Filgrastim
- Atc Codes:L03AA02
- CAS Codes:121181-53-1
- PHARMGKB ID:121181-53-1
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Biograstim, Filgrastim, Neupogen, Ratiograstim, Tevagrastim; Belgium: Neupogen; Bulgaria: Neupogen; Cyprus: Granulokine; Czech Republic: Biograstim, Filgrastim, Neupogen, Ratiograstim, Tevagrastim, Zarzio; Denmark: Neupogen, Ratiograstim; Estonia: Biograstim, Filgrastim, Neupogen, Ratiograstim, Tevagrastim, Zarzio; Finland: Neupogen, Ratiograstim; France: Neupogen, Ratiograstim; Germany: Biograstim, Filgrastim, Granulokine, Neupogen, Ratiograstim, Tevagrastim, Zarzio; Greece: Biograstim, Granulokine, Grastim, Tevagrastim; Hungary: Neupogen, Ratiograstim, Zarzio; Ireland: Biograstim, Filgrastim, Neupogen, Ratiograstim, Tevagrastim; Italy: Granulokine, Ratiograstim; Latvia: Biograstim, Filgrastim, Neupogen, Ratiograstim, Tevagrastim, Zarzio; Lithuania: Biograstim, Filgrastim, Neupogen, Ratiograstim, Tevagrastim, Zarzio; Luxembourg: Neupogen; Malta: Neupogen; Netherlands: Biograstim, Filgrastim, Neupogen, Ratiograstim, Tevagrastim; Poland: Biograstim, Filgrastim, Neupogen, Zarzio; Portugal: Biograstim, Filgrastim, Neupogen, Ratiograstim, Tevagrastim, Zarzio; Romania: Biograstim, Filgrastim, Neupogen, Ratiograstim, Tevagrastim, Zarzio; Slovakia: Biograstim, Filgrastim, Neupogen, Ratiograstim, Tevagrastim, Zarzio; Slovenia: Neupogen; Spain: Neupogen, Ratiograstim, Zarzio; Sweden: Biograstim, Filgrastim, Neupogen, Ratiograstim, Tevagrastim, Zarzio; UK: Neupogen, Zarzio.
North America
Canada: Neupogen; USA: Neupogen.
Latin America
Argentina: Filgen, Filgrastim, G-CSFPCGEN, Neupogen, Neutrofil, Neutromax; Brazil: Filgrastim, Filgrastine, Granulen, Granulokine, Leucin; Mexico: Biofilgran, Filatil, Inmunef, Neupogen.
Asia
Japan: Gran.
Drug combinations
Chemistry
Filgrastim: C~845~H~1339~N~223~O~243~S~9~. Mw: 18800.01. A single chain, 175 aa polypeptide, nonglycosylated, expressed by E. coli. (1) Colony-stimulating factor (human clone 1034), N-L-methionyl-; (2) N-L-Methionylcolony-stimulating factor (human clone 1034). CAS-121181-53-1 (1990).
Pharmacologic Category
Hematopoietic Agents; Colony-Stimulating Factor. (ATC-Code: L03AA02).
Mechanism of action
Filgrastim, a human granulocyte colony-stimulating factor (G-CSF), is a biosynthetic hematopoietic agent which principally affects proliferation and differentiation of neutrophils within bone marrow and possibly other sites (e.g. spleen). Reduces duration and severity of neutropenia in chemotherapy-induced neutropenia.
Therapeutic use
Stimulation of granulocyte production in chemotherapy-induced neutropenia (nonmyeloid malignancies, acute myeloid leukemia, and bone marrow transplantation). Severe chronic neutropenia. Patients undergoing peripheral blood progenitor cell collection.
Pregnancy and lactiation implications
Animal studies demonstrated adverse effects and fetal loss. Filgrastim shown to cross placenta in humans. Use only if potential benefit to mother justifies risk to fetus.
Unlabeled use
Treatment of anemia in myelodysplastic syndrome. Treatment of drug-induced (nonchemotherapy) agranulocytosis in the elderly.
Contraindications
Hypersensitivity to filgrastim, E. coli-derived proteins, or any component of the formulation.
Warnings and precautions
Allergic reactions might occur. Alveolar hemorrhage occurred. Cutaneous vasculitis reported. Rare cases of acute respiratory distress syndrome reported. Rare cases of splenic rupture reported. May precipitate sickle cell crises in sickle cell disease. Do not use filgrastim in period 24 hours before to 24 hours after administration of cytotoxic chemotherapy. Severe congenital neutropenia observed. Packaging of some dosage forms may contain latex. May potentially act as growth factor for any tumor type, particularly myeloid malignancies. Splenic rupture (including fatalities) reported rarely. Adult respiratory distress syndrome reported in neutropenic patients with sepsis receiving filgrastim. Severe sickle cell crisis reported in patients with sickle cell disease receiving filgrastim. Cytogenetic abnormalities, MDS, and AML reported in patients with severe chronic neutropenia. Anaphylactoid and allergic-type reactions (e.g. dyspnea, facial edema, hypotension, rash, tachycardia, urticaria, wheezing) reported rarely.