Care During Chemotherapy and Beyond
Granulocyte - Colony Stimulating Factor
Trade name: Neupogen ®
Other names: G-CSF, granulocyte - colony stimulating
Drug type: Filgrastim is a biologic response modifier.
It is classified as a colony stimulating factor. (For more detail, see "How
this drug works" section below).
What This Drug Is Used For:
- Filgrastim is used to stimulate the production of granulocytes (a type of white
blood cell) in patients undergoing therapy that will cause low white blood cell
counts. This medication is used to prevent infection and neutropenic (low
white blood cells) fevers caused by chemotherapy.
- Filgrastim is a support medication. It does not treat cancer.
Note: If a drug has been approved for one use, physicians
may elect to use this same drug for other problems if they believe it may be helpful.
How This Drug Is Given:
- Filgrastim may be given by subcutaneous (the layer between the skin and muscle)
injection or infused into a vein (intravenous, IV).
- Filgrastim is generally given on a daily basis. The number of days you receive
filgrastim will be prescribed by your doctor.
- Filgrastim should be refrigerated. Remove from refrigerator 30 minutes before
injection. Do not shake the medication.
- The amount of filgrastim that you will receive depends on many factors, including
your height and weight, your general health or other health problems, and the type
of cancer or condition being treated. Your doctor will determine your dose
Important things to remember about the side effects of filgrastim:
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset and duration.
- Side effects are almost always reversible and will go away after treatment is complete.
- There are many options to help minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and the
effectiveness of the medication.
- Filgrastim is a support medication. The following list includes side effects
attributed to filgrastim. Other side effects experienced were attributed to
the chemotherapy and/or the disease.
The following side effects are common (occurring in greater than 30%) for
patients taking filgrastim:
Note: There are no common side effects of filgrastim.
These side effects are less common side effects (occurring in about 10-29%)
of patients receiving filgrastim:
- Pain (bone pain)
- Blood test abnormalities (temporary elevation in lactate dehydrogenase, and alkaline
phosphatase). These will return to normal once treatment is discontinued.
- Tenderness at the site of injection
Not all side effects are listed above. Some that are rare (occurring in less than
10% of patients) are not listed here. However, you should always inform your
health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately,
day or night, if you should experience any of the following symptoms:
- Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)
- Shortness of breath
- Rapid heart beat
- Bleeding that does not stop after a few minutes
- Any new rashes on your skin
The following symptoms require medical attention, but are not an emergency.
Contact your health care provider within 24 hours of
noticing any of the following:
- Bone pain that does not go away despite taking recommended pain reliever
Always inform your health care provider if you experience any unusual symptoms.
- Before starting filgrastim treatment, make sure you tell your doctor about any other
medications you are taking (including prescription, over-the-counter, vitamins,
herbal remedies, etc.). Do not take aspirin, products containing aspirin
unless your doctor specifically permits this.
- The manufacturer recommends that the first dose of filgrastim be given no sooner
than 24 hours after chemotherapy. Your doctor will discontinue therapy with
filgrastim when your white blood cell count has reached acceptable levels.
- Filgrastim may be inadvisable if you have had a hypersensitivity reaction to filgrastim
or E. coli-derived proteins.
- Do not receive any kind of immunization or vaccination without your doctor's approval
while taking filgrastim.
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category C (use in pregnancy only when
benefit to the mother outweighs risk to the fetus).
- For both men and women: Do not conceive a child (get pregnant) while taking filgrastim.
Barrier methods of contraception, such as condoms, are recommended. Discuss with
your doctor when you may safely become pregnant or conceive a child after therapy.
- Do not breast feed while taking this medication.
- Filgrastim should be used with caution in people taking lithium.
- If you are performing your own subcutaneous self-injections, remove the syringe
from the refrigerator 30 minutes prior to injection. This will reduce local
stinging at the injection site.
- You may experience bone or joint pain as a result of this medication. Ask your healthcare
provider if you may take a mild pain medicine to relieve this. Acetominophen
(Tylenol®) may help.
- Apply a warm compress if you have any pain, redness or swelling at the injection
site, and notify your doctor.
- You may be at risk of infection so try to avoid crowds or people with colds, and
report fever or any other signs of infection immediately to your health care provider.
- Wash your hands often.
- Avoid contact sports or activities that could cause injury.
- This medication causes little nausea. But if you should experience nausea, take
anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
Sucking on lozenges, and chewing gum may also help.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided
completely. You should discuss this with your doctor.
- Get plenty of rest.
- Maintain good nutrition.
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that
are effective in managing such problems.
Monitoring and Testing:
You will be checked regularly by your health care professional while you are taking
filgrastim to monitor side effects and check your response to therapy. Periodic
blood work to monitor your complete blood count (CBC) as well as the function of
other organs (such as your kidneys and liver) will also be ordered by your doctor.
How This Drug Works:
In the body's bone marrow (the soft, sponge-like material found inside bones) blood
cells are produced. There are three major types of blood cells; white blood
cells, which fight infection; red blood cells, which carry oxygen to and remove
waste products from organs and tissues; and platelets, which enable the blood to
clot. Cancer treatments such as chemotherapy and radiation therapy can effect
these cells which put a person at risk for developing infections, anemia and bleeding
problems. Colony-stimulating factors are substances that stimulate the production
of blood cells and promote their ability to function. They do not directly
affect tumors but through their role in stimulating blood cells they can be helpful
as support of the persons immune system during cancer treatment.
Filgrastim is a growth factor that stimulates the production, maturation and activation
of neutrophils. Filgrastim also stimulates the release of neutrophils (a type
of white blood cell) from the bone marrow. In patients receiving chemotherapy,
filgrastim can accelerate the recovery of neutrophils, reducing the neutropenic
phase (the time in which people are susceptible to infections).
Note: We strongly encourage you to talk with your health
care professional about your specific medical condition and treatments. The information
contained in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
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