filgrastim


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Related to filgrastim: Sargramostim

filgrastim

 [fil-gras´tim]
a human granulocyte colony-stimulating factor produced by recombinant technology; used to enhance neutrophil function, stimulating hematopoiesis and decreasing neutropenia; administered intravenously or subcutaneously.

filgrastim

Neupogen

Pharmacologic class: Granulocyte colony-stimulating factor

Therapeutic class: Hematopoietic stimulator, antineutropenic

Pregnancy risk category C

Action

Induces formation of neutrophil progenitor cells by binding directly to receptor on surface granulocyte, stimulating cell proliferation and differentiation. Also potentiates effects of mature neutrophils and reduces fever and risk of infection associated with severe neutropenia.

Availability

SingleJect prefilled syringes: 300 mcg, 480 mcg

Vial for injection: 300 mcg/ml, 480 mcg/1.6 ml

Indications and dosages

To prevent infection after myelosuppressive chemotherapy

Adults: 5 mcg/kg/day by subcutaneous injection or I.V. infusion over 15 to 30 minutes, or continuous subcutaneous or continuous I.V. infusion, increased by 5 mcg/kg with each chemotherapy cycle if needed

Neutropenia after bone marrow transplantation

Adults: 10 mcg/kg/day I.V. over 4 or 24 hours or as a continuous subcutaneous infusion over 24 hours

To enhance peripheral blood progenitor cell collection in autologous hematopoietic stem cell transplantation

Adults: 10 mcg/kg/day by subcutaneous injection or as continuous subcutaneous infusion, starting 4 days before first leukapheresis procedure and continuing until last day of leukapheresis

Neutropenia in congenital neutropenia

Adults: 6 mcg/kg subcutaneously b.i.d.

Neutropenia in idiopathic or cyclic neutropenia

Adults: 5 mcg/kg/day subcutaneously

Off-label uses

• AIDS

• Aplastic anemia

• Hairy cell leukemia

• Myelodysplasia

Contraindications

• Hypersensitivity to drug, its components, or Escherichia coli-derived proteins

Precautions

Use cautiously in:

• patients receiving lithium or other drugs that can potentiate neutrophil release

• breastfeeding patients.

Administration

• Know that drug may be injected into venous return line of dialysis tubing after dialysis is completed.

To dilute for I.V. administration, use dextrose 5% in water. Never use saline solution, because it may cause drug to precipitate.

• Administer single dose intermittently over 15 to 30 minutes or by continuous infusion over 4 to 24 hours.

• Don't mix with other drugs, and don't shake.

• Don't give within 24 hours of chemotherapy, bone marrow transplantation, or radiation therapy.

Adverse reactions

CNS: headache, weakness

CV: chest pain, hypotension, transient supraventricular tachycardia, myocardial infarction, arrhythmias

EENT: sore throat

GI: nausea, vomiting, diarrhea, constipation, abdominal pain, splenomegaly, stomatitis

GU: bleeding

Hematologic: leukocytosis, sickle cell crisis, thrombocytopenia, splenic rupture

Metabolic: hyperuricemia

Musculoskeletal: bone, joint, muscle, arm, or leg pain

Respiratory: dyspnea, cough

Skin: pruritus, rash, erythema, alopecia, cutaneous necrotic vasculitis

Other: fever, mucositis, pain at injection site, edema, hypersensitivity reactions

Interactions

Drug-drug. Lithium: increased neutrophil production

Topotecan: prolonged neutropenia

Vincristine: increased risk of severe atypical peripheral neuropathy

Drug-diagnostic tests. Alkaline phosphatase, creatinine, lactate dehydrogenase, uric acid: increased levels

Platelets: decreased count

Patient monitoring

• Obtain CBC with platelet count before starting therapy; monitor these counts often thereafter.

• Monitor cardiovascular status carefully.

• Assess for signs and symptoms of sickle cell crisis and splenic rupture.

Patient teaching

• Teach patient how to recognize and promptly report signs and symptoms of allergic response.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• Advise patient to discuss possible need for iron supplements, vitamin B12, and folic acid with prescriber.

• Teach patient how to monitor blood pressure at home.

• Advise patient to minimize GI upset by eating small, frequent servings of food and drinking adequate fluids.

• Tell female patient to inform prescriber if she is breastfeeding.

• Inform patient that he'll undergo regular blood testing during therapy.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

filgrastim

(fil-gras'tim),
Human granulocyte-stimulating factor produced by recombinant DNA technology.

CSF3

A gene on chromosome 17q11.2-q12 that encodes colony stimulating factor 3 (granulocyte), a cytokine that controls the production, differentiation and function of granulocytes, the active protein product of which is located extracellularly.

filgrastim

Recombinant granulocyte colony-stimulating factor Immunology A colony-stimulating factor that stimulates production of blood cells, especially platelets, during chemotherapy. See Granulocyte colony-stimulating factor.

filgrastim

Human GRANULOCYTE-STIMULATING FACTOR produced by genetic engineering and used to treat severe deficiencies of some of the white cells of the blood and the immune system. A brand name is Neupogen.
References in periodicals archive ?
The study aimed to evaluate the impact of thirteen adjuvant therapies (Intralipid, steroids, melatonin, coenzyme Q10, Filgrastim, testosterone, DHEA, growth hormone, antibiotics, hCG infusion, aspirin, enoxaparin/heparin and dopamine agonists) on the success of embryo transfer, including the clinical pregnancy and live birth rates.
Amgen has marketed Neupogen since 1991 and holds patents on methods of manufacturing and using filgrastim. In July 2014, the FDA accepted Sandoz's application for review.
Representative RT-PCR of ChAT and AChE mRNAs, in the frontal cortex of rats treated with saline (control), filgrastim in dose of 10 and 50 [micro]g/kg and 70 [micro]g/kg are shown in Figure 1.
Secondary objectives were to assess the possible influence of filgrastim on the expression of these markers and the proper functioning of IL-17/IL-23 axis in these patients.
Because of the lack of literature regarding long-term therapy, it is recommended to consider short-term treatment with filgrastim to normalize ANC after a severe drop in a symptomatic patient.
Los individuos que fueron movilizados con filgrastim unicamente tuvieron recuentos de celulas CD34+ en sangre periferica significativamente mas bajos que los de quienes recibieron quimioterapia y filgrastim concomitan temente (38 versus 122 celulas CD34+/[micro]L, p < 0,001).
In this study, we evaluated the oxidative stress and antioxidant parameters in neutropenic patients after chemotherapy both during the neutropenic period and after successful treatment of neutropenia with filgrastim.
The national filgrastim was also approved via the comparative regulatory pathway, being compared to Granulokine.
This is a landmark decision in bringing biosimilars to market in the U.S., and clinicians believe that filgrastim has been underused up until now for various reasons including price.
--Composicion de la formulacion: Retacrit, Silapo, Biograstim, Ratiograstim, Tevagrastim Zarzio y Filgrastim Hexal.
The company already sells in Europe a generic version of a widely used biotech anemia drug under its brand name Retacrit, and last month it gained full global rights to filgrastim, a generic version of Amgen Inc.'s (Thousand Oaks CA) white blood-cell boosting drug Neupogen.