medicationszarxioZarxio dosage

Zarxio Dosage, forms & strengths

Jamie Winn, PharmD
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Medically reviewed by  Jamie Winn, PharmD

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Zarxio (filgrastim-sndz) is an injectable biological growth factor that is manufactured by Sandoz Inc. It was the first FDA-approved biosimilar to Neupogen. It is indicated to treat adult and pediatric patients with febrile neutropenia and other complications from severe neutropenia in:

  • Patients with non myeloid malignancies receiving chemotherapy
  • Patients with acute myeloid leukemia (AML) receiving chemotherapy
  • Patients with cancer undergoing bone marrow transplantation (BMT)
  • Symptomatic patients with congenital neutropenia‚ cyclic neutropenia‚ or idiopathic neutropenia

How does Zarxio work?

Zarxio (filgrastim-sndz) is a man-made granulocyte colony-stimulating factor (G-CSF). Growth factors such as G-CSF help stimulate neutrophil production in your bone marrow. Neutrophils play an important role in fighting infections. Zarxio is effective in helping prevent infections in patients with chemotherapy-induced low white blood cell counts.

Zarxio dosage forms and strengths

  • 300mcg/0.5ml single-dose prefilled syringe
  • 480mcg/0.8ml single-dose prefilled syringe

Zarxio dosage

  • For cancer patients who are receiving myelosuppressive chemotherapy or induction and/or consolidation chemotherapy for acute myeloid leukemia, the starting dose is 5mcg/kg/day.
  • For cancer patients undergoing bone marrow transplantation, the starting dose is 10mcg/kg/day.
  • When used for the mobilization and collection of peripheral blood progenitor cells (PBPCs) for leukapheresis, the dose is 10mcg/kg/day. This should be started at least 4 days before your first procedure and continue until treatment is completed.
  • For patients with congenital neutropenia, the starting dose is 6mcg/kg twice daily.
  • For patients with cyclic or idiopathic neutropenia, the starting dose is 5mcg/kg daily.

You may need a dose reduction or adjustment based on your absolute neutrophil counts (ANC).

Zarxio dosage restrictions

According to the package insert, there are no dosage adjustments necessary for patients with kidney or liver impairment.

How to take Zarxio

  • Read the Full Prescribing Information, Instructions for Use, and Medication Guide that comes with this medication.
  • Zarxio can be given by your healthcare provider as an intravenous infusion or a subcutaneous injection (under the skin). They may let you or a caregiver give Zarxio injections at home but should show you how to prepare and inject Zarxio before you use it.
  • Use Zarxio exactly as your healthcare provider tells you. Do not change your dose or stop taking this medication without talking to them first.
  • The minimum dose you can give from a Zarxio prefilled syringe is 0.3ml (180 mcg). You cannot accurately measure doses less than 0.3ml with a Zarxio prefilled syringe.
  • If you are taking chemo in combination with Zarxio, you should use Zarxio at least 24 hours before or 24 hours after cytotoxic chemotherapy.
  • If you miss a dose of Zarxio, call your healthcare provider to discuss when you should take your next dose.

Zarxio dosage FAQs

What are the most common possible side effects of Zarxio?

Some common side effects of Zarxio in clinical trials include:

  • Fever
  • Nausea
  • Bone pain
  • Diarrhea
  • Alopecia (hair loss)
  • Cough
  • Thrombocytopenia (decreased platelet count)
  • Fatigue
  • Injection site reactions
  • Rash
  • Headache
  • Back pain

Zarxio can sometimes cause more serious side effects, including:

  • Serious hypersensitivity reactions (hives, angioedema, and shortness of breath)
  • Capillary leak syndrome
  • Acute respiratory distress syndrome (ARDS)
  • Myelodysplastic syndrome (MDS), especially in patients with breast cancer or lung cancer
  • Splenic rupture
  • Sickle cell crisis in people with sickle cell anemia
  • Kidney injury (glomerulonephritis)
  • Blood vessel damage
  • Increased risk of blood cancers

Contact your healthcare professional for medical advice about any possible side effects you may experience while taking Zarxio. You can report any adverse reactions to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What drug interactions occur with Zarxio?

When Zarxio is taken with other medications, it may change the way they work or increase the frequency and severity of side effects. You should discuss with your doctor whether 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 with Zarxio?

Zarxio is contraindicated in patients with a history of serious allergic reactions to filgrastim products, pegfilgrastim products, or other granulocyte colony-stimulating factors.

You should use Zarxio with caution if you have:

  • Sickle cell disorder
  • Kidney impairment
  • Severe chronic neutropenia
  • Are currently receiving radiation therapy
  • Are pregnant, plan on becoming pregnant, or are breastfeeding

Can you take Zarxio while you are pregnant or breastfeeding?

Observational studies showed there was not an increased risk of adverse outcomes in pregnant women receiving Zarxio. Animal studies did not show any incidence of birth defects. Filgrastim products can be found in human breast milk during lactation. No adverse effects were seen in infants exposed to the products. 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.

Does Zarxio cause hair loss?

Yes, Zarxio can sometimes cause thinning or loss of hair. You may lose hair from all parts of your body, not just your head. While hair loss is often temporary, it may be permanent in some people.

How long does it take Zarxio to work?

You should see an increase in your neutrophil count 1 to 2 days after starting Zarxio therapy. These effects can last up to a week.

What is the cost of Zarxio?

The average cost for #5 prefilled syringes of Zarxio 300 mcg/0.5 ml is over $1,600.

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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.