Is Neulasta necessary?

Cowgirl13

I had the neulasta shot the next day after chemo and by the 5th chemo my counts were too low so I had it the next week. I'm so glad I had the shot after each chemo--I wonder how bad my low blood count would have been. Ladies on this board have ended up hospitalized for 3, 4 days because their counts went so low.

neverthought

First thing this am: nosebleed, hair falling out then dental abcess .

Officially grateful for Neulasta.  Also grateful for friends, great dentist, and having a job that lets me take off time to go to dentist.

Hope the root canal, all those extra white blood cells, and amoxicillin does the job.

ruthbru

Ouch, just what you do not need ......although I've too had a root canal, and the place it hurt the most was in the pocketbook!

Trvler

I think my MO told me they give the standard does the first time and then adjust after that. I will ask again when I am there getting it today. I should take claritan first?

Trvler

By the way, since claritan is an antihistamine and dries you out, do you need to drink even more to compensate?

Trvler

I am getting a little freaked out mixing all these drugs. The most I have every done is taken one med at a time. Now I am on like 6.

CassieCat

I usually took Claritin about three hours before, but yes, they did suggest I take it the day of the Neulasta shot. As for water, I think the more hydrated you can stay, the better.

SpecialK

Claritin will not work for prevention of Neulasta bone pain unless you take it before the injection.  Most docs advise starting to take it the day before.  You can put all of your drugs into a Rx interaction tool, but prescribing most of these drugs, both Rx and OTC, is routine for oncologists - they know if there are issues, and your pharmacist can confirm.  It is also very important to give both oncologist and pharmacist a list of all the drugs you are taking though.

candycandy

My opinion, first you listen to what doctor says regard to your physical strength and blood test. My doc told me I needed even though my blood was very normal and I didn't see why I needed. But, I decided to receive because I was nervous and everything doc says I thought I should believe it. They planned to give me 4 times during my AC cycle. But after 2nd time, my WBC start getting too high and there were no sign to WBC is going away..... Nurses were saying because I am young and physically strong than other cancer patients. So, 3rd time, they reduced amount and they canceled 4th because doc didn't see any additional WBC were needed.

So, if you have chance to talk to your doc, mention if your WBC is not going low, lower doses or stop using Neulasta. Unless you are covered by a good health insurance, this cost crazy expensive.

Trvler

SPecial: I called the pharmacist this am and told her all the drugs I was taking and should I be worried about mixing this with this or that with this. She told me what was ok. I took the Claritan today (the day I get my first shot). I didn't know about taking it the day before.

Anonymous

I took claritin the day of and for 5 days after. No bone pain. BTW, I wanted my WBC counts up and stable, because if they drop too low, your chemo is delayed, and I wanted the infusions over and done with asap. I also teach at a university and didn't want to miss work because of low WBC or delay tx because of some infection I contracted because of low WBC.

Claire

SpecialK

trvler - you don't have to take it the day before, but sometimes it is easier to remember rather than taking it as you are running out the door to go get the injection - that was why I mentioned it.  I have seen it both ways - night before and day of - whatever works for you.

Janetanned

I know most people take the Claritin to avoid bone pain.  However, I didn't bother to take it.  I'm a 'lightweight' and I really don't like taking meds unless absolutely necessary.  I only felt pain after the first shot.  The pain in my breastbone woke me up in the middle of the night following my shot.  I took an ibuprofen and went back to sleep. I woke up free of pain and felt no pain with the subsequent shots.  I was a little worried that it might not be working if there was no pain.  However, it must have worked sinc my bloodcounts always recovered quickly.

ruthbru

I didn't have bone pain either.

wrmbrownie

Janetanned and Ruthbru....thanks for saying that you guys had little/no pain. Makes me feel better and less anxious for when I will need to take it. 

ruthbru

I think if you can force yourself to keep moving, go for walks etc. that really helps too.

Trvler

So far so good. No pain. I might try to work out today on the elliptical. I was a zombie yesterday after taking the Compazine. I am going to try not to take it today unless absolutely needed. I am guessing it's in the same family as dramamine and I don't get motion sickness, only had minimal pregnancy nausea and haven't felt nauseous yet.

agness

I didn't want to have Neupogen and it wasn't suggested until after my first round when I had urethritis the lab had a standing order for my chemo labs* and did the full panel which showed I was neutropenic. I consulted with my Chinese Medicine doc, especially since I had seen mention in PubMed of (pilot?) studies showing that mode of medicibe had been shown to boost the immune system during treatment. My Chinese Med doc gave me a tea pills formula labeled "Energy" and I started taking it just around my second chemo dose with a promise to my MO that I would be watchful.

At my 3rd chemo dose the nurse said my labs looked weird -- my white blood cell count had gone up instead of down. I stayed on the formula throughout treatment and never needed the Neulasta, nor the Claritin that seems to be the accompanying chaser.

After chemo I continued with Herceptin infusions every three weeks. At my second post-chemo dose my MO expressed concern that my WBC was lowering instead of going up and he suggested that it might have to do with the Chinese herbs I was on. I located on PubMed the reference to arsenic in some Chinese herbs causing a similar problem but this didn't make sense to me as I had been on a group of herb formula throughout treatment without issue.

I was entering my labs into an Excel spreadsheet where I was tracking all of them throughout treatment when suddenly I realized what happened. AF the end of chemo my Chinese Medicine doc gave me a kidney energy formula but not the "energy" formula. The timing of concern about my labs being at first higher than they expected and then lower than they expected aligned exactly with the start and end of taking that one formula.

I called my Chinese Medicine doc and they said yes, I should take it again, plus they believed that the late summer season (Five Element) was also likely responsible.

It was pretty amazing and I saved myself or my insurer several thousand dollars -- I've heard the shots can be as high as $500 per dose.

PS - I have two young sons and one was in preschool (cess pool of viruses) and none of us was sick while I was going through chemo -- I think that was my guardian angel's doing.

* I wanted to get my labs done separately so I wouldn't have so much delay on chemo day due to the associated hassles of timing with cold caps)