Filgrastim

Active pharmaceutical substance formulated in Jan Aushadhi generic products for Oncology & Critical Care treatment.

🧴 Clinical Application

Administer by subcutaneous (SC) injection or short intravenous (IV) infusion (over 15 to 30 minutes diluted in 5% Dextrose ONLY; NEVER in 0.9% NaCl, which precipitates the protein). Standard dose is 5 mcg/kg/day (typically 300 mcg daily). Administer starting at least 24 hours AFTER the completion of cytotoxic chemotherapy; do NOT administer within 24 hours before or after chemotherapy. Continue daily until post-nadir absolute neutrophil count (ANC) reaches >= 2,000 to 3,000/mm³.

⚠️ Side Effects

Common: Mild-to-moderate medullary bone pain (lower back, pelvis, sternum in up to 30-40% of patients; easily managed with paracetamol or antihistamines/loratadine), injection site erythema, headache, mild leukocytosis. Rare/Severe: Splenic rupture (can be fatal), Acute Respiratory Distress Syndrome (ARDS), severe allergic anaphylactoid reactions, and sickle cell crises in patients with sickle cell disease.

🛡️ Safety Warnings

Black Box Warning: Splenic rupture; evaluate any left upper abdominal or shoulder pain immediately. Black Box Warning: ARDS (respiratory distress, hypoxemia). Do NOT administer in the 24 hours before or after chemotherapy (proliferating myeloid cells are rapidly killed by cytotoxic drugs). Avoid in patients with history of sickle cell disorders.