Informational only — Not medical advice. Always consult a licensed healthcare provider.

Shasthya স্বাস্থ্য · Health, made simple
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Community data Updated 2 months ago
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Indications

Fever Bacterial Infection Cancer

Cancer patients receiving myelosuppressive chemotherapy: Reduces the incidence of infection, shown by febrile neutropenia, in patients with nonmyeloid malignancies who are receiving myelosuppressive anticancer drugs that carry a significant risk of severe neutropenia with fever. Cancer patients undergoing treatment for acute myeloid leukemia: Reduces the time to neutrophil recovery and the duration of fever following induction or consolidation chemotherapy in patients with acute myeloid leukemia (AML). Cancer patients receiving bone marrow transplantation (BMT): Reduces the duration of neutropenia and neutropenia related complications, such as febrile neutropenia, in patients with nonmyeloid malignancies undergoing myeloablative chemotherapy followed by bone marrow transplantation. Patients with severe chronic neutropenia: Reduces the incidence and duration of neutropenia related effects, such as fever, infection or oropharyngeal ulcers, in symptomatic patients with congenital neutropenia, cyclic neutropenia or idiopathic neutropenia. Patients acutely exposed to myelosuppressive doses of radiation: Increases survival in patients acutely exposed to myelosuppressive doses of radiation, that is, the hematopoietic syndrome of acute radiation syndrome. Patients with HIV infection: Used for the prevention and treatment of persistent neutropenia in patients with advanced HIV infection, to reduce the risk of bacterial infections when other options for managing neutropenia are not suitable.

⚠️ Always consult a registered physician before taking any medicine.

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.

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.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor 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.