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Granulocyte Colony-Stimulating Factor (Generic Filgrastim Injection)

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Why is this medication prescribed?

People who have non-myeloid cancer (cancer that does not involve the bone marrow) and are receiving chemotherapy medications that may reduce the number of neutrophils (a type of blood cell needed to fight infection) can use filgrastim injection products (Granix, Neupogen, Nivestym, Releuko, Zarxio) to lessen their risk of 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 patients with AML produce more white blood cells and experience less fever. 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?

To be injected subcutaneously (under the skin) or slowly or constantly intravenously (into a vein), filgrastim injectable products are sold as solutions (liquids) in vials and prefilled syringes. Filgrastim injection products (Neupogen, Nivestym, Releuko, Zarxio) are typically administered once daily, but when used to treat severe persistent neutropenia, they may be administered twice daily. How well your body responds to the drug and the disease you have determine how long your therapy will last.

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.

A nurse or other healthcare professional may administer filgrastim injectable products to you, or they may instruct you to administer the medication subcutaneously at home. A medical professional will demonstrate how to administer the drug to you or your caregiver if you or they will be injecting filgrastim injectable products at home. Make certain that you comprehend these instructions. If you have any questions, ask your medical professional. Implement filgrastim injection products exactly as advised. Use only as directed by your doctor, neither more nor less of it, nor more frequently.

Filgrastim solution-filled vials and syringes shouldn’t be shaken. Before injecting, always check the goods for filgrastim injection. If the expiration date has passed, the filgrastim solution contains particles, or it seems foamy, hazy, or discolored, do not use.

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 on specific drugs that reduce neutrophil counts may occasionally utilize filgrastim injectable products to lessen their risk of infection. When using this drug to treat your disease, discuss the risks with your doctor.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

What special precautions should I follow?

Before using filgrastim injection products,

  • If you have any allergies to any of the substances in filgrastim injection products, other drugs, or the active ingredient in filgrastim (pegfilgrastim; Neulasta), let your doctor and pharmacist know right once. Furthermore, let your doctor know if you or the individual receiving the filgrastim injection products (Granix, Neupogen, Zarxio) are latex allergic.
  • Inform your doctor and pharmacist about any vitamins, nutritional supplements, herbal items, and prescription and over-the-counter medicines you are now taking or intend to take. Your doctor might need to adjust your medication doses or keep a close eye out for any negative 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 lack of red blood cells, infection, and internal organ damage. If you have sickle cell disease, you may be more prone to experience a crisis while receiving therapy with filgrastim injection products. While receiving treatment with filgrastim injection products, make sure to stay hydrated and contact your physician immediately 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 filgrastim solution on your skin. If you accidentally get filgrastim solution in your eye, thoroughly 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 joint
  • Headache
  • 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, respiratory difficulties, shortness of breath, and rapid breathing
  • Breathing difficulties and bloody cough
  • Fever, discomfort in the abdomen, back, and general malaise
  • Stomach swelling or other swellings, decreased urination, breathing difficulties, lightheadedness, and exhaustion
  • 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 negative effects from filgrastim injectable 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 ambient 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.

To make sure that pets, kids, and other people cannot take leftover pharmaceuticals, they should be disposed of in a specific manner. You shouldn’t flush this medication down the toilet, though. The best option to get rid of your medication is instead through a medication take-back program. To find out about take-back initiatives in your neighborhood, speak with your pharmacist or get in touch with your city’s waste/recycling department. If you do not have access to a take-back program, you can find more information at the FDA’s Safe Disposal of Medicines website (

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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