Description
SC Administration
– Administer subcutaneously
– Do not use 6 mg fixed dose in infants, children, or adolescents <45 kg
Pegfilgrastim is available in prefilled syringes for manual subcutaneous administration or as a kit for use with the On-body injector
– Direct administration of doses <6 mg using the prefilled syringe is not recommended by the manufacturer (it does not have graduation marks necessary for accurate measurement of doses other than 6 mg)
– Use caution to avoid dosing errors
Storage
– Store under refrigeration at 2°C to 8°C (36°F to 46°F)
– Do not freeze.
– If syringe for manual injection is inadvertently frozen, allow to thaw in refrigerator; discard if frozen more than one time
– Protect from light.
– Do not shake.
Pre-filled Syringe
– Allow prefilled syringe to reach room temperature for at least 30 minutes prior to injection
– Discard if kept at room temperature for longer than 48 hours
Monitoring
Chemotherapy-Induced Neutropenia
– Complete blood count (with differential) and platelet count should be obtained prior to chemotherapy and as clinically necessary.
Hematopoietic Radiation Injury Syndrome
– CBC at baseline (do not delay administration if CBC not readily available)
– Estimate absorbed radiation dose
– Evaluate fever, pulmonary infiltrates, and respiratory distress
– Evaluate for left upper abdominal pain, shoulder tip pain, or splenomegaly
– Monitor for signs/symptoms of glomerulonephritis (azotemia, hematuria, proteinuria) and capillary leak syndrome (hypotension, hypoalbuminemia, edema and hemoconcentration)
– Monitor for sickle cell crisis (in patients with sickle cell anemia)
