yetti's picture
yetti
Posts: 65
Joined: May 2019

I had nuelasta after each chemo ! Had some bone pain and acheness, but wasn't sure what to blame it on !  I did try Claritin, it was helping !  I had the nuelasta plastic disc type. It was a timed injection, it felt like a rubber band snap, not painful ! I heard of patients having to return the next day for regular injection !  Glad I didn't have to do that !  Lol Yetti 

RainbowRita's picture
RainbowRita
Posts: 51
Joined: May 2021

Thanks ladies for your info on Neulasta. :-) Since none of you mentioned low platelets being an issue, I am going to assume that potential side effect is not at all common. Good to know as when I read that, I was concerned that it would drop my platelets and then I'd have another delay for that reason.

 I read about the Claritin helping bone pain associated with Neulasta. I take that now starting the day before chemo for the side effects of the carbo/taxol. I've always taken it upon the advice of my gyn onc. I still have bone pain even with the Claritin, but it is only bad on days 3 and 4 post chemo. So I don't know how much it helps since I've always taken it, but I sure don't want to experiment and not take it just to find out. ;-)

Fridays Child
Posts: 216
Joined: Jul 2019

Rita, I went back and checked my labs and the only time my platelets were even slightly low was the day of my last (11th) chemo, when it was 149, where 150 was the low normal value.

MAbound
Posts: 1153
Joined: Jun 2016

I never needed to take Neulasta, but Claritin did nothing for the bone pain I had from Taxol. My gyn onc switched me to Taxotere, which is in the same family as Taxol and just as effective, and I tolerated that in combination with Carboplatin without any bone pain. It's another option for you to consider if you think the bone pain was happening before you started on Neulasta.

ConnieSW
Posts: 1576
Joined: Jun 2012

Mine dropped at the same round yours did.  Luckily they rebounded in a week and I continued chemo with a lowered dose. I only had the bone pain with neulasta after the initial dose.  I didn't know about Claritin.  

RainbowRita's picture
RainbowRita
Posts: 51
Joined: May 2021

Well, MAbound, since I only have two more cyles left of the carbo/taxol including the one tomorrow, I'd doubt if they'll want to switch up my chemo drugs at this point. I do have some bone pain for a few days, but it hasn't been just too horrible. So will continue on with things as they are.  But good to know. Thanks for the suggestion. :-)

ConnieSW, thanks for sharing your experience. I'll let you all know how things go tommorow and if I do get the Neulasta, I will share any issues I have with it. Always good to hear from others as to what they went through, which is why I've found this board so invaluable. 

Ribbons's picture
Ribbons
Posts: 79
Joined: Jan 2019

I had the on pro thing for 5 of my 6 chemo treatments, I also took Claritin. I don't remember a lot of problems from the Neulasta. It is very expensive though. I was able to apply to Healthwell and got it paid for.

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