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Filgrastim Injection

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Why is this medication prescribed?

Filgrastim injection products (Granix, Neupogen, Nivestym, Releuko, Zarxio) are used to lower the risk of infection in patients with non-myeloid cancer (cancer that does not involve the bone marrow) who are receiving chemotherapy drugs that may lower the number of neutrophils (a type of blood cell needed to fight infection). Acute myeloid leukemia (AML), a form of white blood cell cancer, is treated with chemotherapy drugs. Filgrastim injection products (Neupogen, Nivestym, Releuko, Zarxio) are used to help increase the number of white blood cells and shorten the duration of fever in patients receiving these treatments. Injections of filgrastim (Neupogen, Nivestym, Releuko, Zarxio) are also used to treat severe chronic neutropenia (a disease in which there are not enough neutrophils in the blood) and to treat bone marrow transplant recipients. Injections of filgrastim (Neupogen, Nivestym, and Zarxio) are also used to prepare blood for leukapheresis, a procedure that involves the removal of certain blood cells from the body. Injections of filgrastim (Neupogen) are additionally used to improve survival rates in patients who have been exposed to hazardous levels of radiation, which can seriously and potentially fatally damage your bone marrow. The drug filgrastim belongs to the group of drugs known as colony-stimulating factors. It functions by enhancing the body’s production of neutrophils.

How should this medicine be used?

Injections of filgrastim are available as liquid solutions in vials and prefilled syringes for subcutaneous (under the skin) or intravenously (into a vein) administration. When used to treat severe chronic neutropenia, filgrastim injection products (Neupogen, Nivestym, Releuko, Zarxio) may be administered twice daily. Your ailment and how well your body responds to the medication will determine how long you need to receive treatment.

You will receive your first dose of the medication at least 24 hours after receiving a dose of chemotherapy, and you will continue to receive the medication every day for up to 2 weeks or until your blood cell counts return to normal, whichever comes first, if you are using filgrastim injection products to reduce your risk of infection, shorten the duration of your fever, or increase the number of white blood cells while receiving chemotherapy. You will receive the drug at least 24 hours after receiving chemotherapy and at least 24 hours after the bone marrow is infused if you are taking filgrastim injectable products to reduce the risk of infection after a bone marrow transplant. You will receive your first dose of the medicine at least 4 days before to the first leukapheresis if you are using filgrastim injection products to prepare your blood for leukapheresis. You will continue to receive the medication until the last leukapheresis. You could need to utilize filgrastim injection products for a long time if you’re treating severe persistent neutropenia with them. Your doctor will closely monitor you if you are receiving filgrastim injection because you were exposed to dangerous levels of radiation, and the length of your therapy will depend on how well your body responds to the drug. Stop using filgrastim injection products only after seeing your physician.

You might be given filgrastim injection products by a nurse or other medical professional, or you might be instructed to administer the medication yourself at home. A healthcare professional will demonstrate how to inject the drug if you or a caregiver will be injecting filgrastim injection products at home. Make sure you comprehend these instructions. If you have any questions, ask your healthcare practitioner. As instructed, use filgrastim injection products. Use it only as directed by your doctor, neither more nor less often.

Syringes or vials containing filgrastim solution shouldn’t be shaken. Before injecting, always have a look at the filgrastim injection goods. If the product has beyond its expiration date, contains particles, or seems foamy, foggy, or discolored, do not use it.

Only use one vial or syringe per object. Do not re-use the syringe or vial, even if there is still some solution inside. Put used needles, syringes, and vials in a container that won’t puncture. How to get rid of the puncture-resistant container should be discussed with your doctor or pharmacist.

You might begin with filgrastim injection products at a low dose, then your doctor may gradually raise it. Depending on how your body responds to the drug, your doctor may decide to lower your dose.

You should be aware that utilizing filgrastim injection products to treat severe persistent neutropenia won’t cure your disease; instead, it will only regulate it. Even if you feel well, keep using filgrastim injection products. Without consulting your doctor, do not stop using filgrastim injection products.

For a copy of the manufacturer’s information for the patient, ask your pharmacist or doctor.

Other uses for this medicine

Aplastic anemia (a condition in which the bone marrow does not produce enough healthy blood cells) and certain types of myelodysplastic syndrome (a group of conditions in which the bone marrow produces blood cells that are misshapen and does not produce enough healthy blood cells) are other conditions that may occasionally be treated with filgrastim injection products. Additionally, human immunodeficiency virus (HIV) positive patients and patients taking certain medications that reduce neutrophil counts may occasionally use filgrastim injection products to lessen their risk of infection. When using this medication to treat your condition, discuss the risks with your doctor.

Inquire with your doctor or pharmacist for more details if you believe this drug may be prescribed for other purposes.

What special precautions should I follow?

Before using filgrastim injection products,

  • If you have an allergy to filgrastim, pegfilgrastim (Neulasta), any other drugs, or any of the ingredients in filgrastim injection products, let your doctor and pharmacist know right once. Additionally, let your doctor know if you or the person receiving the filgrastim injection products (Granix, Neupogen, Zarxio) are latex allergic.
  • Inform your doctor and pharmacist about all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products that you are now taking or intend to use. Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
  • Inform your doctor if you are undergoing radiation therapy, have or have ever had chronic myeloid leukemia (a disease that slowly progresses in which the bone marrow produces an excess of white blood cells), or myelodysplasia (a condition in which the bone marrow cells are abnormal and may lead to leukemia).
  • Inform your doctor if you have sickle cell disease, a blood condition that can lead to excruciating crises, a deficiency in red blood cells, infection, and internal organ damage. The likelihood of experiencing a crisis while receiving treatment with filgrastim injectable products may increase if you have sickle cell disease. While receiving treatment with filgrastim injection products, make sure to stay hydrated and contact your physician right away if you experience a sickle cell crisis.
  • Inform your physician if you are nursing a baby, intend to get pregnant, or are already pregnant. Call your doctor if you get pregnant while using filgrastim injectable products.
  • Inform the surgeon or dentist that you are using filgrastim injectable products if you are having surgery, including dental surgery.
  • You should be aware that while some infections that could arise during or after chemotherapy may be prevented by filgrastim injectable products, they do not prevent all infections. If you have symptoms of infection such a fever, chills, redness, swelling, or discomfort around a cut or sore, call your doctor right once.
  • Wash the area with soap and water if you get any of the filgrastim solution on your skin. If you accidentally get filgrastim solution in your eye, immediately rinse it off with water.

What special dietary instructions should I follow?

Keep eating normally unless your doctor instructs you otherwise.

What should I do if I forget a dose?

If you plan to administer the filgrastim injection product at home, discuss with your doctor what to do if you neglect to administer the drug as directed.

What side effects can this medication cause?

Products for injecting filgrastim may have negative effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Redness, swelling, bruising, itching, or a lump where the drug was injected are possible side effects
  • Pain in the mouth, throat, muscle, arm, or jointheadache
  • Rash
  • Constipation
  • Diarrhea
  • Nausea
  • Vomiting
  • Reduced appetite
  • Having trouble falling or staying asleep
  • Reduced sensitivity to touch
  • Hair fall
  • Nosebleeds
  • Fatigue and insufficient energy
  • Feeling poorly
  • Dizziness

Some adverse effects can be very harmful. Call your doctor right away if any of these symptoms occur to you:

  • Discomfort in the left upper stomach or the left shoulder’s crook
  • Fever, breathlessness, difficulty breathing, and rapid breathing
  • Breathing issues and bloody coughing
  • Fever, stomach ache, back pain, and general malaise
  • Inability to urinate less frequently, decreased urination, breathing difficulties, dizziness, and fatigue
  • Hives, itching, swelling around the lips, eyes, or cheeks, wheezing, and rash
  • Odd bruising or bleeding, purple skin marks, or red skin
  • Reduced urination, black or bloody urine, and facial or ankle swelling
  • Frequent, painful, or urgent urinating

Leukemia, a malignancy that originates in the bone marrow, or alterations in the bone marrow cells that suggest leukemia may develop in the future have been observed in some patients who used filgrastim injectable products to treat severe persistent neutropenia. Even if they do not utilize filgrastim, people with severe persistent neutropenia still run the risk of developing leukemia. There is insufficient data to determine whether filgrastim injection products raise the risk that leukemia will develop in patients with severe persistent neutropenia. Discuss the dangers of using this drug with your doctor.

Other side effects from filgrastim injection products are possible. If you experience any strange issues while taking this drug, call your doctor right away.

What should I know about storage and disposal of this medication?

Keep this medication tightly closed in the original container and out of the reach of children. Products for filgrastim injection should be kept cold. Filgrastim (Neupogen, Nivestym, Zarxio) can thaw in the refrigerator if it gets unintentionally frozen. However, you should throw away the same syringe or vial of filgrastim if you freeze it again. Although it should be kept out of direct sunlight, filgrastim (Neupogen, Nivestym, Releuko, Zarxio) may be stored at room temperature for up to 24 hours. Although it should be kept away from light, filgrastim (Granix) can be kept at room temperature for up to 5 days or in the freezer for up to 24 hours.

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilizing a medicine take-back program is the best way to get rid of your medication. To find out about take-back programs in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back program, see the FDA’s Safe Disposal of Medicines website at for additional information.

In case of emergency/overdose

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

What other information should I know?

Keep all of your appointments with your physician and the lab. To monitor your body’s reaction to filgrastim injectable products, your doctor will request specific lab tests.

Inform your doctor and the technician that you are using filgrastim injection products before having a bone imaging study. The outcomes of this kind of investigation may be impacted by products for injecting filgrastim.

Do not share your medication with anybody else. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Granix® (tbo-filgrastim)
  • Neupogen® (filgrastim)
  • Nivestym® (filgrastim-aafi)
  • Releuko® (filgrastim-ayow)
  • Zarxio® (filgrastim-sndz)
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