Is there a Zarxio video?

• Neupogen Zarxio injection at the Cancer Care Clinic in Big Barnes

Last week I posted a video about Neupogen. I've had hundreds of Neupogen injections over the last 3+ years but trying to explain how it works isn't easy (without a medical degree.) I do have the Neupogen routine down though. The injections have to be stored in a refrigerator, so the routine is that my nurse will ask me to the hold the injection in my hand (it comes in a pre-filled syringe) to warm it up once she removes it from the fridge. Studies have shown that it is less painful if it is warmed up before it is given. Out of habit, I always look at it, I look at the dosage (there are 2 different pre-filled amounts available) and I have grown accustomed to the look of the packaging (most of the plastic is clear but there is one piece that is tinted orange.)

Long story to say that yesterday when I was handed the syringe, I noticed that there was no orange piece and upon closer look, the brand listed was not Neupogen but Zarxio. Zarxio? What the heck is Zarxio?

It turns out that Zarxio is a substitute for Neupogen. It is not a generic brand but rather a biosimilar product. Huh? It was just approved for use in 2015. It made me wonder, have I ever had it before? Did I have it the other times when I had injections on the weekends at the Cancer Care Clinic? I can't be sure. I've had a lot of bone pain in my hips and back since yesterday's injection and I've never experienced this level of pain from Neupogen injections. One of the first questions I'm going to ask at my appointment on Tuesday is, "have I had Zarxio before?" I'm not sure I want it again.

Zarxio is the first biosimilar product to ever be approved for use in the US. I have spent a lot of time reading about it in the last twenty-four hours. This article is interesting: https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm436648.htm. Here's a little snippet from it that implies that Dr. T would had to have been notified about the substitution:

"Zarxio has been approved as biosimilar, not as an interchangeable product. Under the BPCI Act, a biological product that has been approved as an “interchangeable” may be substituted for the reference product without the intervention of the health care provider who prescribed the reference product."