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ziextenzo and how long does bone pain last with it

kaynotrealname Member Posts: 366

Had my first ziextenzo shot last Saturday evening, 24 hours after my chemo. I have some bone pain with it and I was wondering how long I can expect it to last. It seems better on some days and then other not so great. I have some meloxicam and I will occasionally take that and it does help (over the counter ibuprofin seems to be a crapshoot) but I would like to get to the point where I don't need anything at all. It's not excruciating pain. It's just constant and it's hard to sleep with it so I usually break down and have a pain pill before I go to bed. I am wondering if some of this pain may also be my blood counts going down, too. I was in more pain yesterday and today was the first day I was told to expect really lowered immunity. And I'm more tired today, too, so I'm wondering if it's linked. Anyway what can I expect with it? Thank you!


  • specialk
    specialk Member Posts: 9,221
    edited August 2022

    Were you advised to take Claritin (not Claritin D) before your injection, and for several days afterward? Some even start with Claritin the day of infusion just to be sure. The bone pain is caused by the rapid stimulation of white cell making in the bone marrow, which also causes edema. The larger bones are usually where the pain is - but that is not always the case. The antihistamine in loratadine (active ingredient in Claritin) helps control the edema, and thus may help mitigate the bone pain. Taxotere, and all taxanes, are also known to cause bone pain, so you get a double whammy from both. The nadir on blood counts is usually at days 7-9, I am not sure if you would notice any symptoms of lowered counts this quickly. It usually also takes more treatments to see the reduced counts on red cells and platelets - they seem to fall in a stairstep fashion, a little each infusion. Make sure you are consuming protein to help keep your red cell count high. Neulasta (and biosimilar Ziextenzo) only work on your white cells, so it is up to you to try to keep your red cells up with diet. I found that Tylenol and warm baths, along with the Claritin, were good for helping with any bone pain. I was fortunate that I didn't have too much issue with any of the six infusions involving both Taxotere and Neulasta, except for the one in the middle when I forgot to take the Claritin in advance - I remembered 30 minutes after the injection, but I had the most bone pain on that one. Good luck!

  • kaynotrealname
    kaynotrealname Member Posts: 366
    edited August 2022

    I've been on a daily zyrtec for years due to allergies which are always an issue. Claritin does nothing for my allergies and since I can't take both I continued taking my zyrtec. Whether it helped or not I don't know but I definitely feel the bone pain. I thought I read taxotere causes it, too, so...I guess yea? As you said doubly whammy. And thank you for the advice with protein. I've been doing okay with it but I'll make sure to definitely have a good amount with every meal for awhile. I read that the first shot is the worst so I hope that's the case and at least this side effect might not be as bad next time around. And I hope this dissipates soon. I'm grateful it's not excruciating. I was fearing that. But it's still pretty damn annoying and I'm getting tired of it.