How long does Neupogen effects like fever go away?

[Cgr2018]

My brother had 3 shots of neopogen on Monday, Tuesday and Wednesday this week, and he has fever, no more than 38 for 3 days. He takes paracetamol and the fever get away for hours, but cone back. How long that’s usually take to go away the fever with Neupogen He hasn’t got another side effect, just a little bit of fever for a few days.

Thank you!

[AussieNeil Partner Administrator]

When you are taking a G-CSF drug such as Neupogen, the fever is more likely to be due to an infection (which can become very serious fairly quickly), than a side effect from the drug, because the neutropenia it is prescribed to address, makes you vulnerable to bacterial and fungal infections. I presume your brother has discussed his fever with his specialist? The standard advice is to go to Emergency/ER if the body temperature exceeds 38/100.3F without an anti-pyrexic such as paracetamol (also known as tylenol or APAP). With the risk of COVID-19, your brother's doctor may be prepared to have him manage his fever with paracetamol, provided it stays below 38C, but this needs to be confirmed.

When I was on regular G-CSF (daily to alternate days), I had a few occasions where I developed fevers that eventually could not be managed by paracetamol and was admitted to hospital for IV antibiotics, but I did manage to avoid hospitalisation on at least one occasion, where the fevers continued for around a week. Don't take more than 8 x 500mg tablets a day and no more than 2 x 500mg every 6 hours - a higher dose of paracetamol is not well tolerated by the liver. I found it took about half an hour for my fever to reduce (I could develop a fine layer of perspiration on my head as the paracetamol started working). The fever would gradually come back, with the time to do so extending as I managed to overcome the cause.

NSAIDs are NOT recommended to lower body temperature when you have CLL, due to the (relatively small) risk of bone marrow suppression, with bone marrow suppression already commonly a problem in CLL.

Neil