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Generic Name: filgrastim (fill GRASS tim)
Brand Names: Neupogen

What is filgrastim?

Filgrastim is a protein that stimulates the production of white blood cells. White blood cells are important for protecting the body from infection.

Filgrastim is used to increase white blood cells, and to decrease the risk of infection, in conditions such as cancer; bone marrow transplant; pre-chemotherapy blood cell collection; and severe chronic neutropenia including congenital neutropenia, cyclic neutropenia, and idiopathic neutropenia.

Filgrastim may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about filgrastim?

Your spleen may become enlarged and, in rare instances, may rupture while taking filgrastim. The spleen is located in the upper left section of your stomach area. Call your doctor right away if you have pain in your left upper stomach area or left shoulder tip area. This pain could mean your spleen is enlarged or ruptured.

What should I discuss with my healthcare provider before using filgrastim?

Before using this medication, tell your doctor if you

• are undergoing radiation or chemotherapy;

• have myeloid (bone marrow) cancer;

• have kidney disease; or

• have liver disease.

You may not be able to uses filgrastim or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

How should I use filgrastim?

Use filgrastim exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

Filgrastim can be used subcutaneously (SC) or intravenously (IV). If you are injecting the medication at home, your doctor, nurse, or pharmacist will give you specific instructions on how and where to inject your medication. Do not give yourself an injection if you are unsure how to inject yourself, how much to inject, or how often to inject the medication. Contact your doctor, nurse, or pharmacist to go over the instructions with you.

Try to receive the injections at the same time each day.

It is important to use filgrastim regularly to get the most benefit.

Rotate injection sites as directed and inject the medication slowly.

Following administration of filgastrim from the prefilled syringe, the "UltraSafe Needle Guard" should be activated to prevent accidental needle sticks. To activate the Needle Guard, place your hands behind the needle, grasp the guard with one hand, and slide the guard forward until the needle is completely covered and the guard clicks into place. NOTE: If an audible click is not heard, the needle guard may not be completely activated. The prefilled syringe should be disposed of by placing the entire prefilled syringe with guard activated into an approved puncture-proof container.

Do not shake any vial of filgrastim. It can be gently swirled if mixing is needed. Do not use any medication that is discolored or that particles in it.

Use each vial filgrastim for only one dose then throw away any remaining solution. Do not re-enter the vial with the same or another needle.

Properly store and discard all syringes and needles.

Your doctor may want you to have blood tests or other medical evaluations during treatment with filgrastim to monitor progress and side effects.

What happens if I miss a dose?

Contact your doctor if you miss a dose of this medication by more than a few hours.

What happens if I overdose?

Symptoms of a filgrastim overdose are not known.

What should I avoid while using filgrastim?

There are no restrictions regarding foods, beverages, or activities during treatment with a filgrastim unless your doctor directs otherwise.

Filgrastim side effects

Your spleen may become enlarged and, in rare instances, may rupture while taking filgrastim. The spleen is located in the upper left section of your stomach area. Call your doctor right away if you have pain in your left upper stomach area or left shoulder tip area. This pain could mean your spleen is enlarged or ruptured.

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

• a fever (over 100.5 degrees Fahrenheit or 38 degrees Celsius); or

• signs of infection such as chills; sore throat; congestion; diarrhea; or redness, pain, or swelling around a wound or sore

Other, less serious side effects may be more likely to occur. Continue to use filgrastim and talk to your doctor if you experience:

• bone pain;

• nausea; or

• swelling, redness, or pain at the injection site.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect filgrastim?

Before using this medication, tell your doctor if you

• are taking lithium (Eskalith, Lithobid, Lithane, others); or

• are undergoing radiation or chemotherapy.

You may not be able to use filgrastim or you may require special monitoring if you are taking any of the medications listed above.

Drugs other than those listed here may also interact with filgrastim. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

• Your pharmacist has additional information about filgrastim written for health professionals that you may read.

What does my medication look like?

Filgrastim is available with a prescription under the brand name Neupogen. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Neupogen 300 mcg (0.5 mL)-prefilled syringe

• Neupogen 480 mcg (0.8 mL)-prefilled syringe

• Neupogen 300 mcg (1 mL)-single-use, preservative-free vials

• Neupogen 480 mcg (1.6 mL)-single-use, preservative-free vials

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.