Sargramostim

Other Names: Leukine®

About This Drug

Sargramostim belongs to a class of medicines called granulocyte colony-stimulating factor (G-CSF). GCSF helps the body make more white blood cells. White blood cells help fight infection in your body. This drug is given in the vein (IV) or as an injection under the skin (subcutaneously).

Possible Side Effects

  • Weakness
  • Headache 
  • Hair loss. Hair loss is often temporary, although with certain medicine, hair loss can sometimes be permanent. Hair loss may happen suddenly or gradually. If you lose hair, you may lose it from your head, face, armpits, pubic area, chest, and/or legs. You may also notice your hair getting thin.
  • Fever
  • Cough or trouble breathing
  • General discomfort, feeling of being unwell (malaise)
  • Infections
  • Nausea and vomiting (throwing up)
  • Decreased appetite (decreased hunger)
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that hurt.
  • Swelling of your legs, ankles and/or feet
  • Pain in your abdomen
  • Loose bowel movements (diarrhea)
  • Weight loss
  • Blood sugar levels may change. If you have diabetes, changes may need to be made to your diabetes medication.
  • Urinary tract infection- Symptoms may include:
    • Pain or burning when you pass urine.
    • Feeling like you have to pass urine often, but not much comes out when you do.
    • Tender or heavy feeling in your lower abdomen.
    • Cloudy urine and/or urine that smells bad.
    • Pain on one side of your back under your ribs. This is where your kidneys are. 
  • Fever, chills, nausea and/or throwing up.
  • High blood pressure
  • Decreased albumin (protein) in the blood
  • Changes in your liver function
  • Changes in electrolytes
  • Rash

Note: Each of the side effects above was reported in 30% or greater of patients treated with sargramostim. Not all possible side effects are included above.

Warnings and Precautions

  • Severe swelling of your legs, ankles and/or feet, or fluid build-up around your lungs, heart or elsewhere 
  • A syndrome where fluid and protein can leak from your blood vessels into your tissues. This can cause a decrease in your blood protein level and blood pressure and fluid can accumulate in your tissues and/or lungs.
  • Abnormal heart beat/EKG
  • While you are getting this drug in your vein (IV), you may have a reaction to the drug. Sometimes you may be given medication to stop or lessen these side effects. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain. These reactions may happen after your infusion. If this happens, call 911 for emergency care.
  • Allergic reactions, including anaphylaxis are rare but may happen in some patients. Signs of allergic reaction to this drug may be swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way. If this happens, do not take another dose of this drug. You should get urgent medical treatment.
  • A rapid increase in your white blood cells may happen 

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

Treating Side Effects

  • To help with hair loss, wash with a mild shampoo and avoid washing your hair every day. 
  • Avoid rubbing your scalp, pat your hair or scalp dry.
  • Avoid coloring your hair.
  • Limit your use of hair spray, electric curlers, blow dryers, and curling irons.
  • If you are interested in getting a wig, talk to your nurse. You can also call the American Cancer Society at 800-ACS-2345 to find out information about the “Look Good, Feel Better” program close to where you live. It is a free program where women getting chemotherapy can learn about wigs, turbans and scarves as well as makeup techniques and skin and nail care.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • Mouth care is very important. Your mouth care should consist of routine, gentle cleaning of your teeth or dentures and rinsing your mouth with a mixture of 1/2 teaspoon of salt in 8 ounces of water or ½ teaspoon of baking soda in 8 ounces of water. This should be done at least after each meal and at bedtime. 
  • If you have mouth sores, avoid mouthwash that has alcohol. Also avoid alcohol and smoking because they can bother your mouth and throat.
  • If you have diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash bothers you.
  • Infusion reactions may occur after your infusion. If this happens, call 911 for emergency care. 

Food and Drug Interactions

  • There are no known interactions of sargramostim with food.
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with sargramostim. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions. 

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms: 

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Headache that does not go away 
  • Cough 
  • Wheezing and/or trouble breathing 
  • Feeling dizzy or lightheaded
  • Fatigue that interferes with your daily activities
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Pain in your mouth or throat that makes it hard to eat or drink
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Swelling of legs, ankles, or feet 
  • Weight gain of 5 pounds in one week (fluid retention)
  • Abnormal blood sugar 
  • Pain or burning when you pass urine
  • Difficulty urinating
  • Feeling like you have to pass urine often, but not much comes out when you do
  • Tender or heavy feeling in your lower abdomen
  • Cloudy urine and/or urine that smells bad
  • Pain on one side of your back under your ribs. This is where your kidneys are.
  • Unusual thirst, passing urine often, headache, sweating, shakiness, irritability
  • Signs of infusion reaction: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain 
  • Signs of allergic reaction: swelling of the face, feeling like your tongue or throat are swelling, trouble breathing, rash, itching, fever, chills, feeling dizzy, and/or feeling that your heart is beating in a fast or not normal way 
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin • A new rash or a rash that is not relieved by prescribed medicines
  • If you think you may be pregnant 

Reproduction Warnings

  • Pregnancy warning: It is not known if this drug may harm an unborn child. For this reason, be sure to talk with your doctor if you are pregnant or planning to become pregnant while receiving this drug. Let your doctor know right away if you think you may be pregnant.
  • Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should not breastfeed during treatment and for 2 weeks after treatment because this drug could enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: Human fertility studies have not been done with this drug. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking. 

Revised June 2018

This patient information was developed by Via Oncology, LLC © 2018. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.

CLIENT acknowledges that the Via Pathways and Via Portal are information management tools only, and that Via Oncology, LLC has not represented the Via Pathways or Via Portal as having the ability to diagnose disease, prescribe treatment, or perform any other tasks that constitute the practice of medicine. The clinical information contained in the Via Pathways and Via Portal are intended as a supplement to, and not a substitute for, the knowledge, expertise, skill, and judgment of physicians, pharmacists and other healthcare professionals involved with patient care at CLIENT facilities.