Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Neulasta (Pegfilgrastim).

Capillary leak syndrome (CLS): Capillary leak syndrome been experienced by people using Neulasta (Pegfilgrastim). This is a condition where blood leaks from the small blood vessels, into your body. CLS can cause severely decreased blood pressure and may be life threatening. If you experience symptoms of CLS, such as swelling or puffiness, difficulty breathing, abdominal swelling, tiredness, feeling of fullness, seek immediate medical attention.

Cytotoxic chemotherapy: The safety of using Neulasta (Pegfilgrastim) at the same time as cytotoxic chemotherapy (a type of chemotherapy that kills cells, especially cancer cells) has not been established. Neulasta (Pegfilgrastim) should not be used within 14 days before or 24 hours after chemotherapy. In addition, it is not known whether it is safe and effective to use Neulasta (Pegfilgrastim) after certain chemotherapy medications (e.g., Mitomycin C, 5-fluorouracil, and nitrosoureas such as carmustine and lomustine).

Ruptured spleen: In rare cases, Neulasta (Pegfilgrastim) has been reported to cause the spleen to rupture, which can be fatal. The spleen is an organ in the body that is involved in the production and removal of blood cells. If you have pain in the left upper stomach or left shoulder tip area, contact your doctor immediately.

Lung problems: Neulasta (Pegfilgrastim) may cause adult respiratory distress syndrome (ARDS), a serious lung condition, when people with neutropenia have sepsis (bacterial infection in the blood). If ARDS occurs, Neulasta (Pegfilgrastim) should be stopped until the ARDS resolves.

Radiation: It is not known whether it is safe and effective to use Neulasta (Pegfilgrastim) with radiation therapy. Neulasta (Pegfilgrastim) should not be used during radiation therapy.

Sickle cell disease: Neulasta (Pegfilgrastim) may cause sickle cell crisis when used by people who have sickle cell disease. You and your doctor should carefully consider the benefits and risks of using Neulasta (Pegfilgrastim) in these circumstances.

Pregnancy: Neulasta (Pegfilgrastim) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Neulasta (Pegfilgrastim), stop taking it immediately and call your doctor.

Breast-feeding: It is not known whether Neulasta (Pegfilgrastim) passes into breast milk. If you are a breast-feeding mother and are taking Neulasta (Pegfilgrastim), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of Neulasta (Pegfilgrastim) have not been established for children.