Uses
What is filgrastim used for?
Filgrastim is commonly used to help prevent infection in people who have low levels of white blood cells, also called neutropenia. Neutropenia can be caused by certain medical conditions and types of chemotherapy or radiation.
Filgrastim may also be used to increase the amount of stem cells available for collection before a stem cell transplant.
Filgrastim may also be used for other conditions as determined by your healthcare provider.
How does filgrastim work (mechanism of action)?
Filgrastim stimulates the growth of a type of cell in your body called neutrophils. Neutrophils help you to fight infection.
How is filgrastim supplied (dosage forms)?
Filgrastim is available as Neupogen, Nivestym, Releuko, and Zarxio in the following dosage forms that are injected.
- 300 mcg/0.5 mL solution for injection (prefilled syringe)
- 480 mcg/0.8 mL solution for injection (prefilled syringe)
- 300 mcg/1 mL solution for injection (vial)
- 480 mcg/1.6 mL solution for injection (vial)
How should I store filgrastim?
Filgrastim should be stored in a refrigerator, between 36 F to 46 F (2 C to 8 C). Do not freeze. If accidentally frozen, thaw in the refrigerator before using it. Throw away any filgrastim that has been frozen more than 1 time. Store in a cool, dry place. Keep in the original carton to protect filgrastim from light.
Side Effects
What are the most common side effects of filgrastim?
The most common side effects of filgrastim are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Fever
- Pain
- Skin rash
- Cough
- Breathing problems
- Bone pain
- Headache
- Anemia
- Nose bleed
- Diarrhea
- Numbness
- Hair loss
There may be other side effects of filgrastim that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of filgrastim?
While less common, the most serious side effects of filgrastim are described below, along with what to do if they happen.
Severe Allergic Reactions. Filgrastim can cause allergic reactions, which can be serious. Stop using filgrastim and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Spleen Enlargement or Rupture. Filgrastim can cause your spleen to get bigger or rupture. A ruptured spleen can cause death. Stop using filgrastim and call your healthcare provider if you have pain in your left shoulder or left upper stomach area.
Acute Respiratory Distress Syndrome (ARDS). Filgrastim can cause a serious lung problem called ARDS. Stop taking filgrastim and call your healthcare provider if you have trouble breathing, shortness of breath, or fast breathing with or without a fever.
Kidney Damage (Glomerulonephritis). Filgrastim can cause a type of kidney problem called glomerulonephritis. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.
- Reduced need to pee
- Swelling in your face or ankles
- Blood in your pee or dark-colored pee
Capillary Leak Syndrome. Filgrastim may cause fluid to move out of your blood vessels into body tissues, which can cause death. Call your healthcare provider right away if you have any of the following symptoms.
- Reduced need to pee
- Swelling in your arms, hands, feet, ankles, or legs
- Trouble breathing
- Swelling in your stomach area or feeling full
- Dizziness, feeling lightheaded, or fainting
- Weakness or unusual tiredness
Low Platelets (Thrombocytopenia). Filgrastim can lower the amount of a type of cell in your body called platelets. You need platelets to form a blood clot. Tell your healthcare provider and stop taking filgrastim if you have bleeding or bruising, which could be a sign of low platelets.
High White Blood Cells (Leukocytosis). Filgrastim can increase the amount of a type of cell in your body called white blood cells. A healthcare provider will check your white blood cells while you are taking filgrastim.
Inflammation of Blood Vessels (Cutaneous Vasculitis). Filgrastim may cause inflammation of your blood vessels. Tell your healthcare provider right away if you develop purple spots or redness of your skin.
Inflammation of the Aorta (Aortitis). Filgrastim may cause inflammation of your aorta, which is a large blood vessel that brings blood from your heart to the rest of your body. Call your healthcare provider if you have any of the following symptoms of aortitis.
- Fever
- Stomach or back pain
- Tiredness
Warnings & Precautions
Who should not use filgrastim?
Allergies to Ingredients. People who are allergic to any of the following should not use filgrastim.
- Neupogen
- Zarxio
- Nivestym
- Releuko
- Filgrastim
- Any other medicine known as a human granulocyte colony-stimulating factor such as pegfilgrastim
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific filgrastim products they stock.
What should I know about filgrastim before using it?
Do not use filgrastim unless it has been prescribed to you by a healthcare provider. Use it as prescribed.
Do not share filgrastim with other people, even if they have the same condition as you. It may harm them.
Keep filgrastim out of the reach of children. Since this medicine must be kept in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.
Only use filgrastim if your healthcare provider has trained you or your caregiver on how to use it.
Do not shake filgrastim. Do not inject where your skin is thickened or bruised.
If you are using filgrastim because you are getting chemotherapy, use filgrastim at least 24 hours before or 24 hours after chemotherapy.
If you or your caregiver will be giving filgrastim, read and follow the instructions for use that you can get from your pharmacist.
Take filgrastim out of the refrigerator for 30 minutes before preparing your dose. After you inject your dose, throw away any unused filgrastim.
You will need to have your blood checked while using filgrastim. Keep all appointments to check your blood.
What should I tell my healthcare provider before using filgrastim?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if filgrastim is right for you.
In particular, make sure that you discuss any of the following.
Breast or Lung Cancer. Filgrastim may increase the risk of a type of cancer called acute myeloid leukemia (AML) or a condition called myelodysplastic syndrome in certain people. If you have breast cancer or lung cancer and use filgrastim with chemotherapy and/or radiation therapy, call your healthcare provider if you become more tired than usual, have easy bruising or bleeding, and fever.
Congenital Neutropenia. Filgrastim may increase the risk of a type of cancer called acute myeloid leukemia (AML) or a condition called myelodysplastic syndrome in certain people. If you have congenital neutropenia, call your healthcare provider if you become more tired than usual, have easy bruising or bleeding, and fever.
Sickle Cell Disorder. Tell your healthcare provider if you have sickle cell disorder. Filgrastim may cause sickle cell crisis in people who have this condition. Call your healthcare provider and stop taking filgrastim if you have symptoms such as pain or difficulty breathing.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Kidney problems
- Receiving radiation therapy
- Allergic to latex
- Upcoming bone scan or test
Pregnancy. It is not known if or how filgrastim could affect your pregnancy or unborn baby. Tell your healthcare provider if you are or plan to become pregnant.
Breastfeeding. It is not known if filgrastim passes into your breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.
Interactions
Does filgrastim interact with foods or drinks?
There are no known interactions between filgrastim and foods or drinks.
It is unknown if drinking alcohol will affect filgrastim.
Does filgrastim interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
Overdose/Missed Dose
What should I do if I accidentally use too much filgrastim?
If you or someone else has used too much filgrastim, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of filgrastim?
If you miss a dose of filgrastim, talk to your healthcare provider about when to use your next dose.
Are you currently using Filgrastim?
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