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How it is administered
Filgrastim is given as an injection, either under the skin (subcutaneous injection) or into a vein (intravenous infusion). It is available in single-dose vials and prefilled syringes, with common strengths being 300 mcg and 480 mcg. The injection can be given by a healthcare provider, or, after proper training, by patients or caregivers at home.
The medication should be stored in the refrigerator and allowed to reach room temperature before use. It should not be shaken. The injection sites should be rotated to avoid irritation.
How it works
Filgrastim is a man-made version of a naturally occurring protein called granulocyte colony-stimulating factor (G-CSF). This protein helps the body make more white blood cells, specifically neutrophils, which are important for fighting infections.
In people with blood cancers or those receiving chemotherapy, the number of neutrophils can drop very low, increasing the risk of infections. Filgrastim works by stimulating the bone marrow to produce more neutrophils, helping to lower the risk and duration of neutropenia (low neutrophil count) and related infections. It binds to specific receptors on blood cell precursors in the bone marrow, encouraging them to multiply and mature into functioning neutrophils. This effect is especially important for patients undergoing myelosuppressive chemotherapy or stem cell transplantation, as it helps the immune system recover more quickly.
Common side effects
- Bone pain
- Fever (pyrexia)
- Rash
- Cough
- Shortness of breath (dyspnea)
- Nausea
- Fatigue
- Back pain
- Headache
- Injection site reactions
Serious but less common side effects include splenic rupture, acute respiratory distress syndrome, serious allergic reactions, sickle cell crisis, glomerulonephritis, capillary leak syndrome, and aortitis. If you experience left upper abdominal or shoulder pain, trouble breathing, swelling, or signs of an allergic reaction, seek medical attention immediately.
Who Should take it
Filgrastim is used in patients with non-myeloid cancers (cancers not starting in the bone marrow) who are receiving chemotherapy that can cause severe neutropenia (low neutrophil counts) and fever. It is also used after bone marrow or stem cell transplantation, and in patients undergoing collection of peripheral blood progenitor cells for transplantation.
Additionally, filgrastim is indicated for patients with severe chronic neutropenia, including congenital, cyclic, or idiopathic types, to reduce the risk and duration of infections. In the context of myelodysplastic syndromes (MDS), filgrastim may be used to help manage low neutrophil counts and reduce infection risk, but its use should be carefully considered and monitored by a healthcare provider.
Who should not take it
Filgrastim should not be used by anyone who has had a serious allergic reaction to filgrastim, pegfilgrastim, or other granulocyte colony-stimulating factors. Symptoms of a serious allergic reaction may include rash, swelling, trouble breathing, or low blood pressure.
Caution is also advised in patients with sickle cell disease, as filgrastim can trigger sickle cell crises. It is not recommended for use in patients with certain types of blood cancers (like chronic myeloid leukemia or myelodysplasia) unless specifically directed by a healthcare provider, as it may potentially stimulate malignant cells. Always discuss your full medical history with your healthcare provider before starting filgrastim.
Commonly used with
Filgrastim is often used alongside chemotherapy in patients with blood cancers or other cancers to reduce the risk of infection. It may also be used with antibiotics if infections develop, and with other supportive care medications such as anti-nausea drugs or pain relievers.
In the context of stem cell transplantation, filgrastim is used to mobilize stem cells before collection and may be used with other medications that support blood cell growth.
Commonly tested with
Filgrastim has been tested in combination with various chemotherapy regimens, especially those known to cause significant neutropenia. It is also studied with antibiotics for infection management and with other growth factors in the setting of stem cell transplantation.
In clinical trials, filgrastim is often compared to placebo or to other growth factors to assess its effectiveness in reducing infection rates and improving recovery of white blood cells after chemotherapy or transplantation.
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