Filgrastim


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : SC Mobilisation of peripheral blood progenitor cells 10 mcg/kg/day for 4-7 days until the last leucapheresis procedure. Congenital neutropenia 12 mcg/kg/day. Idiopathic or cyclic neutropenia 5 mcg/kg/day. HIV infection and persistent neutropenia Initial: 1 mcg/kg/day, up to 4 mcg/kg/day until neutrophil count is normalised. Maintenance: 300 mcg/day. Max: 4 mcg/kg/day. IV/SC Chemotherapy-induced neutropenia 5 mcg/kg/day, starting not <24 hr after the last antineoplastic dose. Continue until neutrophil count has normalised. Bone marrow transplantation 10 mcg/kg/day, adjust according to response.
Dosage Details
Parenteral
Chemotherapy-induced neutropenia
Adult: 5 mcg/kg daily as a single daily SC inj, as a continuous IV or SC infusion, or as a daily IV infusion over 15-30 minutes, starting not <24 hr after the last dose of antineoplastic. Continue treatment until neutrophil count has stabilised within the normal range which may take up to 14 days or more.

Parenteral
Bone marrow transplantation
Adult: 10 mcg/kg daily by IV infusion over 30 min or 4 hr or continuous IV or SC infusion over 24 hr. Adjust according to response.

Subcutaneous
Mobilisation of peripheral blood progenitor cells for autologous peripheral blood stem cell transplantation
Adult: 10 mcg/kg daily, as a single inj or by continuous infusion, for 4-7 days until the last leucapheresis procedure. If it is given after myelosuppressive chemotherapy: 5 mcg/kg daily by inj; given from the 1st day after chemotherapy completion until expected neutrophil nadir is passed and neutrophil count has returned to normal range, so that leucapheresis can be performed.

Subcutaneous
Congenital neutropenia
Adult: 12 mcg/kg daily in single or divided doses. Adjust according to response. In patients with cyclic or idiopathic neutropenia: 5 mcg/kg daily in single or divided doses. Adjust according to response.

Subcutaneous
HIV infection and persistent neutropenia
Adult: Initially, 1 mcg/kg daily. Dose may be increased to 4 mcg/kg daily until normal neutrophil count is achieved. Maintenance: 300 mcg daily. Max: 4 mcg/kg daily.
Contraindications
Myeloid malignancies. Not to be used within 24 hr of cytotoxic chemotherapy admin due to the sensitivity of rapidly dividing myeloid cells. Severe congenital neutropaenia (Kostman's syndrome) with abnormal cytogenetics.
Special Precautions
Premalignant or malignant myeloid condition; sickle-cell disease; osteoporotic bone disease; withdraw treatment if there are signs of pulmonary infiltrates. Fluid retention or heart failure. Monitor CBC and platelet count during therapy. Monitor bone density in patients with osteoporosis (long-term treatment). Regular morphological and cytogenic bone-marrow examinations in severe congenital neutropenia. Pregnancy and lactation.
Adverse Reactions
Musculoskeletal pain, bone pain, hypersensitivity reactions, splenic enlargement, hepatomegaly, thrombocytopaenia, anaemia, epistaxis, headache, nausea, vomiting, diarrhoea, urinary abnormalities (dysuria, proteinuria, haematuria), osteoporosis, exacerbation of rheumatoid arthritis, transient decrease in blood glucose, raised uric acid, cutaneous vasculitis, transient hypotension.
Potentially Fatal: Pulmonary infiltrates leading to resp failure or acute resp distress syndrome.
IM/Parenteral/SC: C
Drug Interactions
Myelosuppressive antineoplastic agents. Drugs which may potentiate the release of neutrophils e.g. lithium.
Lab Interference
May lead to transient positive bone imaging changes.
Action
Description: Filgrastim is a granulocyte-colony stimulating factor which binds to cell surface receptors on haemetopoietic cells thus stimulating the development of granulocytes to increase their migration and cytotoxicity.
Onset: Approximately 24 hr.
Pharmacokinetics:
Absorption: Serum concentrations peak about 8 hr after SC admin.
Excretion: Elimination half-life: About 3.5 hr. Mainly eliminated by neutrophil-mediated clearance.
Storage
Refrigerate at 2-8°C. Do not freeze.
Disclaimer: This information is independently developed by MIMS based on Filgrastim from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
  • Ficocyte
  • Grastim
  • Leukokine
  • Neupogen
  • ReliGrast
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in