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Dr. Rajesh Patel, MD.
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Ask the Doctor!
November 2008
Q:
My friend is on chemotherapy and she receives neulasta and neupogen injections. What's the difference between the two injections?
A:
Neupogen (filgrastim) and Neulasta (pegfilgrastim) both increase the body's neutrophils (disease-fighting white blood cells), thereby lowering the risk of infection. As you mentioned, these injections are typically used in a patient undergoing chemotherapy. Both drugs work the same way and are equally effective when used in the proper dosage. Bone pain is a concern for roughly 1 in 4 patients. Overall, Neulasta carries a slightly higher chance of side effects.
The major difference between the two agents is that Neulasta lasts much longer than Neupogen. Therefore, Neulasta is not taken as frequently as Neupogen. While Neupogen is injected several times a day (between 3-10 shots, depending on individual response), Neulasta is injected only once per round of chemotherapy. However, there are additional factors we must consider.
Neulasta appears to be less effective in people who have had several cycles of chemotherapy or radiation. While chemotherapy and radiation help diminish cancer cells, these therapies also lower the body's number of natural neutrophil progenitor cells. These progenitor cells are necessary for Neulasta to work properly.
Another aspect of Neulasta is that it cannot be administered less than 14 days before the next phase of chemotherapy. So if a person must undergo weekly chemotherapy, Neulasta isn't really useful. Neupogen, on the other hand, works well under this setting.
A physician will take all of these factors into account, as well as other variables particular to each individual. Finding the right treatment can be a true challenge. However, we are constantly discovering new ways to improve care and fight diseases at earlier stages. My best wishes go out to your friend.
Submit your questions to askthedoctor@nowoodennickels.org
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