FILGRASTIM

COMMON BRAND NAME(S): Neupogen

GENERIC NAME(S): FILGRASTIM

Description: Filgrastim is a granulocyte-colony stimulating factor, a hematopoetic agent, that works by stimulating the production of white blood cells by bone marrow.

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.

Uses

Filgrastim is a man-made version of a certain natural substance made in your body. It is used to help your body make more white blood cells. White blood cells are important to help you fight off infections. Filgrastim is given to people whose ability to make white blood cells is reduced (for instance, due to chemotherapy, chronic neutropenia, or exposure to large amounts of radiation). It is also used in certain treatment procedures (such as bone marrow/stem cell transplant).

How to use filgrastim injection

Read the Patient Information Leaflet provided by your pharmacist before you start using filgrastim and each time you get a refill. If you have any questions regarding the information, consult your doctor or pharmacist.

This medication is given by injection into a vein or under the skin, usually once a day or as directed by your doctor, until the proper blood counts are reached. Dosage is based on your medical condition, weight, and response to therapy. Use the exact amount of drug prescribed by your doctor. Too little drug may not protect you against infections. Too much drug may cause your body to make too many white blood cells.

If you are giving yourself injections at home, make sure you learn how to prepare and inject this medication properly. If you are injecting this drug under the skin, choose a new injection site each time you give yourself a dose. This will help prevent soreness. Never inject filgrastim into skin that is tender, red, bruised, and hard or has scars or stretch marks. Ask your doctor, pharmacist or nurse any questions you may have about how to give yourself filgrastim. Learn how to properly dispose of used syringes, needles, and any unused medication. Never reuse needles or syringes.

Remove the medication from the refrigerator 30 minutes before you inject it to allow it to reach room temperature.

Avoid shaking this medication; doing so may make the drug ineffective.

Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid.

Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time each day.

If you are receiving cancer chemotherapy, you should not be given filgrastim at the same time. You should receive filgrastim either before or after the chemotherapy, depending on your blood count results and your doctor’s directions.

Warnings

Pregnancy Risk: Category C (cannot be ruled out)

Side Effects

Aching or pain in the bones and muscles may occur. Taking a non-aspirin pain reliever such as acetaminophen may help relieve pain. Ask your doctor or pharmacist for more details. Nosebleeds or injection site reactions such as redness, swelling, itching, lumps or bruising may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

You should check with your doctor immediately if any of these side effects occur when taking filgrastim:

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
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
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

Some of the side effects that can occur with filgrastim may not need medical attention:

More common

Bone, joint, or muscle pain
hair loss or thinning of the hair
loss of appetite

weight loss

Precautions

Before using filgrastim, tell your doctor or pharmacist if you are allergic to it; or to tbo-filgrastim or pegfilgrastim; or if you have any other allergies. This product may contain inactive ingredients (such as dry natural rubber/latex in the needle cover on the prefilled syringe), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: sickle cell disease, spleen problems.

If you are scheduled to have radiation therapy, tell your doctor you are taking filgrastim. This medication should not be given during the time you are receiving radiation therapy.

This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.

It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Filgrastim is very similar to tbo-filgrastim and pegfilgrastim. Do not use tbo-filgrastim or pegfilgrastim while using filgrastim.

This medication may interfere with certain laboratory tests (e.g., bone tests such as bone imaging). Make sure laboratory personnel and all your doctors know you use this drug.

Overdose & Brands

If overdose is suspected, contact a poison control center or emergency room immediately.

Notes

Do not share this medication with others.

This medication must be taken under close medical supervision so your blood counts can be monitored. Laboratory and/or medical tests (e.g., blood and platelet counts) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Missed Dose

For the best possible benefit, it is important to receive each scheduled dose of this medication as directed. If you miss a dose, contact your doctor or pharmacist immediately to establish a new dosing schedule. Do not double the dose to catch up.

Storage

Store in the refrigerator. Do not freeze or leave out in direct sunlight. If this medication is left out of the refrigerator, it is only stable for up to 24 hours. Avoid shaking. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Brands

Available Brands

Leucogen [ Innogene Kalbiotech ]	Macroleuco [ Dong-A ]
Neupogen [ Roche ]	Religrast [ Reliance ]
SciLocyte [ SciGen ]	White-C [ Shandong Kexing ]

Also marketed as

Endufil [ Heber ]

Recombicyte [ Beijing Four Rings ]