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Filgrastim - Learn about Filgrastim Side Effects and Precautions

Filgrastim Information

The pharmacology action of Filgrastim is that it competitively antagonizes histamine at the H 1 receptor site.

Filgrastim is used for cancer patients receiving myelosuppressive chemotherapy; patients with acute myeloid leukemia receiving induction or consolidation chemotherapy; cancer patients receiving bone-marrow transplant; patients with severe chronic neutropenia; peripheral blood progenitor cell (PBPC) collection and therapy in cancer patients.

Interaction and Contraindication of Filgrastim

Interaction of Filgrastim - Drugs that may potentiate the release of neutrophils, such as lithium, should be used with caution. Use with caution in conjunction with other drugs known to lower the platelet count.

Contraindication of Filgrastim - Hypersensitivity to Escherichia coli -derived proteins, filgrastim, or any component of the product

Side Effects of Filgrastim

Here are the list of some common side effects of Filgrastim :

• Hypertension, hypotension (4%); cardiac events (eg, MI, arrhythmias [3%]).
• Alopecia (18%); petechiae (17%); rash 12%; cutaneous vasculitis; exacerbation of preexisting skin disorders (eg, psoriasis).
• Nausea/vomiting (57%); diarrhea (14%); mucositis (12%); anorexia (9%); stomatitis, constipation (5%); peritonitis (2%).
• Increased neutrophil count (100%); decreased platelet counts (97%); mild to moderate anemia (65%); thrombocytopenia, increased WBC (12%); severe hemorrhage (7%); capillary leak syndrome.
• Splenomegaly (30%); neutropenic fever (13%); fever (12%); transfusion reactions (10%); chest pain (5%); pain (2%); injection site reaction; acute myeloid leukemia, myelodysplastic syndrome (postmarketing [2% annually]).

Precaution and Warning while taking Filgrastim

The precaution and warnings of Filgrastim drug is as follows:

• Ensure patient or caregiver who is administering filgrastim understands how to store, prepare, and administer the dose, and dispose of used equipment and supplies. The first injection should be performed under the supervision of a qualified health care professional.
• Advise patient or caregiver to inject filgrastim at the same time each day.
• Caution patient or caregiver not to shake the vial or prefilled syringe of filgrastim because shaking may damage the filgrastim.
• Caution patient or caregiver not to use any filgrastim that is foamy, clouding, discolored, or contains particulate matter.
• Instruct patient to take exactly as prescribed and not to change or stop taking the dose unless advised by health care provider. Caution patient that taking too little filgrastim may not protect against infections, and taking too much may cause too many WBCs to be produced.
• Remind patient to rotate injection sites and never to inject into tissue that is tender, red, bruised, or hard, or has scars or stretch marks.
• Advise patient or caregiver that aching in the bones and muscles is the most common side effect, but can usually be relieved by taking non-aspirin pain reliever (eg, acetaminophen). Advise patient or caregiver to notify health care provider if bone or muscle aches are severe or are not relieved by acetaminophen.
• Instruct patient or caregiver to immediately notify health care provider if any of the following occur: signs or symptoms of infection (eg, fever, chills, rash, sore throat, diarrhea, or redness, swelling, or pain around a cut or open sore; pain in left upper stomach area or left shoulder tip area; rash; unexplained shortness of breath; wheezing; fast pulse; swelling around mouth or eyes.

How to store Filgrastim

• Do not give filgrastim 24 hr before or 24 hr after cytotoxic chemotherapy.
• Do not shake medication.
• Warm to room temperature before injection. Use within 24 hr.
• Use only 1 dose per vial, and do not reenter vial.
• Do not dilute with saline.
• Give IV injection, diluted in D5W, over 15 to 30 min.
• Store in refrigerator, but do not freeze. Discard any unused vial left at room temperature more than 6 hr.