Sargramostim: Indication, Dosage, Side Effect, Precaution

This information is not country-specific. Please refer to the local prescribing information.

Generic Medicine Info

Indications and Dosage

Intravenous
Bone marrow transplantation

Adult: 250 mcg/m² daily by IV infusion over 2 hr. If engraftment is delayed or has failed, a 14-day course at 250 mcg/m² daily may be given. Course may be repeated after a 7-day interval if engraftment has not occurred. A 3rd course at 500 mcg/m²/day may be given for 14 days after another 7-day interval, if needed. Further dose increment may not be beneficial.

Intravenous
Chemotherapy-induced neutropenia

Adult: 250 mcg/m² daily for up to 42 days as required, to be given as IV infusion over 4 hr.

Parenteral
Mobilisation of peripheral blood progenitor cells

Adult: 250 mcg/m² daily by continuous IV infusion over 24 hr or once daily by SC inj with leucapheresis usually starting on day 5 and continued daily until protocol specified targets are reached. Reduce dose by half if WBC>50,000 cells/mm³. Consider other mobilisation therapy if the numbers of progenitor cells that are collected are inadequate.

Contraindications

Hypersensitivity. Patients with excessive leukaemic myeloid blasts in the bone marrow or peripheral blood (≥10%). 24 hr before or after radiotherapy or chemotherapy.

Special Precautions

Pregnancy; lactation; fluid retention; heart failure; pulmonary disease; any pre-malignant or malignant myeloid condition. Withdraw treatment in patients who develop signs of pulmonary infiltrates. Monitor CBC, renal and hepatic function regularly during therapy. Patients with hypoxia.

Adverse Reactions

Transient hypotension; flushing; bone and musculoskeletal pain; fever, chills, dyspnoea; rash; fatigue; GI effects; anaphylactic reactions, pleural and pericardial effusion; cardiac rhythm abnormalities. Antibodies have been detected.

Overdosage

Overdosage may lead to increased leukocyte counts, dyspnoea, malaise, nausea, fever and rash. Treatment includes discontinuing the drug immediately and monitor for signs of respiratory symptoms and leukocytosis.

Drug Interactions

Action may be potentiated by lithium and corticosteroids.

Action

Description: Sargramostim, a recombinant human granulocyte-macrophage colony-stimulating factor, acts as a haematopoietic growth factor stimulating the development of WBC, particularly granulocytes, macrophages and monocytes.

Storage

Store at 2-8°C.

MIMS Class

Haematopoietic Agents

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