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Neupogen

Neupogen

(filgrastim)

Neupogen (Filgrastim) belongs to the family of medications known as granulocyte colony stimulating factors (G-CSF). It helps the bone marrow produce white blood cells which help the body fight infection.

Available form

Dosage

Injectable

300MCG/ML

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Neupogen information

Dosage

Side Effects

Available Form

Contraindications

Precautions

Warnings

The recommended child and adult dose of Neupogen (Filgrastim) is based on body weight and varies depending on the circumstances of its use. Neupogen (Filgrastim) is given by subcutaneous (under the skin) or intravenous (into a vein) injection once daily. For people who are being treated with chemotherapy, treatment should start no sooner than 24 hours after the chemotherapy has been given.

Your dose may be adjusted depending on your response to Neupogen (Filgrastim) and therapy is usually continued until neutrophil counts reach an acceptable level. For some conditions, Neupogen (Filgrastim) will be needed indefinitely.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Neupogen (Filgrastim) is usually given under medical supervision. If you are giving Neupogen (Filgrastim) to yourself, your doctor or health care professional will instruct you on how to use Neupogen (Filgrastim) properly. It is important that this medication be used exactly as prescribed by your doctor.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

If you are receiving Neupogen (Filgrastim) in a clinic or at your doctor's office and you miss an appointment to receive Neupogen (Filgrastim), contact your doctor as soon as possible to reschedule your appointment.

This medication should be stored in the refrigerator, but do not allow it to freeze. Avoid shaking Neupogen (Filgrastim). Store it in the carton it is packaged in to protect it from light. Neupogen (Filgrastim) may be stored out of the refrigerator, at room temperature, for a single period of up to 24 hours. Keep Neupogen (Filgrastim) out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Neupogen (Filgrastim). If you are concerned about side effects, discuss the risks and benefits of Neupogen (Filgrastim) with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

mild-to-moderate bone or muscle pains or aches
reaction at the injection site (e.g., redness, swelling or itching)

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

bone pain or fractures
enlarged spleen (increased tenderness or swelling in the left upper stomach area)
signs of kidney injury (puffy face or ankles, blood in the urine or brown-coloured urine, decreased urination)
signs of bleeding (e.g., bloody nose, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding)
red or purple spots, patches, or lesions on the skin

Stop taking the medication and seek immediate medical attention if any of the following occur:

signs of acute respiratory distress syndrome (e.g., fever, shortness of breath, cough, or lung congestion)
symptoms of capillary leak syndrome (e.g., swelling or puffiness, decreased urine production or need to pass water, difficulty breathing, abdominal swelling, general feeling of tiredness)
signs of a ruptured spleen (e.g., abdominal pain on the upper left side or pain at the tip of the shoulder)
signs of a Anaphylaxis (severe allergic reaction) (e.g., Hives, shortness of breath, wheezing, swelling of the face or throat, fast heart rate, dizziness)
signs of sickle cell crisis (e.g., severe pain in bones, chest, abdomen or joints)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Neupogen (Filgrastim).

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Capillary leak syndrome (CLS): Neupogen (Filgrastim) has been reported to cause CLS, a condition where blood leaks out of the small blood vessels into the tissues of the body. If you experience symptoms of CLS, such as swelling or puffiness, decreased need to urinate, trouble breathing, swelling in the abdominal area, or a general feeling of tiredness, contact your doctor immediately. The symptoms often develop quickly and the severity of each episode is different. In severe episodes, CLS can be fatal.

Chronic use: When used for long periods of time, Neupogen (Filgrastim) may increase the risk of myelodysplasia (bone marrow disorders) and certain types of leukemia. It is not known if this increased risk is directly related to Neupogen (Filgrastim) or to the conditions Neupogen (Filgrastim) is being used to treat. If you are receiving long-term treatment with Neupogen (Filgrastim), your doctor will monitor your blood regularly and check your bone marrow annually.

Cytotoxic chemotherapy: The safety of using Neupogen (Filgrastim) at the same time as cytotoxic chemotherapy (a type of chemotherapy that kills cells, especially cancer cells) has not been established. Neupogen (Filgrastim) should not be used within 24 hours before or 24 hours after chemotherapy is administered.

Heart conditions: Heart-related conditions such as heart attacks and abnormal heart rhythms have been observed in rare cases with Neupogen (Filgrastim). If you have had a heart condition before starting Neupogen (Filgrastim), discuss with your doctor how Neupogen (Filgrastim) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Neupogen (Filgrastim), and whether any special monitoring is needed.

Lung problems: Neupogen (Filgrastim) may cause adult respiratory distress syndrome (ARDS), a serious lung condition, when people with neutropenia have a bacterial infection in the blood. If you experience difficulty breathing, fever or coughing blood while using Neupogen (Filgrastim), contact your doctor immediately.

Osteoporosis: Long-term use of Neupogen (Filgrastim) may increase the risk of osteoporosis in some people. If you have chronic neutropenia or have osteoporosis, discuss with your doctor how Neupogen (Filgrastim) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Neupogen (Filgrastim), and whether any special monitoring is needed.

Your doctor may want to check your bone density regularly while you are receiving Neupogen (Filgrastim).

Sickle cell disease: Neupogen (Filgrastim) may cause sickle cell crisis when used by people who have sickle cell disease. You and your doctor should carefully consider the benefits and risks of using Neupogen (Filgrastim) in these circumstances if you have sickle cell disease.

Pregnancy: Neupogen (Filgrastim) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Neupogen (Filgrastim), contact your doctor immediately.

Breast-feeding: It is not known whether Neupogen (Filgrastim) passes into breast milk. If you are a breast-feeding mother and are taking Neupogen (Filgrastim), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of Neupogen (Filgrastim) have not been established for newborn babies.

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