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Granulocyte-Macrophage Colony-Stimulating Factor (Generic Sargramostim)

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Why is this medication prescribed?

Sargramostin is used to reduce the risk of infection in patients with acute myelogenous leukemia (AML; a form of malignancy of the white blood cells) who are also receiving chemotherapy drugs that may reduce the number of neutrophils (a type of blood cell needed to fight infection). Sargramostin is also used to prepare the blood for leukapheresis (a treatment in which specific blood cells are removed from the body and then returned to the body after chemotherapy). Sargramostin is also used in people who are undergoing bone marrow transplants, blood stem cell transplants, and transplants of blood stem cells. When a blood marrow transplant recipient has not reacted, sargamostim is also used. Colony-stimulating factors are a class of drugs that includes sargramostin. It functions by encouraging the body’s production of more neutrophils and specific other blood cells.

How should this medicine be used?

Sargramostim is available as a liquid solution or as a powder that must be dissolved in liquid before being injected intravenously (into a vein) or subcutaneously (under the skin). Once daily, it is slowly infused (administered) over a period of 2 to 24 hours. Additionally, a daily subcutaneous injection is an option. Your ailment and how well your body responds to the medication will determine how long you need to receive treatment.

Sargramostim will be administered to you at least 4 days following the last dosage of each chemotherapy cycle if you are using it to lower your risk of infection while receiving treatment for cancer. As long as it takes for your blood cell levels to normalize, which could take up to 6 weeks, you will have to take the drug every day. For the duration of your last leukapheresis, if you are using sargramostim to get your blood ready for it, you will get the medicine once daily. If you are using sargramostim as part of a blood stem cell transplant, you will start taking it the day of the transplant and keep taking it for at least three days. Sargramostim will be administered to you at least 24 hours after chemotherapy and once more 2 to 4 hours after the bone marrow is infused if you need to use it to lower the risk of infection during a bone marrow transplant. You will be given sargramostim once daily for 14 days if you are using it because your bone marrow transplant did not work. Stop using Sargramostim only after consulting your physician.

A nurse or other healthcare professional may provide sargramostim to you, or they may instruct you to administer the injections at home. If you will be injecting sargramostim, administer the drug every day at roughly the same time. Ask your doctor or pharmacist to explain any instructions on your prescription label that you do not understand, and carefully follow their instructions. Follow the instructions for sargramostim precisely. Use only as directed by your doctor, neither more nor less of it, nor more frequently.

If you plan to administer sargramostim yourself, a medical professional will demonstrate how to do so. Make sure you comprehend these instructions. If you have any concerns regarding how to administer the injection, what kind of syringe to use, where on your body to provide the sargramostim injection, or how to discard used needles and syringes after administering the drug, see your healthcare professional.

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 new 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 for which sargramostim is occasionally used. In addition, sargramostim is occasionally used to lower the risk of infection in HIV-positive individuals. The dangers of using this drug for your illness should be discussed 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 sargramostim injection,

  • If you have an allergy to sargramostim, yeast, any other drugs, or any of the ingredients in sargramostim injection, let your doctor and pharmacist know right once. Request a list of the components from your pharmacist.
  • 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. Mention lithium (Lithobid), methylprednisolone (Medrol), betamethasone (Celestone), dexamethasone (Decadron), and prednisone. 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 receiving radiation therapy now or have ever received it, if you have cancer, edema (swelling of the stomach, feet, ankles, or lower legs), any form of heart disease, heart failure, an irregular heartbeat, or any lung, kidney, or liver problems.
  • Inform your physician if you are nursing a baby, intend to get pregnant, or are already pregnant. Call your doctor if you become pregnant while taking Sargramostim.
  • Inform the surgeon or dentist that you are using sargramostim if you are having surgery, including dental surgery.
  • You should be aware that while sargramostim lowers the chance of infection, it cannot completely ward off all infections that could arise during or after chemotherapy. If you experience any infection-related symptoms, including fever, chills, a sore throat, a persistent cough, or congestion, call your doctor right once.

What special dietary instructions should I follow?

Keep eating normally unless your doctor instructs you otherwise.

What side effects can this medication cause?

Side effects from sargramostim could exist. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Where the drug was injected, there may be redness, swelling, bruising, itching, or a lump
  • Joint, muscle, or bone pain
  • Headache
  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal pain
  • Oral sores
  • Reduced appetite
  • Hair fall

Some adverse effects can be very harmful. Call your doctor right away if you encounter any of these symptoms, or seek emergency care:

  • Breathing quickly or with difficulty breathing
  • Having trouble breathing
  • Wheezing
  • Dizziness
  • Sweating
  • Hives
  • Rash
  • Itching
  • Swelling of the stomach, face, eyes, lips, ankles, feet, or lower legs
  • Unexpected weight gain
  • Chest ache
  • Rapid or erratic heartbeat
  • Fainting
  • Purple marks or odd bruises under the skin
  • Uncommon bleeding
  • Nosebleeds
  • Unexpected fatigue or weakened state
  • Less urinations

Other negative effects of sargramostim are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online at or by phone at 1-800-332-1088 if you have a serious side event.

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

Keep this medication out of the reach of children, out of the sun, and in the original container it was given to you. Sargramostim should be kept cold. Sargramostim must not be shaken or frozen. Sargramostim vials that have been opened may be kept in the fridge for up to 20 days. After 20 days, dispose of unsealed vials.

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 (

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.

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.

Overdose signs could include the following:

  • Breathing difficulty
  • Unexpected fatigue or weakened state
  • Fever
  • Rapid or erratic heartbeat
  • Nausea
  • Headache
  • Rash

What other information should I know?

Keep all of your appointments with your physician and the lab. To determine how your body is responding to sargramostim, your doctor will request a few lab tests.

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

  • Leukine®
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