filgrastim, Neupogen

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GENERIC NAME: filgrastim

BRAND NAME: Neupogen

DRUG CLASS AND MECHANISM: Filgrastim is a man-made protein that is similar to the naturally occurring protein, granulocyte-colony stimulating factor (G-CSF). G-CSF is produced in the body by the immune system and stimulates the formation of one type of white blood cell, the neutrophil. Neutrophils take part in the inflammatory reaction. They are responsible for detecting and destroying harmful bacteria and some fungi. Filgrastim is produced by bacteria through the use of genetic engineering and recombinant DNA technology. Filgrastim belongs to a class of drugs called colony-stimulating factors because of their ability to stimulate cells in the bone marrow to multiply and form colonies of new cells. Other CSFs include epoetin alfa (Epogen, Procrit) which stimulates the formation of red blood cells and sargramostim (Leukine) which also stimulates the formation of neutrophils. The FDA approved filgrastim in February 1991.



PREPARATIONS: Filgrastim is available as a liquid for injection in vials or pre-filled syringes containing 300 or 480 micrograms of drug.

STORAGE: Filgrastim should be stored at 2 C to 8 C (36 F to 46 F) and should not be frozen.

PRESCRIBED FOR: Filgrastim is used to prevent infectious complications associated with a decrease in the number of neutrophils in the body (neutropenia). Neutropenia may develop in cancer patients receiving chemotherapy or undergoing bone marrow transplantation. Neutropenia also may occur for unknown reasons in adults and infants. Filgrastim is used in healthy patients who will be donating bone marrow if their white blood cell counts are low.

DOSING: The recommended dose is 5 to 10 mcg/kg per day. Filgrastim is administered intravenously or subcutaneously (under the skin) for 6 to 14 days. Filgrastim vials should not be shaken since the drug may be damaged, and bubbles may form that can prevent some of the drug from being drawn up into the syringe at the time of injection.

DRUG INTERACTIONS: No clinical studies have been done to determine if filgrastim interacts with other drugs.

PREGNANCY: There are no studies of filgrastim use in pregnant women. Women who become pregnant while receiving filgrastim should enroll in Amgen's Pregnancy Surveillance Program (1-800-772-6436).

NURSING MOTHERS: There are no studies to determine if filgrastim is excreted into breast milk.

SIDE EFFECTS: The most common side effect are nausea, vomiting, bone pain, fever, fatigue, hair loss, and diarrhea. Headache, weight loss, shortness of breath, mouth sores, and rash also occur. Uric acid, lactate dehydrogenase, and alkaline phosphatase levels may rise and spontaneously return to normal levels. Heart attacks and abnormal heart rhythm have been reported.

Reference: FDA Prescribing Information

Medically Reviewed by a Doctor on 11/12/2012

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