♦Filgrastim

(fill-grass’-tim)

Neupogen, G-CSF (granulocyte colony-stimulating factor)

Pregnancy Category C

Mechanism of Action

Increases the number of neutrophils in the bone marrow.

Indications

♦ To reduce the incidence of infection in patients with nonmyeloid malignancies who are receiving myelosup-pressive anticancer drugs that have a significant incidence of severe neutropenia with fever

♦ To reduce the duration of neutropenia in patients with nonmyeloid malignancies who are undergoing bone marrow transplant

♦ For patients undergoing peripheral blood progenitor cell collection (for mobilization of hematopoietic progenitor cells in the peripheral blood for collection by leukopheresis)

♦ For treatment of severe chronic neutropenia (congenital, cyclic, or idiopathic neutropenia)

Metabolism/Excretion

Metabolism unknown. Elimination half-life: 210 minutes for IV administration and 210 minutes for SQ injection.

Dosage Range

Adult

♦ Cancer patients receiving myelosuppressive chemotherapy: Starting dose, 5 mcg/kg per day SQ or slow IV infusion (over 15 to 30 minutes). Administer ≥24 hours after the administration of cytotoxic chemotherapy. Obtain CBC with differential before initiating filgrastim and twice weekly during therapy. May increase in increments of 5 mcg/kg for each chemotherapy cycle. Administer for up to 2 weeks until the neutrophil count has reached 10,000/mm³ after the expected chemotherapy-induced neutrophil nadir.

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