Neupogen injection contains the active ingredient filgrastim, which is a type of medicine called a recombinant human granulocyte-colony stimulating factor (G-CSF). G-CSF is a substance produced naturally by the body that stimulates the bone marrow to produce white blood cells known as neautrophils. Filgrastim is a man-made version of G-CSF.
What is it used for?
- Reducing the duration of neutropenia and risk of infection in people treated with chemotherapy for cancer (with the exception of chronic myeloid leukaemia and myelodysplastic syndromes).
- Reducing duration of neutropenia in people who have had a bone marrow transplant.
- Reducing the risk of infections in people with advanced HIV infection and persistant neutropenia.
- Long-term therapy to increase neutrophil counts and reduce the number and duration of infections in people with low neutrophil counts from birth (severe congenital neutropenia), low neutrophil counts that recur at regular intervals (cyclic neutropenia), or low neutrophil counts with no known cause (idiopathic neutropenia).
- To increase production of immature blood cells (stem cells or progenitor cells) that are then collected by drawing blood, so the patient can receive transfusions of their own stem cells, for example following hi
How does it work?
- Neupogen injection contains the active ingredient filgrastim, which is a type of medicine called a recombinant human granulocyte-colony stimulating factor (G-CSF). G-CSF is a substance produced naturally by the body that stimulates the bone marrow to produce white blood cells known as neutrophils. Filgrastim is a man-made version of G-CSF.
- Neutrophils, like all blood cells, are produced naturally by the bone marrow. They play a cental role in the body's immune system because they help defend the body from infections. A low level of neutrophils in the blood (neutropenia), leaves a person very susceptible to life threatening infections.
- Neutropenia can be caused by a number of factors, including cancer chemotherapy, which often kills normal healthy cells such as blood cells as well as the cancer cells. Neutropenia also often occurs in people who have recently had a bone marrow transplant or who are suffering from AIDS.
- Filgrastim is used to correct low neutrophil levels in the blood and thereby reduce the duration and severity of neutropenia. As a result, filgrastim minimises the need for antibiotic treatment, the risk of complications due to infections and length of time spent in hospital.
- The injection is given on a daily basis, with the length of treatment depending on the reason the medicine is being given and the results of blood cell counts. It is given either under the skin (subcutaneous injection), most often of the thigh, arm or abdomen, or as a drip into a vein (intravenous infusion).
Use with caution in
- Acute myeloid leukaemia (AML)
- People who have recently had pneumonia
- Hereditary fructose intolerance
- Sickle cell disease.
Not to be used in
- Severe congenital neutropenia (Kostman's syndrome) with abnormal chromosomes.
Pregnancy and Breastfeeding
- There safety of this medicine during pregnancy has not been established, therefore it is not recommended for use during pregnancy, unless considered essential by your doctor. Seek medical advice from your doctor.
- There is no information available about the safety of this medicine during breastfeeding. For this reason it is not recommended for women who are breastfeeding. Seek medical advice from your doctor.
- Pain in muscles or bones (musculoskeletal pain)
- Disturbances of the gut, such as nausea, vomiting, diarrhoea, constipation
- Enlargement of the spleen
- Loss of appetite
- Hair loss (alopecia)
- Skin rash
- Alteration in results of liver function tests
- Nosebleeds (epistaxis)
- Difficulty or pain on passing urine (dysuria)
- Protein or blood in the urine
- Decrease in the number of platelets in the blood (thrombocytopenia)
- Decrease in the number of red blood cells in the blood (anaemia)
- Injection site reaction
- Worsening of arthritis
- Fluid on the lungs (pulmonary oedema)
- A sudden inability to breath (adult respiratory distress syndrome, ARDS)
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
- This medicine is not known to affect other medicines. However, it is important to tell your doctor or pharmacist what medicines you are already taking, before you start treatment with this medicine. Similarly, always check with your doctor or pharmacist before taking any new medicines while you are having treatment with this one, to ensure that the combination is safe.
- The first dose of this medicine should not be administered in the 24 hours before and 24 hours after chemotherapy for cancer, as the chemotherapy medicine may also affect any new blood cells produced by the filgrastim.
- The first dose of this medicine should not be given within 24 hours of bone marrow infusion.