Filgrastim interactions

Conditions

Conditions in which Filgrastim needs care, as documented in this source.

• Glomerulonephritis

  Major

  Although it has been reported that renal dysfunction has no effect on the pharmacokinetics of colony stimulating factors (CSF), filgrastim and pegfilgrastim may cause glomerulonephritis. Symptoms include swelling of the face or ankles, dark colored urine, or blood in the urine, or a decrease in urine production. Advise patients to report signs or symptoms of glomerulonephritis immediately. Monitoring of patients with renal dysfunction is recommended.

  3 sources

  1. "Product Information. Neupogen (filgrastim)." Amgen (2002):
  2. "Product Information. Neulasta (pegfilgrastim)." Amgen (2002):
  3. "Product Information. Granix (tbo-filgrastim)." Teva Pharmaceuticals USA (2013):

• Leukemia, Myeloid

  Major

  Colony stimulating factors primarily stimulates the proliferation of neutrophils but may also, theoretically, enhance tumor growth, particularly in myeloid malignancies. Therapy with these drugs should be administered cautiously in patients with myeloid tumors. Additionally, if used for PBPC (peripheral blood progenitor cell) collection in such patients, tumor cells may be released from the marrow and collected in the leukapheresis product. The effect of reinfusion of tumor cells is uncertain at this time.

  2 sources

  1. "Product Information. Neupogen (filgrastim)." Amgen (2002):
  2. "Product Information. Neulasta (pegfilgrastim)." Amgen (2002):

• Leukocytosis

  Major

  Filgrastim and pegfilgrastim are growth factors for neutrophil progenitor cells. Therefore, these should not be used in patients with leukocytosis. If excessive white blood cell counts occur during CSF therapy, treatment should be interrupted or the dosage reduced.

  3 sources

  1. Hollingshead LM, Goa KL "Recombinant granulocyte colony-stimulating factor (rG-CSF). A review of its pharmacological properties and prospective role in neutropenic conditions." Drugs 42 (1991): 300-30
  2. "Product Information. Neupogen (filgrastim)." Amgen (2002):
  3. "Product Information. Neulasta (pegfilgrastim)." Amgen (2002):

• Anemia, Sickle Cell

  Moderate

  Severe and sometimes fatal sickle cell crises have been reported in sickle cell disease patients receiving filgrastim products. Consider the potential risks and benefits prior to initiating therapy in these patients.

  2 sources

  1. "Product Information. Neupogen (filgrastim)." Amgen (2002):
  2. "Product Information. Granix (tbo-filgrastim)." Teva Pharmaceuticals USA (2013):

• Neoplasms

  Moderate

  Tbo-filgrastim can act as a growth factor for any tumor type, including myeloid malignancies and myelodysplasia disease, diseases for which its use has not been approved.

  1 source

  1. "Product Information. Granix (tbo-filgrastim)." Teva Pharmaceuticals USA (2013):

• Sepsis

  Moderate

  When filgrastim is used in septic patients, clinicians should be alerted to the theoretical possibility of adult respiratory distress syndrome, which may occur as a result of the influx of neutrophils at the site of inflammation. Monitoring of respiratory status may be appropriate in these patients.

  2 sources

  1. Hollingshead LM, Goa KL "Recombinant granulocyte colony-stimulating factor (rG-CSF). A review of its pharmacological properties and prospective role in neutropenic conditions." Drugs 42 (1991): 300-30
  2. "Product Information. Neupogen (filgrastim)." Amgen (2002):

• Thrombocytopenia

  Moderate

  Filgrastim may occasionally lower platelet counts. Thrombocytopenia has been reported, although most often the effects are mild or moderate and not associated with serious hemorrhagic sequelae. Nevertheless, therapy with filgrastim should be administered cautiously in patients with preexisting thrombocytopenia. Frequent blood counts are recommended, and the dosage of filgrastim adjusted if necessary.

  5 sources

  1. Wun T "The Felty syndrome and G-CSF-associated thrombocytopenia and severe anemia ." Ann Intern Med 118 (1993): 318-9
  2. Balmer CM "Clinical use of biologic response modifiers in cancer treatment: an overview. Part II. Colony-stimulating factors and interleukin-2." DICP 25 (1991): 490-8
  3. Momin F, Kraut M, Lattin P, Valdivieso M "Thrombocytopenia in patients receiving chemoradiotherapy and G-CSF for locally advanced non-small cell lung cancer (NSCLC) (meeting abstract)." Proc Annu Meet Am Soc Clin Oncol 11 (1992): a983
  4. "Product Information. Neupogen (filgrastim)." Amgen (2002):
  5. Kawachi Y, Watanabe A, Uchida T, Yoshizawa K, Kurooka N, Setsu K "Acute arterial thrombosis due to platelet aggregation in a patient receiving granulocyte colony-stimulating factor." Br J Haematol 94 (1996): 413-6