filgrastim Injection

fil-GRA-stim

Commonly used brand name(s)

In the U.S.

• Neupogen

Available Dosage Forms:

• Solution


• Injectable

Therapeutic Class: Hematopoietic

Pharmacologic Class: Colony Stimulating Factor

Uses For filgrastim

Filgrastim is a synthetic (man-made) version of a substance that is naturally produced in your body called a colony stimulating factor. It helps the bone marrow to make new white blood cells.

When certain cancer medicines are used to fight cancer cells, they also affect the white blood cells that fight infections. Filgrastim is used to prevent or reduce the risk of infection while you are being treated with cancer medicines. filgrastim is also used to help the bone marrow recover after a bone marrow transplantation, and for a process called peripheral blood progenitor cell collection in cancer patients.

filgrastim is available only with your doctor's prescription.

Before Using filgrastim

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For filgrastim, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to filgrastim or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of filgrastim in children. However, safety and efficacy have not been established in patients with autoimmune neutropenia and babies younger than 1 month of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of filgrastim in the elderly. .

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking filgrastim, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using filgrastim with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Topotecan


• Vincristine


• Vincristine Liposome

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of filgrastim. Make sure you tell your doctor if you have any other medical problems, especially:

• Bleeding problems or


• Lung disease or breathing problems or


• Sickle cell disease (red blood cell disease) or


• Skin disorders (e.g., cutaneous vasculitis)—Use with caution. May make these conditions worse.

• Bone marrow problems (e.g., chronic myeloid leukemia [CML], myelodysplastic syndrome [MDS])—It is not known if filgrastim will work in patients with these conditions.

• Peripheral blood progenitor cell (PBPC) mobilization—Use of filgrastim is not recommended for PBPC mobilization in healthy donors.

Proper Use of filgrastim

A nurse or other trained health professional may give you filgrastim. filgrastim is given as a shot under your skin or into a vein.

You may be taught how to give filgrastim at home. Make sure you understand all of the instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.

filgrastim comes with patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions about:

• How to prepare the injection.


• The proper use of disposable syringes.


• How to give the injection.


• How long the injection can be stored at home.

If you have any questions about any of this, check with your doctor.

filgrastim can be used for several different reasons, so there are different schedules for using it. Make sure you understand your personal schedule.

Dosing

The dose of filgrastim will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of filgrastim. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For injectable dosage form:
  
  • To increase white blood cells:
    
    • Adults and children—Dose is based on body weight and must be determined by your doctor.
    
    
    • Newborn babies—Use and dose must be determined by your doctor.
    
    
  
  

Missed Dose

filgrastim needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.

Storage

Store in the refrigerator. Do not freeze.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

Precautions While Using filgrastim

It is very important that your doctor check the progress of you or your child at regular visits to make sure filgrastim is working properly. Blood tests may be needed to check for unwanted effects.

Check with your doctor right away at the first sign of any infection such as fever, chills, cough, sore throat, or unusual tiredness or weakness.

filgrastim may cause serious allergic reactions that requires immediate medical attention. Tell your doctor right away if you or your child have a rash; itching skin; dizziness, lightheadedness, or fainting; swelling of the face, tongue, or throat; trouble with breathing; or chest pain after you receive the medicine.

Check with your doctor right away if you or your child are having a pain in the upper left part of your abdomen (stomach) or at the tip of the left shoulder. This could be a symptom of a serious side effect with the spleen.

Stop using filgrastim and check with your doctor right away if you or your child develop fever, shortness of breath, chest pain or tightness, trouble with breathing, or wheezing. These could be symptoms of a serious lung condition called acute respiratory distress syndrome (ARDS).

filgrastim may also cause bleeding in your lungs. Check with your doctor right away if you or your child cough up blood or if you have blood in your sputum (spit).

The needle cover of the prefilled syringe contains dry natural rubber (a derivative of latex), which may cause an allergic reaction in people who are sensitive to latex. Tell your doctor if you or your child have a latex allergy before you start using filgrastim.

You or your child should not receive filgrastim within 24 hours (1 day) before and after you receive cancer medicines or radiation treatments.

filgrastim Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Abdominal or stomach pain


• bleeding gums


• bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site


• blood in the urine or stools


• bloody nose


• cough


• coughing up blood


• decrease in height


• diarrhea


• difficult or labored breathing


• difficulty with swallowing


• dizziness


• facial swelling


• feeling of fullness


• fever or chills


• headache


• increased menstrual flow or vaginal bleeding


• lower back or side pain


• nausea or vomiting


• nosebleeds


• pain in the back, ribs, arms, or legs


• pain spreading to the left shoulder


• painful or difficult urination


• pale skin


• paralysis


• pinpoint red or purple spots on the skin


• prolonged bleeding from cuts


• red or black, tarry stools


• red or dark brown urine


• shortness of breath


• skin rash


• sore throat


• sores, ulcers, or white spots on the lips, tongue, or inside the mouth


• tightness in the chest


• troubled breathing with exertion


• unusual bleeding or bruising


• unusual tiredness or weakness


• wheezing

Less common

• Blurred vision


• chest pain


• nervousness


• pounding in the ears


• slow or fast heartbeats

Incidence not known

• Blisters on the skin


• blue lips, fingernails, or skin


• difficult or fast breathing


• sores on the skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Bone, joint, or muscle pain


• hair loss or thinning of the hair


• loss of appetite


• weight loss

Less common

• Cracked lips


• difficulty having a bowel movement (stool)


• swelling or inflammation of the mouth

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: filgrastim Injection side effects (in more detail)

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More filgrastim Injection resources

• Filgrastim Injection Side Effects (in more detail)
• Filgrastim Injection Use in Pregnancy & Breastfeeding
• Filgrastim Injection Drug Interactions
• Filgrastim Injection Support Group
• 0 Reviews for Filgrastim Injection - Add your own review/rating

Compare filgrastim Injection with other medications

• Aplastic Anemia
• Bone Marrow Transplantation
• Myelodysplastic Syndrome
• Neutropenia
• Neutropenia Associated with AIDS or Zidovudine
• Neutropenia Associated with Chemotherapy
• Peripheral Progenitor Cell Transplantation
• Sepsis