Name of the Procedure:

Injection, pegfilgrastim-bmez, biosimilar, (Zirabev), 0.5 mg (Q5120)
Common Names: Pegfilgrastim-bmez Injection, Ziextenzo Injection
Technical Term: Subcutaneous Injection of Pegfilgrastim-bmez (Ziextenzo)

Summary

This procedure involves the subcutaneous (under the skin) injection of Pegfilgrastim-bmez, a biosimilar medication marketed under the brand name Ziextenzo. It's used to promote the growth of white blood cells in patients undergoing chemotherapy.

Purpose

The primary purpose of this injection is to reduce the risk of infection by boosting white blood cell counts in patients receiving chemotherapy. It helps to prevent febrile neutropenia, a condition characterized by a fever and a low number of neutrophils (a type of white blood cell).

Indications

• Patients undergoing myelosuppressive chemotherapy
• Individuals at risk of febrile neutropenia
• Those with a history of neutropenic complications

Patient criteria:

• Must be undergoing chemotherapy
• Must be at increased risk of infection due to low white blood cell counts

Preparation

• No specific fasting required.
• Inform your healthcare provider about any other medications you are taking.
• Blood tests may be required to assess your baseline white blood cell counts.

Procedure Description

1. Pre-Procedure Assessment: Confirmation of the patient's current health status and white blood cell count.
2. Medication Preparation: Ziextenzo is prefilled in a syringe and prepared for injection.
3. Injection Site Preparation: The injection site (typically the abdomen or thigh) is cleaned with an antiseptic solution.
4. Administration: The prefilled syringe is used to inject the medication subcutaneously.
5. Post-Injection Monitoring: Observation for any immediate adverse reactions.

Tools and Equipment:

• Prefilled syringe with Ziextenzo
• Antiseptic solution and sterile wipes

Anesthesia/Sedation:

• Not required for this procedure.

Duration

The injection itself typically takes just a few minutes. Including preparation and post-injection observation, the entire process may take around 15-30 minutes.

Setting

This procedure is usually performed in an outpatient clinic or a hospital oncology department.

Personnel

• Registered Nurse (RN)
• Oncologist or Hematologist may be available for consultation

Risks and Complications

• Common: Mild pain at the injection site, headaches, bone pain, nausea
• Rare: Allergic reactions, capillary leak syndrome, splenic rupture

Management of Complications:

• Pain management with over-the-counter analgesics
• Immediate medical attention for severe reactions or symptoms

Benefits

• Decreased risk of infection
• Enhanced recovery and continuation of chemotherapy without delays
• Benefits usually realized within a few days as white blood cell counts increase

Recovery

• Post-injection observation for 15-30 minutes.
• Normal activities can typically be resumed immediately.
• Follow-up blood tests may be required to monitor white blood cell counts.

Alternatives

• Filgrastim injections: More frequent administration required
• Other biosimilar drugs may be an option Pros and Cons:
• Ziextenzo requires less frequent dosing compared to filgrastim
• Costs and insurance coverage may vary between options

Patient Experience

During the Procedure:

• Minor discomfort or pain at the injection site.

After the Procedure:

• Possible mild side effects like bone pain or headaches. Pain Management:
• Over-the-counter pain relievers, such as acetaminophen or ibuprofen, may be suggested to manage mild discomfort.