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Neupogen; why does it cause bone pain?
Mar 13, 2002

Dr Dezube; I started Neupogen 480 micrograms and started having bad headaches and bad pain in my femur bones.The headache wake me up.Saw my Doctor yesterday and my WBC jumped from 2.0 to 6.8. They told me no more Neupogen at present.They said Neupogen causes headache and bone pain,why is that ? Thank you.

Response from Dr. Dezube

Neupogen is a drug which patients self-administer as an injection to stimulate the bone marrow to produce new white blood cells. It does indeed cause bone pain in many patients. The bone pain is a sign that the bone marrow is "revving" up (working overtime) to produce those new white blood cells. Usually the pain lasts for a day or two, just as the white count jumps up as in your case. You can take either ibuprofen (motrin, advil, nupren) or something stronger for the pain (codeine, percocet). You might want to ask your doctor if a lower dose might be appropriate for you; often HIV patients need only 300 micrograms. I reserve the 480 microgram dose for patients who are unusually huge or for the rare patient who does not respond to the 300 microgram dose. Neupogen has been a true life saver for many, many of my patients.

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