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Neulasta

jkreyn
Posts: 6
Joined: Jun 2017

Hi everyone,

mom just received her two day chemo treatment of (Rituxin and Bendamustine) for mantle cell lymphoma.  She is supposed to have Nuelasta injection or go home with an on body injector for Neulasta.  Has anyone used this on body injector before?  The side effects don't sound great for Neulasta- bone pain?

Thoughts?

Jen

Sal0101's picture
Sal0101
Posts: 125
Joined: Sep 2015

Hi Jen, 

I've had both neupogen and neulasta.  The very first time I had bone pain for several days.  After that I was advised  to take Claritin beforehand and for several days.  I'm not sure if it really works or why, but I had very minor if any bone pain after that and I had quite a few injections. 

I gave myself the neupogen injections, and when they switched me to Neulasta I went into the office for the injection, so I can't help with the auto injector. 

Sharon

Evarista
Posts: 268
Joined: May 2017

Hi JKreyn...I've just finished 6 rounds of chemo with Neulasta injection after each.  We discussed the "on-body" as an option for my last cycle (3-day weekend in the way), but I ended up having the regular.  From what I can tell, there is really no difference, but the "on-body" does offer the convenience of not having to go back to clinic for the injection.  Here's a link that might help:  http://www.neulastahcp.com/neulasta-onpro/

As for bone pain, I was encouraged by my Dr. to take Claritin to prevent it.  I ignored that advice the first round, much to my regret. I took it consistently with the other rounds & had no or very little bone pain.  They suggested starting one to two days before Neulasta.  Note that while it can be the generic form, it does need to be loratadine (as opposed to another antihistiamine). People may come on and note that there is no clinical data to support that this works, and AFAIK, that is still true.  But my experience was the same as a whole lot of other anecdotal ones: it worked.  Good luck.

PBL
Posts: 185
Joined: Jul 2016

Hello JKreyn,

I had 6 R-CHOP21 each followed within 48 hours with a shot of Neulasta, which was done by a nurse at home - so I cannot be of much help as regards the auto-injector.

As regards side-effects, I did feel some slight bone pain (in the top of my femurs and humerus) in the first couple of days after the first shot. Never even felt any symptom for the subsequent five shots. Never needed any pain medication for that.

Let me mention here that I have primary bone lymphoma, diagnosed further to a spontaneous pelvic fracture, and that it is possible in my case that whatever pain due to the Neulasta was so "minor" it went unnoticed.

I have however read elsewhere that Clarityn - as mentioned above - seemed to help those patients experiencing pain after Neulasta, so why not ask for a prescription for that in advance if you are worried about possible pain?

Best of luck!

PBL

Evarista
Posts: 268
Joined: May 2017

Over-the-counter (OTC), so no RX needed. You want the 10 mg tablets; ~$5.00 for a box of 60 of the generic tablets.

PBL
Posts: 185
Joined: Jul 2016

Sorry about that... Clarityn is not available over the counter where I live, but seems to be in the US.

However, it is always advisable to at least discuss any prescription or non-prescription drugs or supplements of any kind with your hematologist as even the most innocuous-looking may interfere with treatment.

Evarista
Posts: 268
Joined: May 2017

Could not agree more!  Do be sure to clear with with your medical team.  Sorry for assuming that everyone was in the U.S....

jkreyn
Posts: 6
Joined: Jun 2017

Okay- sounds like Claritin will help!  Thanks for the information and the advice!  Mom had a very rough first treatment - she had an allergic reaction to Rituxamin and it was fairly scary.  They settled her and gave her some steriods and was able to continue.  She finished her Ritux. today along with her second Bendamustine treatment.  She needs a blood transfusion tomorrow in order to deal with her low platelets and we hope that this will make her feel better soon.

Thanks again for all of your support and information!  Please keep my mother in your thoughts and prayers.  Thank you! Jen

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3323
Joined: May 2012

Like almost everyone, I got my injection at the oncologists office, but because I finished my infusions on Fridays, I always went in Monday mornings for the shot.

I was almost hospitalized with pain the day after my first Neulasta, but I have a broken back and collapsed disks, which is where the pain was located. My femur was broken in half at the same time I broke my back, but the Neulasta did not cause any pain there at all, possibly because there is a rod inside it. Thereafter I was given a half-dose, which always kept my WBCs normal over the next 6 months.   No one ever mentioned an auto-injector or the Clariton, so I can't comment on those particulars.

Many people who have reactions to their first Rituxan infusion do fine thereafter, but the infusion nurse will no doubt apply it at a very slow drip rate next time, which also helps.  My point here is that she will very likely be able to continue Rituxan without significant (Rituxan-related) problems.

max

jkreyn
Posts: 6
Joined: Jun 2017

thank you, Max.  You are always so informative and helpful.  Mom had a back surgery about 10 years ago that had some complications, including damaging a nerve bundle that affects her ability to urinate on her own (she can't feel the urge to pee).  So, she has self cathed for years and is prone to UTIs.  Her urine looked a little dark this morning, so when we were getting the blood transfusion today we asked the lab to get a urine/ UTI test.  They cathed her there and her urine was quite dark.  Turns out that she has blood in her urine and protein.  No UTI.  I called the dr. on call and she said that there isn't any reason from a chemo/ med stand point and she could have some kidney issues going on.  She's not on any blood thinners (the doc asked about that), so we just need to call the office on Monday and see if we need to go visit a nephrologist.  If it's not one thing, it's another.  yikes.    

Anyone else have blood/ protein in the urine?

thanks,

Jen

 

Sandy Ray's picture
Sandy Ray
Posts: 97
Joined: May 2017

I have had the On pro one the last 3 treatments. The first 2 treatments we had to play catch up with my WBC so I had Neupogen shots 3 each time( 2 the first day and then 1 the next it was 2 weeks after the treatments so again it was after my counts had dropped.) I will say that with the Neupogen I was already off my 5 days of 100mg Prednisone and I ached like I had the flu and slept a lot the first 24 hours after each shot. With the Neulasta my shot was dispensed 27 hours after treatment. Not sure if it was the Prednisone I was on for 5 days but I did not have much discomfort until day 7 when Prednisone had left system. Then that was a day I ached like the flu and slept more that day. It has been that way after every treatment. I run a low grade fever that day and ache and then pretty much it is over. Maybe a little muscle aches every now and then. So far I have not had all the horror pains I read in the forums. I just think everyone is different and really just how to see how it goes. Prayers and well wishes that she has no ill effects. The Onpro sticks on pretty good so is uncomfortable to remove but really is not bad.

Sandy Ray

lindary's picture
lindary
Posts: 663
Joined: Mar 2015

I had no problems with neulasta. If there was any discomfort I wasn't aware of it. When I got neuprogen the first time I found out what bone pain was like. That is when one of the nurses told me about the claritin. Used that before the nueprogen shots and I felt fine. 

 

PeprmntPat55's picture
PeprmntPat55
Posts: 60
Joined: Aug 2016

Jen, i had the Neulasta injector the last 4 of my treatments. I also had Rituximab and Bendamustine for Follicular lymphoma. I am currently in remission but am on 2 years maintenance with Rituxan infusiions every 12 weeks.   The only side effects I had with the injector were mild bone pain the first time. After that it didn't seem to bother me as much.  I did have problems with the area on my arm where the injector was placed but after a couple of days it was back to normal.  BTW, I also had a bad reaction to the Rituxan on my first visit.  They ended up stopping my treatment short but after that I never had another issue.  It was very scary, though.  Your Mom is so lucky to have you advocate for her.   I am sure she really appreciates it.  Good luck!

catwink22's picture
catwink22
Posts: 280
Joined: Sep 2009

Hi Jen,

I had the Neulasta box 3 times with no issues. They stick the box to the back of your upper arm. There is a short wait period (I think 3 minutes) and it injects a catheter, it wasn't painful for me at all, felt like a mosquito bite, but some say it feels like the snap of a rubber band. After 24 hours it will start beeping and injects the Neulasta over 45 minutes. There is a window that shows the box is empty so you know the medication has been administered. Remove the box like a band-aid. I used Claritin too for body aches, but also found iced tea made my body aches go away.

Wish you & your mom the best!

Cat

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