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Oprelvekin

(oh-prel-vuh-kin)

Trade/other name(s): Neumega, interleukin-11 (IL-11)

Why would this drug be used?

Oprelvekin is used to help prevent thrombocytopenia (having a lower than normal number of platelets in the blood), which in turn lowers a person's risk of serious bleeding episodes. Thrombocytopenia can sometimes result from cancer chemotherapy or other treatments.

How does this drug work?

Oprelvekin is a man-made version of a protein called interleukin-11 (IL-11). This protein is normally made by some cells in the body to stimulate the bone marrow to make more cells called megakaryocytes. These are cells that make platelets, which are important for stopping bleeding. The man-made version of IL-11 has the same effect when injected into the body.

Before taking this medicine

Tell your doctor…

  • If you are allergic to any medicines, dyes, additives, or foods.
  • If you have ever had congestive heart failure, fluid retention, or are taking a diuretic (water pill). This drug may cause you to retain fluids, which could make some of these problems worse.
  • If you have ever had heart disease, irregular heartbeat, or stroke. This drug can cause heart problems, such as abnormal heartbeats, in some people. In rare cases this has been linked to strokes.
  • If you have ever had kidney disease. This drug is cleared from the body mainly by the kidneys. Reduced kidney function might result in more drug than expected staying in the body, which could lead to unwanted side effects. Your doctor may need to adjust your dose.
  • If you have any type of eye condition, or tumor in the brain near the optic nerve. This drug can cause eye problems in some people, including blurring or loss of vision.
  • If you have any other medical conditions such as liver disease (including hepatitis), lung disease, diabetes, gout, or infections. You may need closer monitoring of these conditions while being treated, or the drug dose, regimen, or timing may need to be changed.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. It is not known if this drug might cause problems if either the male or female is taking it at the time of conception or during pregnancy. Check with your doctor about what kinds of birth control can be used with this medicine. This drug should be used during pregnancy only if the expected benefit is thought to outweigh the potential risk to the fetus.
  • If you are breast-feeding. While no studies have been done, this drug may pass into breast milk and affect the baby. Talk with your doctor about the possible risks of breast-feeding while taking this drug.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

This drug can cause problems with heart rhythms in some people. Drugs that lower potassium levels in the body, such as certain "water pills" (diuretics), can make this worse.

No other serious interactions are known at this time. But this does not necessarily mean that none exist. Check with your doctor, nurse, or pharmacist about all of your medicines, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether some foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Oprelvekin is given as a shot under the skin (subcutaneously, or SubQ) in either the abdomen, thigh, hip, or upper arm. It is injected once a day, starting within 24 hours after completing a chemotherapy cycle. It is usually given for 10 to 21 days or until a patient’s blood platelet count reaches a certain level. Treatment should be stopped at least 2 days before starting a new chemotherapy cycle.

The dose will depend on your weight and how well your kidneys are working. The dose and/or schedule may need to be changed based on how your body responds to treatment. This drug can be given in a doctor’s office, or you or a family member can learn how to give the shot at home.

If you are taking it at home, make sure to keep the medicine in its original container in the refrigerator. Take this drug exactly as directed by your doctor. If you are not sure of the instructions, ask your doctor or nurse to explain them to you. Keep the needles and other equipment in a safe place out of reach of children and pets. Keep used needles in a closed needle bucket and bring them back to your doctor or nurse.

Precautions

Patients with acute myeloid leukemia (AML) or chronic myelogenous leukemia (CML) should not get this drug, as it could potentially spur the growth of these types of cancer cells.

This drug should not be used after high-dose chemotherapy for a bone marrow transplant or peripheral blood stem cell transplant.

Your doctor will test your blood frequently throughout your treatment, looking for possible effects of the drug on blood counts or on blood chemistry levels. Based on the test results, your doctor may need to reduce or delay your next dose of this drug, or even stop it altogether.

This drug can cause the body to retain fluid. This can lead to swelling (edema) in the hands or feet, or fluid buildup in the lungs or belly. Tell your doctor or nurse if you notice any swelling or sudden weight gain, or if you start to have shortness of breath or a new cough.

This drug can cause changes in heart rhythms in some people. Most often this involves a fast heartbeat, but it may include other abnormal rhythms. In rare cases this has led to strokes. Tell your doctor or nurse right away if you feel your heart is pounding or may be skipping beats, if you notice chest pain or shortness of breath, or if you feel dizzy or lightheaded.

In rare cases, this drug can cause swelling of the optic nerve (which connects the eye to the brain), a condition known as papilledema. This can lead to blurred vision or even blindness. Tell your doctor or nurse right away if you notice any changes in vision.

In rare cases, this drug can cause allergic reactions when the drug is given. Mild reactions may consist of fever, chills, skin itching, or feeling flushed. More serious reactions happen rarely, but can be dangerous. Symptoms can include feeling lightheaded or dizzy (due to low blood pressure), chest tightness, shortness of breath, back pain, or swelling of the face, eyes, tongue, or throat. Tell your doctor or nurse right away if you notice any of these symptoms during or after being given the drug.

A rare but serious side effect is capillary leak syndrome, in which the small blood vessels in the body become leaky. This can allow fluid to leave the bloodstream and enter other parts of the body. This results in low blood pressure, fluid buildup, and poor blood flow to the internal organs. Tell your doctor right away if you feel dizzy or notice sudden swelling or rapid weight gain, trouble breathing, abnormal heart beats, chest pain, or little or no urine output.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

  • fluid buildup (weight gain, swelling in the hands or feet, or fluid in the chest or belly)*
  • shortness of breath
  • anemia (shortage of red blood cells that can cause tiredness or weakness)

Less common

  • feeling weak or tired
  • fast heart rate, pounding heart, irregular heart beat, or palpitations*
  • feeling dizzy or faint
  • redness in the eyes
  • runny nose
  • skin rash or itching
  • headache
  • fever
  • trouble sleeping

Rare

  • injection site reaction (redness, pain, or swelling)
  • vision changes*
  • sores or white patches in the mouth
  • diarrhea
  • allergic reaction (may include shortness of breath, wheezing, swelling of the face, eyes, mouth or throat, hives, itching, flushing, or fever)*
  • capillary leak syndrome*
  • stroke

*See "Precautions" section for more detailed information.

There are some other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 1997.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.


Last Medical Review: 11/19/2009
Last Revised: 11/19/2009