Oprelvekin (Neumega®, IL-11)

OncoLink
Last Modified: January 14, 2012

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Pronounced: oh-PREL-ve-kin
Classification: Colony Stimulating Factor

About Oprelvekin

Oprelvekin is a type of colony stimulating factor, which is a group of medications that stimulate the production and function of blood cells, including white blood cells, red blood cells, and platelets. IL-11 is a protein produced by the body to increase production and maturation of platelets. Oprelvekin is a man-made version of IL-11 that stimulates platelet production. A platelet is a type of blood cell that is responsible for making blood clot properly, thereby preventing bleeding; platelet levels are often decreased during cancer therapy. Oprelvekin is a supportive therapy, not a cancer treatment. It is used to reduce the number of platelet transfusions needed by patients.

How to Take Oprelvekin

Oprelvekin is given as a subcutaneous (under the skin) injection once daily, starting 6 to 24 hours after completion of chemotherapy. The actual dose is based on your body size and will be determined by your healthcare provider. The drug does not need to be refrigerated.

Possible Side Effects of Oprelvekin

There are a number of things you can do to manage the side effects of Oprelvekin. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:

Allergic Reaction

This drug can cause an allergic reaction, which can be very serious. If you experience any of the following, report them to your healthcare provider immediately: swelling of the face, tongue or throat; shortness of breath; wheezing; chest pain; confusion; rash; flushing or fever. These reactions can occur after the first injection, but can also occur after subsequent injections.

Nausea and/or Vomiting

Take anti-nausea medications as prescribed. If you continue to have nausea or vomiting, notify your doctor or nurse so they can help you manage this side effect. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try antacids, (e.g. milk of magnesia, calcium tablets such as Tums), saltines, or ginger ale to lessen symptoms. Read the Nausea & Vomiting Tip Sheet for more suggestions.

Call your doctor or nurse if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.

Constipation

There are several things you can do to prevent or relieve constipation. Include fiber in your diet (fruits and vegetables), drink 8-10 glasses of non-alcoholic fluids a day and keep active. Your doctor or nurse can also recommend medications to relieve constipation. A stool softener once or twice a day may prevent constipation.

Decrease in Appetite

Visit OncoLink's section on Nutrition for tips on dealing with this side effect. Ask your nurse about nutritional counseling services.

  • Try to eat five or six small meals or snacks throughout the day, instead of 3 larger meals.
  • If you are not eating enough, nutritional supplements may help.
  • You may experience a metallic taste or dislike foods or beverages that you liked before receiving chemotherapy. These symptoms can last up to several months.
  • Avoid any food that you think smells or tastes bad. If red meat is a problem, eat chicken, turkey, eggs, dairy products and fish without a strong smell.
  • Flavor meat or fish by marinating it in sweet juices, sweet and sour sauce or dressings. Use seasonings like basil, oregano or rosemary. Bacon, ham and onion can also add flavor to vegetables.

Bone Pain or Muscle Aches

Oprelvekin stimulates the bone marrow to produce platelets, which can lead to pain in the bones. This pain is often felt in the bones of the thighs, hips and upper arms. You may also experience achy muscles, chills or a "flu-like" syndrome. Your healthcare team may not want you to take acetaminophen (Tylenol®) because it can "mask" a fever, so talk to them about what pain relievers you can take.

Heart Problems

Oprelvekin can cause heart problems including tachycardia (rapid heart beat), palpitations (feeling of a pounding heart beat) and arrhythmias (irregular heart beat). Notify your doctor immediately if you are short of breath, have chest pain, feel like your heart is pounding or skipping a beat. If you take a diuretic (water pill), be sure your doctor is aware. Diuretics can decrease the potassium level in your blood and oprelvekin can make this worse.

Edema (Swelling)

You may develop swelling, which is often most noticeable in the feet or ankles. If you do develop swelling, notify your healthcare team, as this can be a sign of a more serious problem called capillary leak syndrome.

Capillary Leak Syndrome

Capillary leak syndrome is a rare but potentially serious complication in which fluids from the veins and capillaries (small blood vessels) leak into the tissue outside the bloodstream. This results in low blood pressure and poor blood flow to the internal organs. Capillary leak syndrome is characterized by the presence of 2 or more of the following 3 symptoms: low blood pressure, swelling, and low levels of protein in the blood (hypoalbuminemia). You should notify your doctor immediately if you notice dizziness (especially when changing position), sudden swelling or rapid weight gain, little or no urine output (for 8-12 hours), shortness of breath, difficulty breathing, irregular heart beats, or chest pain.

Other Side Effects

Oprelvekin can, in rare cases, cause an eye problem called papilledema, which is a swelling of the optic nerve. This can cause changes in your eyesight, such as blurry vision and vision loss. Optic neuropathy has also been reported, which is a loss of the blood supply to the optic nerve. This results in a loss of vision, which can happen quite rapidly. If you develop any changes in your vision, let your healthcare team know right away. In addition, some patients had allergic reactions or developed rashes.