Filgrastim

Filgrastim is a prescription medication used to reduce the risk of infection in people with some tumors receiving strong chemotherapy that decreases the number of infection-fighting white blood cells known as neutrophils. Filgrastim belongs to a group of drugs called colony stimulating factors, which stimulate the body to produce neutrophils.

This medication comes in an injectable form that is given just under the skin or directly into a vein (IV), usually once a day.

Common side effects include bone pain and muscle pain.

Filgrastim is a prescription medication used to prevent infections in people getting chemotherapy or bone marrow transplants, or in people who have low neutrophil counts caused by other conditions. It is also used to prepare blood for stem cell collection.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Filgrastim may be found in some form under the following brand names:

• Neupogen

• Zarxio

Serious side effects can occur with filgrastim use. See "Filgrastim Precautions".

The most common side effect is aching in the bones and muscles. This aching can usually be relieved by taking a non-aspirin pain reliever such as acetaminophen.

Some people experience redness, swelling, or itching at the site of injection. This may be an allergy to the ingredients in filgrastim, or it may be a local reaction. If you are giving an injection to a child, look for signs of redness, swelling, or itching at the site of injection because they may not be able to tell you they are experiencing a reaction. If you notice any signs of a local reaction, call your doctor.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take lithium (Eskalith, Lithobid).

This is not a complete list of filgrastim drug interactions ask your doctor or pharmacist for more information.

Do not take filgrastim if you are:

• Allergic to filgrastim or any ingredient in it.

• Allergic to other medicines made using the bacteria E coli. Ask your doctor if you are not sure.

Filgrastim may reduce your chance of getting an infection, but does not prevent all infections. An infection can still happen during the short time when your neutrophil levels are low. You must be alert and look for some of the common signs or symptoms of infection, such as fever, chills, rash, sore throat, diarrhea, or redness, swelling, or pain around a cut or sore. If you have any of these signs or symptoms during treatment with filgrastim, tell your doctor or nurse immediately.

There is a possibility that you could have a reaction at an injection site. If there is a lump, swelling, or bruising at an injection site that does not go away, call your doctor.

If you have a sickle cell disorder, make sure that you tell your doctor before you start taking filgrastim. If you have a sickle cell crisis after getting filgrastim, tell your doctor right away.

Talk to your doctor if you experience unusual bleeding or bruising while taking filgrastim, as this could mean a decrease of platelets which reduces the ability of blood to clot.

If you are receiving filgrastim because you are also receiving chemotherapy, the last dose of filgrastim should be injected at least 24 hours before your next dose of chemotherapy.

The possible serious side effects of filgrastim are:

• Spleen Rupture. Your spleen may become enlarged and can rupture while taking filgrastim. A ruptured spleen can cause death. The spleen is located in the upper left section of your stomach area. Call your doctor right away if you have pain in the left upper stomach area or left shoulder tip area. This pain could mean your spleen is enlarged or ruptured.
• Serious Allergic Reactions. Filgrastim can cause serious allergic reactions. These reactions can cause a rash over the whole body, shortness of breath, wheezing, dizziness, swelling around the mouth or eyes, fast pulse, and sweating. If you start to have any of these symptoms, stop using filgrastim and call your doctor or seek emergency care right away. If you have an allergic reaction during the injection of filgrastim, stop the injection right away.
• A serious lung problem called acute respiratory distress syndrome (ARDS). Call your doctor or seek emergency care right away if you have shortness of breath, trouble breathing or a fast rate of breathing.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of filgrastim there are no specific foods that you must exclude from your diet when receiving this medication.

Tell your doctor if you are allergic to filgrastim or any other ingredient in it.

Tell your doctor about all of your medical conditions, especially if you have any diseases of the blood.

Tell your doctor if you are pregnant or breastfeeding.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell  your doctor if you are pregnant or plan to become pregnant. Filgrastim has not been studied in pregnant women, and its effects on unborn babies are not known. If you take filgrastim while you are pregnant, it is possible that small amounts of it may get into your baby’s blood.

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known if filgrastim is excreted in human breast milk or if it will harm your nursing baby.

If you breastfeed during filgrastim treatment, you are encouraged to enroll in Amgen’s Lactation Surveillance Program. You should call 1-800-77-AMGEN (1-800­ 772-6436) to enroll.

Filgrastim should be injected at the same time each day. If you miss a dose contact your doctor or nurse.

You must always use the correct dose of filgrastim. Too little filgrastim may not protect you against infections, and too much filgrastim may cause too many neutrophils to be in your blood. Your doctor will determine your/your child’s correct dose based on your body weight.

If you are giving someone else filgrastim injections, it is important that you know how to inject filgrastim, how much to inject, and how often to inject filgrastim.

Filgrastim is available as a liquid in vials or in prefilled syringes. When you receive your filgrastim, always check to see that:

• The expiration date on the vial or prefilled syringe label has not passed. You should not use a vial or prefilled syringe after the date on the label.

• The strength of the filgrastim (number of micrograms in the colored dot on the package containing the vial or prefilled syringe) is the same as your doctor prescribed.

• The filgrastim liquid in the vial or in the prefilled syringe is clear and colorless. Do not use filgrastim if the contents of the vial or prefilled syringe appear discolored or cloudy, or if the vial or prefilled syringe appears to contain lumps, flakes, or particles.

If you are using vials of filgrastim only use the syringe that your doctor prescribes.

Your doctor or nurse will give you instructions on how to measure the correct dose of filgrastim. This dose will be measured in milliliters. You should only use a syringe that is marked in tenths of milliliters, or mL (for example, 0.2 mL). The doctor or nurse may refer to an mL as a cc (1 mL = 1 cc). If you do not use the correct syringe, you could receive too much or too little filgrastim.

Only use disposable syringes and needles. Use the syringes only once and dispose of them as instructed by your doctor or nurse.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your weight
• your height
• your age
• your gender

The recommended starting dose of filgrastim is 5 mcg/kg/day‚ given as a single daily injection.

If you take too much filgrastim, call your local Poison Control Center or seek emergency medical attention right away.

• Filgrastim should be stored in the refrigerator at 2º to 8ºC (36º to 46ºF), but not in the freezer.
• Avoid shaking filgrastim.
• If filgrastim is accidentally frozen, allow it to thaw in the refrigerator before giving the next dose. However, if it is frozen a second time, do not use it and contact your doctor or nurse for further instructions.
• Filgrastim can be left out at room temperature for up to 24 hours.
• Do not leave filgrastim in direct sunlight.
• If you have any questions about storage or how to carry filgrastim when you travel, contact your doctor, nurse, or pharmacist.