Grastigen

Treatment or prevention of neutropenia in patients receiving myelosuppressive cancer chemotherapy & period reduction of neutropenia in patients undergoing bone marrow transplantation. Mobilisation of peripheral blood progenitor cells for use as alternative to bone marrow transplantation, in management of chronic neutropenia (congenital, cyclic, or idiopathic), & for persistent neutropenia in patients w/ advanced HIV infection.

Adult & childn Adjunct to antineoplastic therapy 5 mcg/kg daily starting not <24 hr after last dose of antineoplastic, can be given as single daily SC inj, as continuous IV/SC infusion, or as daily IV infusion over 15-30 min. Continue until neutrophil count has stabilised w/in normal range, may take up to ≥14 days. Bone marrow transplantation Initially 10 mcg/kg daily, adjusted according to response, may be given by IV infusion over 30 min or 4 hr, or by continuous IV/SC infusion over 24 hr. Mobilisation of peripheral blood progenitor cells 10 mcg/kg daily may be given as single daily SC inj or by continuous infusion for 4-7 days until leucapheresis. Dose is halved to 5 mcg/kg daily by SC inj if given after myelosuppressive chemotherapy. Patient w/ congenital neutropenia Initially 12 mcg/kg daily given SC in single or divided doses & adjusted according to response. Patient w/ idiopathic or cyclic neutropenia Initially 5 mcg/kg daily given SC in single or divided doses & adjusted according to response. Patient w/ HIV infection & persistent neutropenia Initially 1 mcg/kg daily by SC inj, may be titrated up to max of 4 mcg/kg daily until normal neutrophil count is achieved, then adjusted for maintenance according to response. Maintenance dose: 300 mcg daily on 1-7 days a wk.

Hypersensitivity.

Avoid simultaneous use w/ chemotherapy & RT; administration in patients receiving cytotoxic drugs, for 24 hr prior to & 24 hr after chemotherapy. May act as growth factor for any tumor type. Monitor patients who have history of gout or malignancies that are associated w/ increased uric acid levels regularly. Pregnancy & lactation. Safety & efficacy have not been established in neonates & autoimmune neutropenia of infancy.

Mild to moderate (occasionally severe) medullary bone pain. Pyrexia, vomiting, diarrhea, asthenia, generalized pain, cough, abdominal pain, anemia, pain in extremity, nausea, anorexia, hypoaesthesia, paraesthesia, mucosal inflammation & dysuria.

Use drugs which may potentiate release of neutrophils eg, lithium w/ caution.

Haematopoietic Agents / Supportive Care Therapy

L03AA02 - filgrastim ; Belongs to the class of colony stimulating factors. Used as immunostimulants.

Rx