Filgrastim

What is filgrastim?

Filgrastim is a drug used to help the body make new white blood cells. White blood cells are the cells in the blood that fight infection. Filgrastim may be given following cancer treatments or after bone marrow or stem cell transplants when white blood cells are low. It may also be used in other situations where the white blood count is low.

Filgrastim is a type of medication called granulocyte colony stimulating factor or G-CSF. You may hear filgrastim also called by its brand name, Neupogen or Grastofil. Filgrastim comes as a clear liquid for injection. It is given by a needle just under the skin (subcutaneously or sc), or into a vein (intravenously or IV).

Before giving filgrastim to your child

Tell your doctor if your child has any drug allergies or has ever had a reaction to filgrastim, pegfilgrastim, E. coli-derived products or any other medications.

The Grastofil syringe system contains a substance similar to latex. Those with sensitivities to latex should not handle the medication. Patients with latex allergies should not take Grastofil.

Talk with your doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• a history of inflammatory disease or immune system problems
• heart problems
• liver or kidney problems
• lung problems
• sickle cell disease
• history of uncontrolled bleeding

How should you give your child filgrastim?

Your child's first dose of filgrastim will likely be given in the hospital or in clinic. If your child is to receive filgrastim at home, arrangements may be made to have a nurse come into the home to give it. Alternatively, you may be taught by one of the nurses to give your child the subcutaneous (sc) injections at home.

If you give the injections at home:

• Make sure you understand and are comfortable with the way to prepare and inject filgrastim and know how to dispose of the needle and syringe.
• Make sure to check the dose of filgrastim your child should receive.
• Give filgrastim at the same time each day.
• Check with your nurse the best area(s) to inject the filgrastim into.
• Always inspect each vial or syringe of filgrastim. The liquid should be clear. If it is cloudy or you see little particles in the vial or syringe, do not use the medication.
• Do not shake the vials or syringes of filgrastim. Shaking causes bubbles and froth, which makes it difficult to draw up a full dose. If bubbles or froth occur, let the vial or syringe stand for a few minutes so that the bubbles or froth disappear.

Use only one dose per vial or pre-filled syringe. Discard unused portions. Do not save unused medication to give to your child later.

What should you do if your child misses a dose of filgrastim?

• If your child misses a dose, contact your health-care provider.

What are the possible side effects of filgrastim?

Your child may have some of these side effects while they take filgrastim. Check with your child's doctor if your child continues to have any of these side effects, and they do not go away, or they bother your child:

• slight redness or soreness where the needle was put in
• mild headache
• bone pain, especially in the lower back or hips
• muscle aches or pains
• nausea and/or vomiting (throwing up)

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:

• severe stomach (belly) pain
• rash or any other sign of an allergic reaction
• swelling and faintness
• rapid or irregular heartbeat
• trouble breathing
• fever

What safety measures should you take when your child is using filgrastim?

There are some medicines that should not be taken together with filgrastim or in some cases the dose of filgrastim or the other medicine may need to be adjusted. It is important that you tell your doctor and pharmacist if your child takes any other medications (prescription, over the counter, or herbal).

What other important information should you know about filgrastim?

• Do not stop giving filgrastim without checking with your child's doctor. Filgrastim is usually only prescribed for a short course of up to 10 to 14 days, or as otherwise directed by your child's physician.
• Tell your doctor or dentist that your child is receiving filgrastim before your child has any operation, even on the teeth, or an emergency treatment.
• Do not share your child's medicine with others. Do not give anyone else's medicine to your child.
• Make sure you always have enough filgrastim to last through weekends, holidays and vacations. Call your pharmacy at least two days before your child runs out of medicine to order refills. Not all pharmacies carry filgrastim, so make sure you have arranged a supply before leaving the hospital.
• After you give your child the injection, throw away the needles and syringes in the special container (sharps container) that was given to you. Do NOT throw used needles and syringes in the garbage. If you did not receive a sharps container, or if your container is full, use an empty large plastic container with a small opening, such as an empty liquid laundry detergent container.
• Filgrastim vials or syringes may be stored in the fridge at room temperature. If left at room temperature for longer than 14 days, it should be discarded. Do not freeze this medicine.
  
• Do not use or keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
  

Keep filgrastim out of your child’s sight and reach and locked up in a safe place. If your child takes too much filgrastim, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.