Filgrastim is used to decrease the chance of infection in people who have certain types of cancer and are receiving chemotherapy medications that may decrease the number of neutrophils (a type of blood cell needed to fight infection), in people who are undergoing bone marrow transplants, and in people who have severe chronic neutropenia (condition in which there are a low number of neutrophils in the blood). Filgrastim is also used to prepare the blood for leukapheresis (a treatment in which certain blood cells are removed from the body and then returned to the body following chemotherapy). Tbo-filgrastim is used to decrease the chance of infection in people who have certain types of cancer and are receiving chemotherapy medications that may decrease the number of neutrophils (a type of blood cell needed to fight infection). Filgrastim and tbo-filgrastim are in a class of medications called colony-stimulating factors. They work by helping the body make more neutrophils.
Filgrastim comes as a solution (liquid) in vials and pre-filled syringes to inject under the skin or into a vein. It is usually given once a day, but may be given twice a day when it is used to treat severe chronic neutropenia. The length of your treatment depends on the condition that you have and how well your body responds to the medication. If you are using filgrastim to decrease the risk of infection during chemotherapy, you will receive your first dose of filgrastim at least 24 hours after you receive a dose of chemotherapy, and will continue to receive the medication every day for up to 2 weeks. If you are using filgrastim to decrease the risk of infection during a bone marrow transplant, you will receive the medication at least 24 hours after you receive chemotherapy and at least 24 hours after the bone marrow is infused. If you are using filgrastim to prepare your blood for leukapheresis, you will receive your first dose of filgrastim at least 4 days before the first leukapheresis and will continue to receive the medication until the last leukapheresis. If you are using filgrastim to treat severe chronic neutropenia, you may need to use the medication for a long period of time.
Tbo-filgrastim comes as a solution (liquid) in prefilled syringes to inject under the skin. It is usually given once a day. You will receive your first dose of tbo-filgrastim at least 24 hours after you receive a dose of chemotherapy. The length of your treatment depends on the condition that you have and how well your body responds to the medication.
Filgrastim or tbo-filgrastim may be given to you by a nurse or other healthcare provider, or you may be told to inject the medication at home. If you will be injecting filgrastim or tbo-filgrastim at home, inject the medication at about the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use filgrastim or tbo-filgrastim exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
If you will be injecting filgrastim or tbo-filgrastim yourself, a healthcare provider will show you how to inject the medication. Be sure that you understand these directions. Ask your healthcare provider if you have any questions about where on your body you should inject filgrastim or tbo-filgrastim, how to give the injection, what type of syringe to use, or how to dispose of used needles and syringes after you inject the medication.
Do not shake vials or syringes containing filgrastim or tbo-filgrastim. If you shake filgrastim or tbo-filgrastim injection it may look foamy and should not be used.
Your doctor may start you on a low dose of filgrastim and gradually increase your dose. Your doctor may also decrease your dose, depending on how your body reacts to the medication.
If you are using filgrastim to treat severe chronic neutropenia, you should know that filgrastim will control your condition but will not cure it. Continue to use filgrastim even if you feel well. Do not stop using filgrastim without talking to your doctor.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.
Filgrastim is also sometimes used to treat certain types of myelodysplastic syndrome (a group of conditions in which the bone marrow produces blood cells that are misshapen and does not produce enough healthy blood cells) and acute myeloid leukemia (cancer of the white blood cells). Filgrastim is also sometimes used to decrease the chance of infection in people who have human immunodeficiency virus (HIV) or people who are taking certain medications that decrease the number of neutrophils. Talk to your doctor about the risks of using this medication for your condition.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Unless your doctor tells you otherwise, continue your normal diet.
If you will be injecting filgrastim or tbo-filgrastim at home, talk to your doctor about what you should do if you forget to inject the medication on schedule.
redness, swelling, bruising, itching or a lump in the place where the medication was injected
bone, joint, or muscle pain
pain in the left upper part of the stomach or the tip of the left shoulder
shortness of breath
swelling around the mouth, face, eyes, stomach, feet, ankles, or lower legs
unusual bruising or purple markings under the skin
unusual bleeding or bruising
Some people who used filgrastim to treat severe chronic neutropenia developed leukemia (cancer that starts in the bone marrow) or changes in the bone marrow cells that show that leukemia may develop in the future. People who have severe chronic neutropenia may develop leukemia even if they do not use filgrastim. There is not enough information to tell if filgrastim increases the chance that people with severe chronic neutropenia will develop leukemia. Talk to your doctor about the risks of using this medication.
Filgrastim and tbo-filgrastim may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store filgrastim and tbo-filgrastim in the refrigerator. Filgrastim may be kept at room temperature for up to 24 hours but should be kept away from direct sunlight. Tbo-filgrastim may be kept at room temperature for up to 5 days but should be protected from light. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to filgrastim or tbo-filgrastim.
Before having a bone imaging study, tell your doctor and the technician that you are using filgrastim or tbo-filgrastim. Filgrastim and tbo-filgrastim may affect the results of this type of study.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Last Revised - 03/15/2015
AHFS® Consumer Medication Information. © Copyright, 2015. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.