Generic drug: pegfilgrastim-bmez
Brand name: Ziextenzo
What is Ziextenzo (pegfilgrastim-bmez), and how does it work?
Ziextenzo (pegfilgrastim-bmez) is a man-made form of granulocyte colony-stimulating factor (GCSF). G-CSF is a substance produced by the body. It stimulates the growth of neutrophils, a type of white blood cell important in the body’s fight against infection.
Do not take Ziextenzo if you have had a serious allergic reaction to pegfilgrastim products or filgrastim products.
What are the side effects of Ziextenzo?
Ziextenzo may cause serious side effects, including:
- Spleen Rupture. Your spleen may become enlarged and can rupture. A ruptured spleen can cause death. Call your healthcare provider right away if you have pain in the left upper stomach area or your left shoulder.
- A serious lung problem called Acute Respiratory Distress Syndrome (ARDS). Call your healthcare provider or get emergency help right away if you have shortness of breath with or without a fever, trouble breathing, or a fast rate of breathing.
- Serious allergic reactions. Ziextenzo can cause serious allergic reactions. These reactions can cause a rash over your whole body, shortness of breath, wheezing, dizziness, swelling around your mouth or eyes, fast heart rate, and sweating. If you have any of these symptoms, stop using Ziextenzo and call your healthcare provider or get emergency medical help right away.
- Sickle cell crises. You may have a serious sickle cell crisis, which could lead to death, if you have a sickle cell disorder and receive Ziextenzo. Call your healthcare provider right away if you have symptoms of sickle cell crisis such as pain or difficulty breathing.
- Kidney injury (glomerulonephritis). Ziextenzo can cause kidney injury. Call your healthcare provider right away if you develop any of the following symptoms:
- swelling of your face or ankles
- blood in your urine or dark colored urine
- you urinate less than usual
- Increased white blood cell count (leukocytosis). Your healthcare provider will check your blood during treatment with Ziextenzo.
- Capillary Leak Syndrome. Ziextenzo can cause fluid to leak from blood vessels into your body’s tissues. This condition is called “Capillary Leak Syndrome” (CLS). CLS can quickly cause you to have symptoms that may become life-threatening. Get emergency medical help right away if you develop any of the following symptoms:
- Inflammation of the aorta (aortitis). Inflammation of the aorta (the large blood vessel which transports blood from the heart to the body) has been reported in patients who received pegfilgrastim. Symptoms may include fever, abdominal pain, feeling tired, and back pain. Call your healthcare provider if you experience these symptoms.
The most common side effects of Ziextenzo are pain in the bones, arms, and legs. These are not all the possible side effects of Ziextenzo. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800- FDA-1088.
What is the dosage for Ziextenzo?
Patients With Cancer Receiving Myelosuppressive Chemotherapy
The recommended dosage of Ziextenzo is a single subcutaneous injection of 6 mg administered once perchemotherapy cycle. For dosing in pediatric patients weighing less than 45 kg, refer to Table 1. Do notadminister Ziextenzo between 14 days before and 24 hours after administration of cytotoxic chemotherapy.
Administration
- Ziextenzo is administered subcutaneously via a single-dose prefilled syringe for manual use.
- Prior to use, remove the carton from the refrigerator and allow the Ziextenzo prefilled syringe to reach roomtemperature for a minimum of 15-30 minutes. Discard any prefilled syringe left at room temperature for greater than 120 hours.
- Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Ziextenzo is supplied as a clear and colorless toslightly yellowish solution. Do not administer Ziextenzo if discoloration or particulates are observed.
- The needle cap on the prefilled syringes contains dry natural rubber (derived from latex) which may cause allergic reactions; persons with latex allergies should not administer these products.
Pediatric Patients Weighing Less Than 45 kg
- The Ziextenzo prefilled syringe is not designed to allow for direct administration of doses less than 0.6 mL(6 mg).
- The syringe does not bear graduation marks, which are necessary to accurately measure doses of Ziextenzo less than 0.6 mL (6 mg) for direct administration to patients. Thus, the direct administration to patients requiring dosing of less than 0.6 mL (6 mg) is not recommended due to the potential for dosing errors. Refer to Table 1.
Table 1: Dosing of Ziextenzo for pediatric patients weighing less than 45 kg
Body Weight | Ziextenzo Dose | Volume to Administer |
Less than 10 kg* | See below* | See below* |
10 -20 kg | 15 mg | 0.15 mL |
21 -30 kg | 2.5 mg | 0.25 mL |
31 -44 kg | 4 mg | 0.4 mL |
*For pediatric patients weighing less than 10 kg, administer 0.1 mg/kg (0.01 mL/kg) of Ziextenzo. |

SLIDESHOW
Skin Cancer Symptoms, Types, Images See SlideshowIs Ziextenzo safe to use while pregnant or breastfeeding?
- Although available data with Ziextenzo or pegfilgrastim product use in pregnant women are insufficient to establish whether there is a drug associated risk of major birth defects, miscarriage, or adverse maternal or fetaloutcomes, there are available data from published studies in pregnant women exposed to filgrastim products.
- These studies have not established an association of filgrastim product use during pregnancy with major birth defects, miscarriage, or adverse maternal or fetal outcomes.
- There are no data on the presence of pegfilgrastim products in human milk, the effects on the breastfed child, orthe effects on milk production.
- Other filgrastim products are secreted poorly into breast milk, and filgrastimproducts are not absorbed orally by neonates.
- The developmental and health benefits of breastfeeding should beconsidered along with the mother's clinical need for Ziextenzo and any potential adverse effects on thebreastfed child from Ziextenzo or from the underlying maternal condition.
Health News
Summary
Ziextenzo (pegfilgrastim-bmez) is a man-made form of granulocyte colony-stimulating factor (GCSF). G-CSF is a substance produced by the body. It stimulates the growth of neutrophils, a type of white blood cell important in the body’s fight against infection. Serious side effects of Ziextenzo include spleen rupture, Acute Respiratory Distress Syndrome (ARDS), serious allergic reactions, sickle cell crises, kidney injury, increased white blood cell count (leukocytosis), Capillary Leak Syndrome, and inflammation of the aorta (aortitis).
Multimedia: Slideshows, Images & Quizzes
-
Understanding Cancer: Metastasis, Stages of Cancer, and More
Learn the basics about cancer including types, causes, how it spreads, symptoms and signs, stages and treatment options. Read...
-
Signs of Cancer in Women: Symptoms You Can't Ignore
Colon and stomach cancer symptoms can surprise women but can be treated if detected early. Learn about breast cancer signs and...
-
Cancer: Guide to Leukemia
Learn about the common types and stages of leukemia, who gets it, symptoms, tests, treatments, and more. People with blood cancer...
-
Cancer-Fighting Foods: Resveratrol, Green Tea, and More
Experts have praised certain foods for their ability to reduce cancer risks. Learn which foods and eating strategies may help...
-
Top 10 Cancers Quiz
Take this quiz to learn the causes of cancer. Get the facts about the causes, symptoms, and treatments for the world's most...
-
Cancer: Visual Guide to Thyroid Cancer
Find out the symptoms of thyroid cancer, and learn how to treat it after you get a diagnosis.
-
Cancer: Does This Cause Cancer?
Everything gives you cancer, right? Not really. WebMD's slide show tells you about the research into cancer and cell phones,...
-
Cancer: How to Lower and Cut Your Risk of Cancer
About a third of all cases of cancer can be prevented. Find out how to lower your chances of getting it.
-
Cancer: Symptoms of Common Cancers in Men
Can men get breast cancer? Cancer symptoms men need to watch out for include skin changes, difficulty swallowing, rapid weight...
-
Cancer: Guide to Testicular Cancer
Testicular cancer is one of the most common cancers for men ages 15 to 35, but it's very treatable. WebMD explains when to see...
-
Cancer: Cancer 'Remedies' That Don't Work
You may have read about an all-natural cure for cancer. While many therapies are helpful, some aren't worth your time or money....
Related Disease Conditions
-
Cancer
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
-
Cancer Risk Factors and Causes
Though it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing cancer. These risk factors include growing older, family history of cancer, diet, alcohol and tobacco use, and exposure to sunlight, ionizing radiation, certain chemicals, and some viruses and bacteria.
-
At What Stage of Cancer is Chemotherapy Used?
The decision to use chemotherapy may vary depending on the aggressiveness, stage and type of cancer. Usually, chemotherapy may be used for all stages in most cancer types. Chemotherapy is a type of medicine or combination of medications that is used to treat or kill cancer cells.
-
Which Cancer Is the Most Painful?
Cancer spreading to the bone is the most painful type of cancer. Pain can be caused by a tumor pressing on the nerves around the bone. As the tumor size increases, it can release chemicals that irritate the area around the tumor.
-
What Type of Cancer Makes You Very Tired?
Extreme and recurrent tiredness is one of the common symptoms of most types of cancers. Tiredness is usually considered a warning sign of cancer progressing. Tiredness related to cancers usually does not get better with adequate rest or sleep.
-
Is Cancer Contagious?
Cancer is an abnormal growth of cells. A variety of parasites and viruses have been linked to various cancers. Cancer may metastasize, spreading from its original location to other organs. If you have cancer, you should seek medical care immediately if you experience high fever, shortness of breath, intense headaches, vomiting blood or passing blood rectally, chest pain or moderate to severe weakness, passing out (fainting), mental status changes, or seizures.
-
What Is the Breast Cancer BRCA Gene Test?
BRCA genes (BRCA 1 and 2, when normal, repair damaged DNA) are among the genetic mutations linked to breast cancer, ovarian cancer, and other cancers when mutated. Every woman with a BRCA mutation is at high risk for breast cancer, irrespective of whether she has a family history of breast cancer or not. By age 80, a woman with a BRCA mutation has about an 80% chance of developing breast cancer. BRCA1 and BRCA2 gene mutations also increase the risk of ovarian cancer, by 54% and 23%, respectively.
-
Which Is the Deadliest Cancer?
Lung cancer is considered to be the most deadly cancer. More people die from lung cancer each year than from breast, colorectal and prostate cancer combined.
-
What Is the Number 1 Cause of Cancer?
Cancer refers to a collection of large number of diseases characterized by the development of abnormal cells that divide uncontrollably and can infiltrate and destroy the normal body tissue.
-
Cancer Pain
Cancer pain is a common experience that may result from the disease, treatment, or diagnostic procedure. Check out the center below for more medical references on cancer, including multimedia (slideshows, images, and quizzes), related disease conditions, treatment and diagnosis, medications, and prevention or wellness.
-
How Can You Get Cancer?
Cancer is the second leading cause of death worldwide. It refers to uncontrolled growth of the cells that results in overgrowth of the organ it affects along with a tendency to spread to nearby and distant sites in the body.
-
What Are the Top Ten Cancers?
Lung cancer is the number one killer cancer in the world. It is the most common cause of cancer-related deaths in both men and women.
-
What Are the 15 Common Signs of Cancer?
The term cancer is given to a group of diseases characterized by the uncontrolled growth of abnormal cells in the body. Some of the common signs of cancer include unintended weight loss, fatigue, bleeding, presence of a mass, persistent cough, abdominal pain and other signs.
-
Guide for COVID-19 Vaccine for Cancer Patients
The authorities have jointly agreed that patients on active cancer treatment are at a higher risk of COVID-19 infection and complications. Hence, there is a necessity to prioritize patients with cancer for the COVID-19 vaccine.
Treatment & Diagnosis
- Cancer: The Importance of Joining a Cancer Support Group with Selma Schimmel
- Cancer Survival and Attitude with Hamilton Jordan
- Cancer: Confronting Cancer with Humor
- Cancer Research: Going the Distance
- Cancer and Green Tea
- Cancer Pain Management with Ann Reiner
- Cancers: Children's Cancers
- Cancer: Childhood Cancer Survivors
- Cancer Patients Need Proper Diet and Exercise
- Cancer: Living Well Despite with Win Boerckel
- Cancer Treatment: Writing to Heal with Margie Davis
- Cancer: Journaling to Save Your Life
- Cancer: Emotional Aftershocks: When Cancer Comes Back 10/30/02
Medications & Supplements
Health Solutions From Our Sponsors

Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.