Indications & Uses
Filgram is indicated for:
Pharmacology
Filgrastim is a 175 amino acid human granulocyte colony-stimulating factor (G-CSF) produced using recombinant DNA technology. It regulates neutrophil production in the bone marrow and influences the proliferation and differentiation of neutrophil progenitor cells. It also improves phagocytic ability, primes the cellular metabolism linked to respiratory burst, supports antibody-dependent killing, and increases the expression of certain cell surface antigens.
Filgrastim's pharmacokinetics are nonlinear: its clearance depends on both drug concentration and neutrophil count. It is cleared by the kidney, reaches peak plasma levels (tmax) within 2 to 8 hours, and has an absolute bioavailability of 60-70% after subcutaneous administration.
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 usual dose of Filgrastim is 0.5 MU (5 mcg)/kg/day, given as a single daily subcutaneous injection or as an intravenous infusion over 30 minutes. The first dose should not be given within 24 hours of cytotoxic chemotherapy. Keep going until the neutrophil count is back in the normal range, which usually takes 14 days (up to 38 days in AML).
Cancer patients undergoing bone marrow transplantation (BMT): The usual dose of Filgrastim after bone marrow transplantation (BMT) is 1.0 MU (10 mcg)/kg/day, given as an intravenous infusion lasting no longer than 24 hours. Give the first dose at least 24 hours after cytotoxic chemotherapy and at least 24 hours after the bone marrow transplantation. The dose should be adjusted according to the absolute neutrophil count (ANC).
Patients undergoing autologous peripheral blood progenitor cell (PBPC) collection and therapy: The usual dose of Filgrastim for mobilising autologous PBPC is 1.0 MU (10 mcg)/kg/day, given as a subcutaneous injection for 5 to 7 days. Start Filgrastim at least 4 days before the first leukapheresis procedure and continue until the last one. Stop Filgrastim if the white blood cell (WBC) count rises above 100,000/mm³.
Patients with severe chronic neutropenia: The usual starting dose in patients with congenital neutropenia is 0.6 MU (6 mcg)/kg as a subcutaneous injection twice daily. In patients with idiopathic or cyclic neutropenia, it is 0.5 MU (5 mcg)/kg as a single daily subcutaneous injection. The dose should be adjusted according to the ANC and the complete blood count (CBC).
Patients acutely exposed to myelosuppressive doses of radiation (hematopoietic syndrome of acute radiation syndrome): The usual 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 usual starting dose of Filgrastim is 0.1 MU (1.0 mcg)/kg/day, given daily as a subcutaneous injection. The dose is increased step by step to a maximum of 0.4 MU (4 mcg)/kg/day until a normal neutrophil count is reached and can be maintained (ANC above 2.0 x 10 9 /I), or as directed by the registered physicians.
Side Effects
In patients with non-myeloid malignancies who receive myelosuppressive anti-cancer drugs, the most common side effects are fever, pain, rash, cough and shortness of breath. In patients with AML, they are pain, nosebleeds and rash. For non-myeloid malignancy patients who have myeloablative chemotherapy followed by bone marrow transplant (BMT), rash is the most common. In people undergoing peripheral blood progenitor cell mobilization and collection, the common side effects are bone pain, fever and headache. In patients with severe chronic neutropenia (SCN), they are pain, anaemia, nosebleeds, diarrhoea, reduced sensation (hypoesthesia) and hair loss (alopecia).
Cautions & Contraindications
Warnings & Precautions
Neufil should not be given within 24 hours before or after chemotherapy. The possibility of Neufil acting as a growth factor for any type of tumour cannot be ruled out. To avoid the adverse effects of too many neutrophils, a complete blood count is recommended twice a week during treatment. Neufil is given as a subcutaneous or intravenous infusion, as required. Dilution of Neufil to a concentration below 5 mcg/ml is not recommended at any time. Neufil may be diluted in 5% dextrose if needed.
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).
Pregnancy & Breastfeeding
Pregnancy Category C. Well-controlled studies in pregnant women are lacking, so the risks to a developing baby are not fully established. It is also not known whether filgrastim passes into human breast milk. Since many medicines do pass into breast milk, it should be used cautiously by mothers who are breastfeeding.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
No maximum tolerated dose has been set for Filgrastim. In the BMT studies, patients received up to 13.8 MU(138 mcg)/kg/day and showed no toxic effects.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Filgrastim in a refrigerator at 2 to 8° C. Protect it from light. Don't freeze it, and avoid shaking it.
Common questions about Filgram 300 mcg/0.5 ml
What is Filgram 300 mcg/0.5 ml IV/SC Injection?
Filgram 300 mcg/0.5 ml IV/SC Injection is a medicine that contains Filgrastim. It is made by Eskayef Pharmaceuticals Ltd. It belongs to the Haematopoietic Agents group of medicines.
What is Filgram used for?
Filgram is used for: Fever, Bacterial Infection, Cancer.
What are the side effects of Filgram?
In patients with non-myeloid malignancies who receive myelosuppressive anti-cancer drugs, the most common side effects are fever, pain, rash, cough and shortness of breath. In patients with AML, they are pain, nosebleeds and rash.
Can I take Filgram during pregnancy or while breastfeeding?
Pregnancy Category C. Well-controlled studies in pregnant women are lacking, so the risks to a developing baby are not fully established. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Filgram?
No maximum tolerated dose has been set for Filgrastim. In the BMT studies, patients received up to 13.8 MU(138 mcg)/kg/day and showed no toxic effects. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Filgram?
Keep Filgrastim in a refrigerator at 2 to 8° C. Protect it from light.
Do I need a prescription for Filgram?
Filgram is a prescription (Rx) medicine. Take it as your doctor advises.