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Other Names: Neupogen®, Zarxio®, Nivestym™

About This Drug

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

Possible Side Effects  

  • Decrease in platelets. This may raise your risk of bleeding.
  • Fever
  • Tiredness
  • Dizziness
  • Chest pain
  • Cough and trouble breathing
  • Nauseav
  • General pain and aching
  • Back and bone pain
  • Headache
  • Rash
  • Changes in your liver function

Note: Each of the side effects above was reported in 10% or greater of patients treated with filgrastim. These side effects may be more severe if you are receiving high doses of this medication included in autologous progenitor cell collection therapy or for other medical reasons. Not all possible side effects are included above.

Warnings and Precautions 

  • Enlargement and inflammation (swelling) of your spleen, which can rupture and be life-threatening. Signs of enlargement may be left-sided pain in your abdomen and/or shoulder.
  • Trouble breathing because of fluid build-up in your lungs caused by inflammation (swelling) of the lungs
  • Bleeding in lungs which may cause coughing up of blood when used in healthy donors for stem cell mobilization
  • 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.
  • Sickle cell crisis which may be life-threatening, in sickle cell patients treated with filgrastim
  • Changes in your kidney function
  • Injection site reaction - you may get a rash, swelling or bruising or your skin may get red, warm, itchy or painful at the site of your infusion or injection
  • A rapid increase in your white blood cells may happen
  • A decrease in the number of platelets, which increases your risk of bleeding
  • 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.
  • Inflammation of the blood vessels in your skin which can cause red or purple spots on your skin
  • Inflammation of the aorta- symptoms may include fever, abdominal pain, back pain and feeling tired.

Note: Some of the side effects above are very rare and may depend on the type and dose of filgrastim you are taking. If you have any concerns and/or questions, please discuss them with your medical team. 

How to Take Your Medication

  • Talk to your doctor, nurse and/or pharmacist for proper preparation, dosing and administration if you are self-injecting this medicine.
  • Do not shake the medicine. You can take it out of the refrigerator 30 minutes before use to allow it to come to room temperature. Throw away any medicine that has been left at room temperature for longer than 24 hours.
  • Do not substitute the vial for the pre-filled syringes.
  • Do not reuse the needles, or any unused medicine left in the syringe after your dose is injected.
  • Missed dose: If you miss a dose, contact your physician right away.
  • Handling: Wash your hands after before and after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • The cap of the pre-filled syringe contains latex. Please speak to your doctor if you have a latex allergy. Caregivers with latex allergies should use precaution.
  • Storage: Store this medicine in the refrigerator between 36°F to 46°F (2°C to 8°C). Store this medicine in the original carton to protect it from light. Do not freeze. Discuss with your nurse or your doctor how to dispose of unused medicine/needles.

Treating Side Effects 

  • To decrease the risk of bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Manage tiredness by pacing your activities for the day.
  • If you are dizzy, get up slowly after sitting or lying.
  • Be sure to include periods of rest between energy-draining activities.
  • 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 of 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 stop or lessen these symptoms.
  • 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.
  • While you are getting this drug, please tell your nurse right away if you get a rash, swelling or bruising or your skin gets red, warm, itchy or painful at the site of your infusion or injection.

Food and Drug Interactions

  • There are no known interactions of filgrastim with food.
  • This drug may interact with other medicines. Tell your doctor and pharmacist about all the prescription and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. 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 100.4° F (38° C) or higher
  • Chills
  • Easy bleeding or bruising
  • Cough and/or coughing up of blood
  • Wheezing and/or trouble breathing
  • Feeling dizzy or lightheaded
  • A headache that does not go away
  • Tiredness that interferes with your daily activities
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Pain in the left side of your abdomen and/or shoulder pain
  • Back pain or abdominal pain
  • Decreased urine, or very dark urine
  • Pain that does not go away or is not relieved by prescribed medicine
  • New rash and/or itching
  • Red or purple spots on your skin
  • Swelling of legs, ankles, or feet
  • Rash that is not relieved by prescribed medicines
  • 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
  • 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. If this happens, call 911 for emergency care.
  • 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 talk to their doctor about the risks and benefits of breastfeeding during treatment with this drug because this drug may 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 July 2019

This patient information was developed by Via Oncology, LLC © 2019. 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.