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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :18 800
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Very high
  • %Excreted unchanged in urine &nbsp &nbsp : 0

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.15

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :3.5/–

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function and titrate dose to response
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function and titrate dose to response
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function and titrate dose to response

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

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

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp :Not dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp: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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