Nyvepria Side Effects Center

Last updated on RxList: 6/2/2022
Nyvepria Side Effects Center

What Is Nyvepria?

Nyvepria (pegfilgrastim-apgf) is a leukocyte growth factor indicated to decrease the incidence of infection, as manifested by febrile neutropenia, in patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a clinically significant incidence of febrile neutropenia. Nyvepria is biosimilar to Neulasta (pegfilgrastim).

What Are Side Effects of Nyvepria?

Side effects of Nyvepria include:

  • bone pain and
  • pain in extremities

Dosage for Nyvepria

The dose of Nyvepria for patients with cancer receiving myelosuppressive chemotherapy is 6 mg administered subcutaneously once per chemotherapy cycle. Use weight-based dosing for pediatric patients weighing less than 45 kg.

Nyvepria In Children

The safety and effectiveness of Nyvepria have been established in pediatric patients. No overall differences in safety were identified between adult and pediatric patients based on postmarketing surveillance and review of the scientific literature.

Use of Nyvepria in pediatric patients for chemotherapy-induced neutropenia is based on adequate and well-controlled studies in adults with additional pharmacokinetic and safety data in pediatric patients with sarcoma.

What Drugs, Substances, or Supplements Interact with Nyvepria?

Nyvepria may interact with other medicines.

Tell your doctor all medications and supplements you use.

Nyvepria During Pregnancy and Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant before using Nyvepria; it is unknown how it might affect a fetus. Available data from published studies in pregnant women exposed to other filgrastim products have not established an association of filgrastim product use during pregnancy with major birth defects, miscarriage, or adverse maternal or fetal outcomes. It is unknown if Nyvepria passes into breast milk. Other filgrastim products are secreted poorly into breast milk, and filgrastim products are not absorbed orally by neonates. Consult your doctor before breastfeeding.

Additional Information

Our Nyvepria (pegfilgrastim-apgf) Injection, for Subcutaneous Use Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


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Nyvepria Professional Information


The following clinically significant adverse reactions are discussed in greater detail in other sections of the labeling:

  • Splenic Rupture [see WARNINGS AND PRECAUTIONS]
  • Acute Respiratory Distress Syndrome [see WARNINGS AND PRECAUTIONS]
  • Serious Allergic Reactions [see WARNINGS AND PRECAUTIONS]
  • Use in Patients with Sickle Cell Disorders [see WARNINGS AND PRECAUTIONS]
  • Glomerulonephritis [see WARNINGS AND PRECAUTIONS]
  • Leukocytosis [see WARNINGS AND PRECAUTIONS]
  • Thrombocytopenia [see WARNINGS AND PRECAUTIONS]
  • Capillary Leak Syndrome [see WARNINGS AND PRECAUTIONS]
  • Potential for Tumor Growth Stimulatory Effects on Malignant Cells [see WARNINGS AND PRECAUTIONS]
  • Myelodysplastic Syndrome [see WARNINGS AND PRECAUTIONS]
  • Acute Myeloid Leukemia [see WARNINGS AND PRECAUTIONS]

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Pegfilgrastim clinical trials safety data are based upon 932 patients receiving pegfilgrastim in seven randomized clinical trials. The population was 21 to 88 years of age and 92% female. The ethnicity was 75% Caucasian, 18% Hispanic, 5% Black, and 1% Asian. Patients with breast (n = 823), lung and thoracic tumors (n = 53) and lymphoma (n = 56) received pegfilgrastim after nonmyeloablative cytotoxic chemotherapy. Most patients received a single 100 mcg/kg (n = 259) or a single 6 mg (n = 546) dose per chemotherapy cycle over 4 cycles.

The following adverse reaction data in Table 2 are from a randomized, double-blind, placebo-controlled study in patients with metastatic or non-metastatic breast cancer receiving docetaxel 100 mg/m2 every 21 days (Study 3). A total of 928 patients were randomized to receive either 6 mg pegfilgrastim (n = 467) or placebo (n = 461). The patients were 21 to 88 years of age and 99% female. The ethnicity was 66% Caucasian, 31% Hispanic, 2% Black, and <1% Asian, Native American, or other.

The most common adverse reactions occurring in ≥5% of patients and with a between-group difference of ≥5% higher in the pegfilgrastim arm in placebo-controlled clinical trials are bone pain and pain in extremity.

Table 2. Adverse Reactions with ≥5% Higher Incidence in Pegfilgrastim Patients Compared to Placebo in Study 3

Body System
Adverse Reaction
(N = 461)
Pegfilgrastim 6 mg SC on Day 2
(N = 467)
Musculoskeletal and connective tissue disorders
  Bone pain 26% 31%
  Pain in extremity 4% 9%


In clinical studies, leukocytosis (WBC counts >100 x 109/L) was observed in less than 1% of 932 patients with non-myeloid malignancies receiving pegfilgrastim. No complications attributable to leukocytosis were reported in clinical studies.


As with all therapeutic proteins, there is potential for immunogenicity. The detection of antibody formation is highly dependent on the sensitivity and specificity of the assay. Additionally, the observed incidence of antibody (including neutralizing antibody) positivity in an assay may be influenced by several factors, including assay methodology, sample handling, timing of sample collection, concomitant medications, and underlying disease. For these reasons, comparison of the incidence of antibodies in the studies described below with the incidence of antibodies in other studies or to other pegfilgrastim products may be misleading.

Binding antibodies to pegfilgrastim were detected using a BIAcore assay. The approximate limit of detection for this assay is 500 ng/mL. Pre-existing binding antibodies were detected in approximately 6% (51/849) of patients with metastatic breast cancer. Four of 521 pegfilgrastim-treated subjects who were negative at baseline developed binding antibodies to pegfilgrastim following treatment. None of these 4 patients had evidence of neutralizing antibodies detected using a cell-based bioassay.

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of pegfilgrastim products. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

  • Splenic rupture and splenomegaly (enlarged spleen) [see WARNINGS AND PRECAUTIONS]
  • Acute respiratory distress syndrome (ARDS) [see WARNINGS AND PRECAUTIONS]
  • Allergic reactions/hypersensitivity, including anaphylaxis, skin rash, urticaria, generalized erythema, and flushing [see WARNINGS AND PRECAUTIONS]
  • Sickle cell crisis [see WARNINGS AND PRECAUTIONS]
  • Glomerulonephritis [see WARNINGS AND PRECAUTIONS]
  • Leukocytosis [see WARNINGS AND PRECAUTIONS]
  • Thrombocytopenia [see WARNINGS AND PRECAUTIONS]
  • Capillary Leak Syndrome [see WARNINGS AND PRECAUTIONS]
  • Injection site reactions
  • Sweet’s syndrome (acute febrile neutrophilic dermatosis), cutaneous vasculitis
  • Myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) in patients with breast and lung cancer receiving chemotherapy and/or radiotherapy [see WARNINGS AND PRECAUTIONS]
  • Alveolar hemorrhage


No Information Provided

Read the entire FDA prescribing information for Nyvepria (Pegfilgrastim-apgf Injection)

© Nyvepria Patient Information is supplied by Cerner Multum, Inc. and Nyvepria Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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