Filgrastim

CLINICAL USE

Recombinant human granulocyte-colony stimulating factor (rhG-CSF):Treatment of neutropenia

DOSE IN NORMAL RENAL FUNCTION

0.5–1.2 MU/kg/day according to indication and patient response

PHARMACOKINETICS

Molecular weight :18 800

%Protein binding :Very high

%Excreted unchanged in urine : 0

Volume of distribution (L/kg) :0.15

half-life – normal/ESRD (hrs) :3.5/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function and titrate dose to response

10 to 20 : Dose as in normal renal function and titrate dose to response

<10 : Dose as in normal renal function and titrate dose to response

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in GFR <10 mL/min

HD :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Not dialysed. Dose as in GFR <10 mL/min

CAV/VVHD :Not dialysed. Dose as in GFR=10–20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

None known

ADMINISTRATION

Reconstition

–

Route

IV, SC

Rate of Administration

IV: Over 30 minutes or continuous IV infusion over 24 hoursSC: Can give as continuous SC infusion over 24 hours

Comments

IV: Dilute with glucose 5% ONLY; minimum concentration 0.2 MU per mL – add Human Serum Albumin if concentration is less than 1.5 MU per mLSC: Continuous infusion – dilute with 20 mL of glucose 5%Dilute Neupogen may be adsorbed to glass and plastic materials – follow recommendations for dilution

OTHER INFORMATION

One very small study (2–3 patients) concluded that body clearance of filgrastim was not affected by any degree of renal impairment

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