Oprelvekin (Neumega®, IL-11)

Oprelvekin (Neumega®, IL-11) 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 the 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 not a cancer treatment, but a supportive care medicine. This means it is used to counteract the effects of cancer and its treatments.

How to Take Oprelvekin (Neumega®, IL-11)

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.

Storage and Handling

If you give this medication at home, you should store the bottles in the refrigerator, protected from light. Once mixed with sterile water, you must use it within 3 hours. Your provider will teach you or a caregiver how to mix the dose and inject it. Keep the vials out of the reach of children and pets.

Do not reuse or recap syringes or needles. Do not throw the vials, syringes, or needles in the household trash. Dispose of all used vials, needles, and syringes in a puncture-proof disposable container with a lid. The FDA provides further information about the disposal of vials, syringes, and needles.

Possible Side Effects of Oprelvekin

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

Talk to your oncology care team so they can prescribe medications to help you manage nausea and vomiting. 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 saltines, or ginger ale to lessen symptoms.

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

Fluid Retention

This medication can cause fluid retention. This may result in swelling of the arms or legs, fluid in the lungs (pleural effusion), or heart (pericardial effusion). Notify your healthcare team if you develop swelling in your arms, legs, feet, or abdomen, have an unexpected weight gain, racing heartbeat, shortness of breath, or difficulty breathing, or if you develop a dry cough.

Fever

Fever can be a side effect of this medication. Contact your care provider for a temperature of 100.4°F or 38°C or greater.

Low Red Blood Cell Count (Anemia)

Your red blood cells are responsible for carrying oxygen to the tissues in your body. When the red cell count is low, you may feel tired or weak. You should let your doctor or nurse know if you experience any shortness of breath, difficulty breathing, or pain in your chest. If the count gets too low, you may receive a blood transfusion.

Muscle or Joint Pain/Aches and Headache

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.

Important but Less Common Side Effects

• Heart Problems: Oprelvekin can cause heart problems including arrhythmias (irregular heartbeat) and new or worsening heart failure. Notify your doctor immediately if you develop new or worsening shortness of breath, chest pain, or 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.
• Blood Clots, Heart Attack, and Stroke: Oprelvekin can increase the risk of blood clots, stroke, and heart attack. Symptoms can include swelling, redness or pain in an extremity, chest pain or pressure, pain in your arm, back, neck, or jaw, shortness of breath, numbness or weakness on one side of the body, trouble talking, confusion or mental status changes. If you experience any of these symptoms, you should contact your oncology care team immediately or go to an emergency room.
• Eye Problems: Oprelvekin can, in rare cases, cause eye problems. These include papilledema (swelling of the optic nerve), which 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. Your eye may get red or you may have bleeding in the eye. If you develop any changes in your vision, let your healthcare team know right away.

Reproductive Concerns

Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should consult with your healthcare team before breastfeeding while receiving this medication.