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

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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

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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