Oprelvekin (Subcutaneous)

Oprelvekin is used in the treatment of cancer patients to prevent the low platelet counts that can result from treatment with certain cancer medications.

Overview

In the US, oprelvekin is known under the brand name, Neumega. It is a prescription-only medicine that is available in powder form and is used to make a solution for subcutaneous administration.

Oprelvekin is a man-made copy of a naturally occurring substance called interleukin-11. This substance is made in the bone marrow cells of the body and helps in the creation of platelets. Good levels of platelets in the blood are essential for an efficient blood clotting function. Some cancer drugs can hinder the production of platelets, leading to a lack of platelets in the blood and potential complications, such as uncontrolled bleeding.

Oprelvekin is one of a family of drugs called cytokines. It works by stimulating the production of platelets by the bone marrow, reducing the need for platelet transfusions and helping to prevent problems such as uncontrolled bleeding.

This medication is not suitable for use in patients who have myeloid malignancies such as leukemia. The drug will not cure your cancer; it is solely used to help control the unwanted effects of certain cancer drugs.

Conditions treated

  • Low platelet count in certain cancer patients

Type of medicine

  • Cytokine
  • Powder for solution

Side effects

In addition to the beneficial effects it has, oprelvekin can cause a few unwanted side effects. Not everyone who is treated with this drug will suffer side effects, but if they do occur, you may need to ask your treating physician for assistance.

The side effects that are discussed in this guide refer only to those that may be caused by oprelvekin. To learn more about other side effects that you may experience due to the other chemotherapy medicines you are also taking, ask your treating physician for more information.

If you notice any of the following effects while you are receiving oprelvekin, you must check with your treating physician right away:

  • White patches on the tongue or in the mouth
  • Wheezing
  • Unexpected weight gain
  • Warmth at the infusion site
  • Vomiting
  • Unusual tiredness or weakness
  • Ulceration of the skin
  • Troubled breathing
  • Tingling sensations
  • Tightness of chest
  • Tenderness
  • Swelling of lower legs and/or feet
  • Swelling
  • Stomach pains
  • Stinging
  • Soreness
  • Sore tongue or mouth
  • Skin rash
  • Shortness of breath
  • Severe peeling or redness of the skin
  • Scarring
  • Redness
  • Rash
  • Swelling or puffiness of the eyelids or around the eyes, tongue, face, or lips
  • Pain
  • Numbness
  • Nausea
  • Lumps
  • Lower back/side pain
  • Loss of appetite
  • Itching
  • Irregular heartbeat
  • Inflammation
  • Infection
  • Increased thirst
  • Increased blood pressure
  • Hives
  • Heart rhythm problems
  • Fluid retention
  • Feeling of pressure
  • Fast heartbeat
  • Fainting or lightheadedness
  • Dizziness
  • Discoloration of the skin
  • Difficulty in swallowing
  • Increase or decrease in urine production
  • Cough
  • Feeling cold
  • Cloudy urine
  • Change in ability to see colors, especially blue or yellow
  • Burning
  • Blurred vision
  • Bloody urine
  • Bloody eye
  • Blistering
  • Bleeding

Oprelvekin can sometimes cause side effects that will resolve without the need for further medical intervention. These effects will settle down, once your body acclimatizes to the new drug. Your treating physician or nurse may give you some advice on how you can control or prevent some or all of these effects.

If you notice any of the effects noted below, check with your treating physician if they persist or prove to be especially bothersome:

  • Weakness
  • Skin rash at the place of injection
  • Skin discoloration
  • Red eyes
  • Numbness or tingling of hands or feet

The side effects caused by oprelvekin are not necessarily all included here. If you notice any other odd effects, check with your treating physician.

Dosage

Oprelvekin is administered via subcutaneous injection (between the skin and the muscle).

You will receive the drug six to 24 hours following your chemotherapy treatment, on a daily basis. Your treating physician will decide on the duration of your course. It may be possible for you to self-administer the injections, but you may also opt to receive them from a trained health professional.

The dose of the drug that you will receive will depend on a number of factors, including your condition, your weight, and your general health. Your treating physician will advise you of the precise dose and administration instructions.

Self-administration guidelines

Your prescription of oprelvekin will come with a set of patient guidelines. You must read all the instructions to ensure that you understand them and are confident in administering the drug. The guide will tell you:

  • How to measure the dose and prepare the injection
  • How to use the disposable syringes
  • How to administer the injection
  • How to store the medication to ensure it remains stable

If you have any questions, check with your treating physician.

Note that this drug works most effectively if you take it at the same time each day.

The dose of oprelvekin that you are told to take will vary between patients. You must follow the instructions given to you by your treating physician or the directions on the dispensary label. Do not change the dose or stop using the drug unless you are told to by your treating physician.

If you forget or miss a dose of oprelvekin, do not take a double dose. Leave out the dose you missed and revert to your correct schedule.

Do not share this medicine with anyone else.

If you think you are not feeling any better or are getting worse, check with your doctor.

Interactions

Drug interactions

Some medication should never be used with certain other drugs, as doing so could trigger an interaction between them. Be sure to mention to your doctor if you are currently using any other medicines, including over the counter products.

Other interactions

In some cases, a drug should not be taken with a meal or with particular food groups, when using tobacco, or when drinking alcohol. Discuss this facet of your treatment with your treating physician before you begin using oprelvekin.

Medical interactions

Some existing or historical medical conditions can affect how oprelvekin works. Be sure to discuss your medical history fully with your treating physician before you begin receiving this drug.

Patients who have a history of congestive heart failure should not be treated with oprelvekin as the drug can cause water retention, which would make this health condition worse.

Oprelvekin should be used with caution in people with a history of atrial arrhythmias, as this drug can trigger problems with the heart rhythm.

Patients with a build-up of fluid in their lungs or abdomen should not use oprelvekin, as this can make these conditions worse.

Oprelvekin should not be given to patients who are undergoing myeloablative chemotherapy, as this could trigger serious side effects.

Warnings

Before deciding to undergo treatment with a particular drug, you should consider the risks of doing so against the benefits that it will bring. This decision will be made following full and frank discussion with your treating physician.

Be sure to mention any allergies that you know of to this or other medicines. Also tell your treating physician if you are allergic to any animal derivatives, food dyes, preservatives, or particular food groups.

Pediatric

It has been shown in studies that oprelvekin can cause tendon and joint problems in children. If your child is due to receive treatment with this drug, you should discuss the risks and benefits with your child's treating physician.

Pregnancy and breastfeeding

There is nothing to suggest that receiving oprelvekin could pose a risk to an unborn baby. However, pregnant women may wish to discuss the benefits and risks of using this drug with their treating physician before agreeing to receive treatment with it.

Similarly, there has been no research carried out that would suggest a risk to breastfed infants. If you have concerns in this regard, you should discuss them with your treating physician or midwife. You may decide to find an alternative method of feeding your child until you have completed your course of treatment.

Storage

You should keep your prescription of oprelvekin in the fridge. Do not freeze the drug. Keep it out of direct sunlight and away from heat sources.

Keep the medication away from children and pets.

Do not keep any medicine that has gone out of date or that you no longer need. Ask your GP or pharmacist for advice on how to dispose of unwanted medications.

Summary

Oprelvekin is a cytokine that is used in the treatment of cancer patients. It works by causing the bone marrow to produce more platelets, effectively combatting the adverse effects of some chemotherapy drugs that can lower platelet production. The drug is not a cure for your cancer; it is only used to help mitigate some of the side effects that other drugs may cause.

There are a number of side effects that may be caused by oprelvekin. Throughout the course of your treatment with oprelvekin, you should attend regular check-ups with your treating physician. These visits are designed to monitor your treatment to make sure that it is working properly and to discuss any unwanted effects that have been experienced. You may need to have blood tests as part of this process.