Pelgraz Patient Counseling Information

What Pelgraz is and what it is used for: Pelgraz contains the active substance pegfilgrastim. Pegfilgrastim is a protein produced by biotechnology in bacteria called E. coli. It belongs to a group of proteins called cytokines, and is very similar to a natural protein (granulocyte-colony stimulating factor) produced by your own body.
Pelgraz is used to reduce the duration of neutropenia (low white blood cell count) and the occurrence of febrile neutropenia (low white blood cell count with a fever) which can be caused by the use of cytotoxic chemotherapy (medicines that destroy rapidly growing cells). White blood cells are important as they help your body fight infection. These cells are very sensitive to the effects of chemotherapy which can cause the number of these cells in your body to decrease. If white blood cells fall to a low level there may not be enough left in the body to fight bacteria and you may have an increased risk of infection.
Your doctor has given you Pelgraz to encourage your bone marrow (part of the bone which makes blood cells) to produce more white blood cells that help your body fight infection.
How to use Pelgraz: Pelgraz is for use in adults aged 18 and over.
Always take Pelgraz exactly as your doctor has told you. You should check with your doctor or pharmacist if you are unsure. The usual dose is one 6 mg subcutaneous injection (injection under your skin) using a pre-filled syringe and it should be given at least 24 hours after your last dose of chemotherapy at the end of each chemotherapy cycle.
Do not shake Pelgraz vigorously as this may affect its activity.
Injecting Pelgraz yourself: Your doctor may decide that it would be more convenient for you to inject Pelgraz yourself. Your doctor or nurse will show you how to inject yourself. Do not try to inject yourself unless you have received special training from your doctor or nurse.
The instructions how to inject yourself are given as follows, but proper treatment of your disease requires close and constant co-operation with your doctor.
If you are not sure about giving yourself the injection or you have any questions, please ask your doctor or nurse for help.
How do I inject Pelgraz myself: You will need to give yourself the injection into the tissue just under the skin. This is known as a subcutaneous injection.
Equipment that you need: To give yourself a subcutaneous injection you will need: a pre-filled syringe of Pelgraz; alcohol swab.
What should I do before I give myself a subcutaneous injection of Pelgraz: Take the pre-filled syringe out of the refrigerator.
Do not remove the needle cover from the syringe until just before you are ready to inject.
Check the expiry date on the pre-filled syringe label (EXP). Do not use it if the date has passed the last day of the month shown or if it has been kept outside of the refrigerator for more than 72 hours or has otherwise expired.
Check the appearance of Pelgraz. It must be a clear and colourless liquid. If there are particles in it, you must not use it.
For a more comfortable injection, let the pre-filled syringe stand for 30 minutes to reach room temperature or hold the pre-filled syringe gently in your hand for a few minutes. Do not warm Pelgraz in any other way (for example, do not warm it in a microwave or in hot water).
Wash your hands thoroughly.
Find a comfortable, well-lit place and put everything you need where you can reach them (the pre-filled syringe and alcohol swab).
How do I prepare my Pelgraz injection: Before you inject Pelgraz you must do the following: 1. Hold the syringe and gently take the cover from the needle without twisting. Pull straight. Do not touch the needle or push the plunger.
2. You may notice a small air bubble in the pre-filled syringe. You do not have to remove the air bubble before injecting. Injecting the solution with the air bubble is harmless.
3. You can now use the pre-filled syringe.
Where should I give my injection: The most suitable places to inject yourself are: the top of your thighs; and the abdomen, except for the area around the navel.
If someone else is injecting you, they can also use the back of your arms.
It is better to change the injection site every time to avoid the risk of soreness at any one site.
How do I give my injection: a. Disinfect the injection site by using an alcohol swab and pinch the skin between your thumb and forefinger, without squeezing it.
Pre-filled syringe with needle safety guard: b. Put the needle fully into the skin as shown by your nurse or doctor.
c. Pull slightly on the plunger to check that a blood vessel has not been punctured. If you see blood in the syringe, remove the needle and re-insert it in another place.
d. Always keeping your skin pinched, depress the plunger slowly and evenly while grasping the finger flange until the entire dose has been given and the plunger cannot be depressed any further. Do not release the pressure on the plunger.
e. After injecting the liquid, while keeping the syringe at the same angle and maintaining pressure on the plunger, remove the needle and then let go of your skin. The protective sleeve will automatically cover the needle and an audible "click" will be heard to confirm shield activation. The needle guard will not activate unless the entire dose has been given.
Remember: If you have any problems, please ask your doctor or nurse for help and advice.
Disposing of used syringes: Dispose of the syringe as instructed by your doctor, pharmacist or nurse.
If you use more Pelgraz than you should: If you use more Pelgraz than you should contact your doctor, pharmacist or nurse.
If you forget to inject Pelgraz: If you are injecting yourself and have forgotten your dose of Pelgraz, you should contact your doctor to discuss when you should inject the next dose.
If you stop using Pelgraz: Your doctor will tell you when to stop using Pelgraz. It is quite normal to have a number of courses of treatment with Pelgraz.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.