Tbo-filgrastim (Granix®)

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About This Drug

Tbo-filgrastim 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. It is given as an injection under the skin (subcutaneously). 

Possible Side Effects

  • Bone pain

Note: Each of the side effects above was reported in 1% or greater of patients treated with tbo-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
  • 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 
  • A rapid increase in your white blood cells may happen
  • 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 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 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 5 days.
  • 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.
  • If you get any of the content of a syringe or vial on your skin or in your eyes, you should wash the area of the skin well with soap and water right away. Wash your eyes with flowing water for at least 15 minutes and call your doctor. Call your doctor if you get a skin reaction
  • 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

  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.

Food and Drug Interactions

  • There are no known interactions of tbo-filgrastim with food.
  • 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
  • Wheezing and/or trouble breathing
  • 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 your left-sided 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
  • 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 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, women of child-bearing potential should use effective methods of birth control during your cancer treatment. 
  • Breastfeeding warning: Women should not breastfeed during treatment and for 3 days 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 March 2019

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.