Filgrastim
Also known as: filgrastim, G-CSF, Granix, Neupogen, Nivestim, Nivestym, r-metHuG-CSF, Zarxio
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Summary
Filgrastim is a recombinant 175‑amino‑acid protein used to reduce the duration of chemotherapy‑induced neutropenia and to mobilize peripheral blood stem cells for transplantation.
Mechanism of Action
Binds G‑CSF receptor on myeloid progenitors, activating JAK/STAT pathway to stimulate proliferation, differentiation and activation of neutrophil precursors
Routes of Administration
Goals & Uses
- Severe chronic neutropeniaHematologyModerate
- Chemotherapy‑induced neutropeniaHematologyHigh
- Reduction of chemotherapy-induced febrile neutropeniaOncology / Supportive CareHigh
- Acceleration of neutrophil recovery post bone marrow transplantTransplantationHigh
- Severe chronic neutropenia managementHematologyHigh
- Peripheral blood stem cell mobilizationHematology / TransplantationHigh
- Acute radiation syndrome (hematopoietic subsyndrome)Radiation EmergencyModerate
Contraindications
- Hypersensitivity to filgrastim or E. coli‑derived proteinsAllergyHigh
- Hypersensitivity to filgrastim or E. coli-derived proteinsAllergy / ImmunologyHigh
- Use in myeloid malignancies (AML/CML) without specific justificationOncologyHigh
- Sickle cell diseaseHematologyModerate
Adverse Effects
- Acute respiratory distress syndrome (ARDS)PulmonaryRare
- Splenomegaly / splenic ruptureOrgan ToxicityUncommon
- Bone painMusculoskeletalCommon
- Injection site reactionsLocalCommon
- LeukocytosisHematologicRare
- ThrombocytopeniaHematologicUncommonLow platelet count
- FeverSystemicCommonElevated body temperature
- SplenomegalyHematologicUncommon
- Injection‑site reactionLocalCommon
- Bone pain / musculoskeletal painMusculoskeletalCommon
Drug Interactions
- Cytotoxic chemotherapy agentsModerate
- Chemotherapeutic agentsHigh
- BleomycinModerate
- CorticosteroidsLow
- LithiumLow
Population Constraints
- PregnancyReproductive SafetyRelative
- Renal impairmentOrgan ImpairmentRelative
- Elderly (>65 years)AgeRelative
- Pediatric patientsAgeRelative
- Patients with sickle cell diseaseHematologic DisorderRelative
- Pediatric patients (<2 years)AgeRelative
Regulatory Status
- European UnionApprovedApproved: Chemotherapy‑induced neutropenia, Peripheral blood stem cell mobilizationApproved under EMA centralized procedure
- United StatesApprovedApproved: Chemotherapy‑induced neutropenia, Peripheral blood stem cell mobilization, Severe chronic neutropeniaMarketed as Neupogen, Zarxio
- United KingdomApprovedApproved: Chemotherapy‑induced neutropenia, Peripheral blood stem cell mobilizationAvailable via NHS formularies
Approved by FDA in 1991 (Neupogen). Multiple biosimilars approved in the US and EU. Not interchangeable with pegfilgrastim without clinical reassessment.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Filgrastim?
Filgrastim is a recombinant 175‑amino‑acid protein used to reduce the duration of chemotherapy‑induced neutropenia and to mobilize peripheral blood stem cells for transplantation.
What is Filgrastim used for?
Filgrastim is educationally associated with: Severe chronic neutropenia, Chemotherapy‑induced neutropenia, Reduction of chemotherapy-induced febrile neutropenia, Acceleration of neutrophil recovery post bone marrow transplant, Severe chronic neutropenia management, Peripheral blood stem cell mobilization, Acute radiation syndrome (hematopoietic subsyndrome). Educational only — not medical advice.
How is Filgrastim administered?
Recorded routes of administration: Intravenous, Subcutaneous.
What are the potential side effects of Filgrastim?
Reported adverse effects include: Acute respiratory distress syndrome (ARDS), Splenomegaly / splenic rupture, Bone pain, Injection site reactions, Leukocytosis, Thrombocytopenia, Fever, Splenomegaly, Injection‑site reaction, Bone pain / musculoskeletal pain. This list is not exhaustive — consult a qualified clinician.
Who should avoid Filgrastim?
Recorded contraindications: Hypersensitivity to filgrastim or E. coli‑derived proteins, Hypersensitivity to filgrastim or E. coli-derived proteins, Use in myeloid malignancies (AML/CML) without specific justification, Sickle cell disease. Consult a qualified clinician before use.