Neupogen Dosage, forms & strengths
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Neupogen (filgrastim) is an injectable leukocyte growth factor that is manufactured by Amgen. It is FDA-approved to:
- Reduce the incidence of infection if you have certain non-myeloid malignancies such as breast cancer and are receiving chemotherapy
- Increase neutrophil levels following induction or consolidation chemotherapy if you have acute myeloid leukemia (AML)
- Reduce the duration of febrile neutropenia if you are receiving chemotherapy followed by bone marrow transplantation (BMT) or stem cell transplant
- Reduce the incidence and duration of severe neutropenia if you have symptoms of congenital neutropenia‚ cyclic neutropenia‚ or idiopathic neutropenia
- Increase survival when you are exposed to high doses of radiation therapy
What is Neupogen’s mechanism of action?
Neupogen works like the granulocyte colony-stimulating factor (G-CSF) protein your body naturally makes. It stimulates your bone marrow to produce neutrophils, a type of white blood cell (WBC) to help you fight off infections.
Neupogen dosage forms and strengths
- 300mcg/ml in a single-dose vial
- 480mcg/1.6ml in a single-dose vial
- 300mcg/0.5ml in a single-dose prefilled syringe
- 480mcg/0.8ml in a single-dose prefilled syringe
Patients with cancer who are receiving myelosuppressive chemotherapy or induction and/or consolidation chemotherapy for acute myeloid leukemia (AML):
The starting dose is 5 mcg/kg/day of Neupogen given as a daily injection under the skin, a continuous IV infusion, or a 15 to 30-minute IV infusion. Your doctor should perform a complete blood count (CBC) and platelet count before starting Neupogen as well as twice a week during therapy. Your dose can be increased by 5 mcg/kg each chemo cycle, depending on the duration and severity of the absolute neutrophil count’s (ANC) lowest level (nadir). Neupogen can be given once a day for up to 14 days or until your ANC reaches 10,000/mm^3 following its lowest level.
Patients with cancer receiving a bone marrow transplantation (BMT):
The recommended dose following BMT is 10 mcg/kg/day of Neupogen given as an intravenous infusion. The first dose of Neupogen should be given at least 24 hours after cytotoxic chemotherapy and bone marrow infusion. Your doctor should perform CBCs and a platelet count frequently following BMT.
Patients receiving autologous peripheral blood progenitor cell (PBPC) collection and therapy:
The dose of Neupogen for the mobilization of autologous PBPC is 10 mcg/kg/day given by subcutaneous injection. Neupogen should be given for at least 4 days before the first leukapheresis procedure and continue until the last procedure. Clinical studies suggest it is safe to give Neupogen for 6 to 7 days with leukapheresis on days 5‚ 6‚ and 7. Your doctor should perform a neutrophil count after 4 days of Neupogen therapy and be discontinued if your WBC count reaches 100,000/mm^3.
Patients with severe chronic neutropenia (SCN):
The starting dose for congenital neutropenia is 6 mcg/kg of Neupogen given twice a day as an injection under the skin and the starting dose for idiopathic neutropenia or cyclic neutropenia is 5 mcg/kg of Neupogen given once daily as an injection under the skin. Your doctor should monitor CBCs for dose adjustments.
Patients with acute radiation syndrome:
The dose is 10 mcg/kg of Neupogen given once daily as an injection under the skin. It should be given immediately after a suspected or confirmed exposure to radiation doses greater than 2 gray (Gy). Your doctor should perform a baseline CBC and then a CBC approximately every third day until your ANC remains above 1,000/mm^3 for 3 consecutive CBCs.
Neupogen dosage restrictions
There is no dose reduction or adjustment necessary in patients with kidney or liver impairment.
How to take Neupogen
- Read the Patient Information, Instructions for Use, and Medication Guide that comes with this medication.
- You can receive this medication via an IV infusion or a subcutaneous injection. Your healthcare provider may determine whether you or a caregiver can administer Neupogen at home. Your healthcare provider will show you or your caregiver how to give Neupogen before you receive your first dose.
- Use this medication exactly as your healthcare provider tells you to. They will do blood tests to monitor your white blood cell count and adjust your dose if needed. Do not adjust your dose or stop Neupogen without discussing it with them first.
- If you miss a dose of this medication, call your doctor right away to reschedule.
- Store Neupogen in its original carton in the refrigerator between 36°F to 46°F (2°C to 8°C). Take it out of the refrigerator about 30 minutes before you plan to administer it so it can reach room temperature. Throw away any Neupogen left at room temperature for over 24 hours or any left in the vial or prefilled syringe after giving a dose.
Neupogen dosage FAQs
What are some side effects of Neupogen?
Some common adverse events of Neupogen seen in clinical trials include:
- Injection site reactions
- Thrombocytopenia (low platelet count)
- Epistaxis (nosebleeds)
- Alopecia (hair loss)
- Shortness of breath
- Stomach, back, or bone pain
Neupogen can sometimes cause serious side effects such as:
- Severe, life-threatening hypersensitivity reactions (hives, swelling of your face or throat, and shortness of breath)
- Splenic rupture
- Kidney impairment
- Cutaneous vasculitis (inflammation of your blood vessels)
- Acute respiratory distress syndrome (ARDS)
- Increased incidence of myelodysplastic syndrome (MDS) and AML in patients with breast and lung cancer.
- Severe sickle cell crisis
- Capillary leak syndrome
- Aortitis (inflammation of your aorta)
- Contact your healthcare professional for medical advice about any adverse reactions you experience while taking Neupogen. You can report your adverse effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
What are some drug interactions with Neupogen?
The concomitant use of Neupogen with other drugs can change how they work or increase the frequency and severity of side effects. You should ask your healthcare professional if any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication.
Are there any contraindications or precautions for Neupogen?
Neupogen shouldn’t be used if you have a history of serious allergic reactions to human G-CSFs such as filgrastim or pegfilgrastim or have a known hypersensitivity to E. coli-derived proteins. You should use this medication with caution if you have sickle cell disease, or kidney disease, are receiving radiation therapy, or if you are allergic to latex.
Is it safe to use Neupogen while pregnant or breastfeeding?
The use of Neupogen during pregnancy or lactation is not associated with any adverse effects on the mother or baby. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.
How long do the effects of Neupogen last?
After the discontinuation of Neupogen, your neutrophil count will decrease by 50% within 1 to 2 days. They will return to pretreatment levels within a week.
How long does it take Neupogen to start working?
If you are receiving cytotoxic chemotherapy, your neutrophil count typically starts to increase 1 to 2 days after starting Neupogen treatment.
How often is Neupogen given?
Neupogen is typically given by injection under the skin or a short intravenous infusion daily for up to 2 weeks.
How long does bone pain last with Neupogen?
For most people who receive Neupogen, bone pain starts within 2 days after receiving a dose and can last 2 to 4 days.
What is the average price of Neupogen?
While there are biosimilars, there is no generic for Neupogen that can be substituted for Neupogen. The average cost of 1 prefilled syringe of Neupogen 300 mcg/0.5 ml is almost $500.
Related resources for Neupogen dosage
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.