Indications & Uses
Grastim is indicated for:
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Cancer patients receiving myelosuppressive chemotherapy or induction and/or consolidation chemotherapy for AML: The recommended dose of Filgrastim is 0.5 MU (5 mcg)/kg/day, administered as a single daily subcutaneous injection or by intravenous infusion (over 30 minutes). The first dose shouldn't be administered in less than 24 hours following cytotoxic Chemotherapy. Continue until neutrophil count in normal range, usually for 14 days (up to 38 days in AML.)Cancer patients undergoing bone marrow transplantation: The recommended dosage of Filgrastim following bone marrow transplantation (BMT) is 1.0 MU (10 mcg)/kg/day given as an intravenous infusion no longer than 24 hours. Administer the first dose of Filgrastim at least 24 hours after cytotoxic chemotherapy and at least 24 hours after bone marrow transplantation. Dose adjustment should be accordingly to absolute neutrophil count (ANC).Patients undergoing autologous peripheral blood progenitor cell (PBPC) collection and therapy: The recommended dosage of Filgrastim for the mobilization of autologous PBPC is 1.0 MU (10 mcg)/kg/day given by subcutaneous injection for 5-7 days. Administer Filgrastim for at least 4 days before the first leukapheresis procedure and continue until the last leukapheresis. Discontinue Filgrastim if the white blood cell (WBC) count rises to greater than 100,000/mm³.Patients with severe chronic neutropenia: The recommended starting dosage in patients with congenital neutropenia is 0.6 MU (6 mcg)/kg as a twice daily subcutaneous injection and with idiopathic or cyclic neutropenia is 0.5 MU (5 mcg)/kg as a single daily subcutaneous injection. Dose adjustment should be accordingly to ANC and complete blood count (CBC).Patients acutely exposed to myelosuppressive doses of radiation hematopoietic syndrome of acute radiation syndrome: The recommended dose of Filgrastim is 1.0 MU (10 mcg)/kg as a single daily subcutaneous injection for patients exposed to myelosuppressive doses of radiation.Patients with HIV infection: The recommended starting dose of Filgrastim is 0.1 MU (1.0 mcg)/kg/day is given daily by subcutaneous injection with titration up to a maximum of 0.4 MU (4 mcg) /kg/day until a normal neutrophil count is reached and can be maintained (ANC > 2.0 x 10 9 /I), Or, as directed by the registered physicians.
Side Effects
Most common side effects in patients- With nonmyeloid malignancies receiving myelosuppressive anti-cancer drugs are pyrexia, pain, rash, cough and dyspnea. With AML are pain, epistaxis and rash. With nonmyeloid malignancies undergoing myeloablative chemotherapy followed by BMT is rash. Undergoing peripheral blood progenitor cell mobilization and collection are bone pain, pyrexia and headache. With severe chronic neutropenia (SCN) are pain, anemia, epistaxis, diarrhea, hypoesthesia and alopecia.
Cautions & Contraindications
Warnings & Precautions
Neufil should not be administered within 24 hours before and afier chemotherapy The possibility of Neufil acting as a growth factor for any tumor type cannot be excluded To avoid -adverse effects of excessive neutrophils complete blood count is recommended twice per week during treatment Neufil is given by subcutaneous or intravenous infusion as required Dilution of Neufil conc less than 5 mcg/ml is not recommended at any time Neufil may be diluted in 5% dextrose as required
Contraindications
Filgrastim should not be used in patients who have previously had a serious allergic reaction to human granulocyte colony-stimulating factors, including Filgrastim or peg-Filgrastim, or in those with severe congenital neutropenia (Kostmann's syndrome).