Monograph Details
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Hematology
> White blood cell disorders
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NEUPOGEN |
| Manufacturer |
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Amgen, Inc. |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Granulocyte colony stimulating factor. |
| Generic Name |
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Filgrastim 600micrograms/mL prefilled syringe; for SC or IV infusion; preservative-free. |
| Also |
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• NEUPOGEN VIALS
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| Indications |
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See literature. To decrease incidence of infection in patients with nonmyeloid malignancies receiving certain myelosuppressive anti-cancer drugs. To reduce time to neutrophil recovery and fever duration after induction and consolidation chemotherapy treatment of adults with AML. To reduce duration of neutropenia and related sequelae in patients with nonmyeloid malignancies undergoing myeloablative chemotherapy followed by bone-marrow transplantation (BMT). To mobilize hematopoietic progenitor cells (PBPC) into peripheral blood for collection by leukapheresis. To reduce the incidence and duration of neutropenia sequelae in severe chronic neutropenia (SCN). |
| Children |
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See literature. |
| Adults |
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See literature. Do not give for at least 24 hrs before or after cytotoxic chemotherapy dose. BMT: Give 1st dose at least 24 hrs after bone marrow infusion. SCN: Give on a daily basis. |
| Contraindications |
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Hypersensitivity to E. coli-derived products. |
| Precautions |
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Monitor blood, including CBC and differential and platelets, before and during therapy (myelosuppressive chemotherapy: monitor twice weekly; BMT: at least 3 times weekly; SCN: twice per week during initial 4 weeks of therapy and during 2 weeks after dose adjustment). Discontinue if post nadir absolute neutrophil count (ANC) reaches 10,000/mm3 for patients receiving myelosuppressive chemotherapy; other indications: see literature. Monitor for splenomegaly/splenic rupture and for adult respiratory distress syndrome (ARDS); suspend until ARDS resolves if fever or lung infiltrates occur. Confirm diagnosis and do appropriate pretreatment hematological workup in SCN. Preexisting cardiac or hyperplastic skin conditions. Sickle cell disease (may cause sickle cell crisis). Avoid simultaneous chemo- and radiation therapy. Pregnancy (Cat.C). Nursing mothers. |
| Interactions |
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Caution with mitomycin C, and with concomitant (same day) drugs that decrease platelets, or increase release of neutrophils (eg, lithium), or cause delayed myelosuppression, or with myelosuppressive doses of antimetabolites (eg, nitrosoureas, 5-FU). |
| Adverse Reactions |
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Bone pain, cutaneous vasculitis, splenomegaly, others (see literature). |
| How Supplied |
Prefilled syringes (0.5mL, 0.8mL)—10
Vials (1mL, 1.6mL)—10 |
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