What is Zarxio Uses, warnings & interactions
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Zarxio (filgrastim-sndz) is an injectable medication that is manufactured by Sandoz Inc. It was approved in 2015 by the U.S. Food and Drug Administration (FDA) to stimulate the growth of neutrophils, a type of white blood cell (WBC) that plays an important role in fighting infections. Zarxio is typically used to treat low white blood cell counts that are caused by chemotherapy. It is also used in certain treatment procedures such as bone marrow or stem cell transplants.
If your doctor has prescribed Zarxio to you, you may want to know more about what it is and how it works. Here we’ll explain what Zarxio is used for, how it works, its side effects, and more.
What is Zarxio used for?
Zarxio is a growth factor that is FDA-approved to treat febrile neutropenia and other complications from low neutrophil counts in:
- Patients receiving chemotherapy that causes bone marrow suppression
- Patients with acute myeloid leukemia (AML) that have received chemotherapy
- Cancer patients who have received bone marrow transplantation
- Symptomatic patients with congenital neutropenia‚ cyclic neutropenia‚ or idiopathic neutropenia
How does Zarxio work?
Zarxio (filgrastim-sndz) is a synthetic (man-made) form of a granulocyte colony-stimulating factor (G-CSF). G-CSF stimulates your bone marrow to produce and activate a type of white blood cell called neutrophils. Neutrophils work along with substances such as lymphocytes and monocytes to help fight infections.
What are the most commonly prescribed doses of Zarxio?
- 300mcg/0.5ml single-dose prefilled syringe
- 480mcg/0.8ml single-dose prefilled syringe
Before taking Zarxio
Before beginning Zarxio, tell your doctor about your medical conditions, including:
- Sickle cell disorder
- Kidney disease
- Are receiving radiation therapy
- Are pregnant, plan on becoming pregnant, or are breastfeeding
How to take Zarxio
- Read the Full Prescribing Information, Instructions for Use, and Medication Guide that comes with Zarxio.
- Zarxio injections can be given by your doctor as an IV infusion or a subcutaneous injection (under the skin). Your doctor may let you or a caregiver give subcutaneous injections at home. They should show you how to prepare and inject Zarxio before you give your first dose.
- Use Zarxio exactly as your doctor prescribes it to you. Do not change your dose or stop taking this medication unless your doctor tells you to.
- The minimum dose you can inject from a Zarxio syringe is 0.3ml (180 mcg). You cannot accurately measure doses less than 0.3ml with a Zarxio syringe.
- If you are taking chemotherapy along with Zarxio, you should use Zarxio at least 24 hours before or 24 hours after your chemotherapy dose.
- If you miss a dose of Zarxio, call your doctor to discuss when you should take your next dose.
You should not take Zarxio if you have a history of serious hypersensitivity reactions to filgrastim products, pegfilgrastim products, or other granulocyte colony-stimulating factors.
- Cases of an enlarged spleen were reported with the use of Zarxio. In serious cases, the spleen ruptured and caused death.
- Notify your doctor or seek medical assistance if you have trouble breathing as it may be a sign of acute respiratory distress syndrome (ARDS).
- Serious allergic reactions, including anaphylaxis, have occurred with Zarxio. Seek immediate medical attention if you have symptoms of anaphylaxis.
- Patients with breast cancer and lung cancer should be monitored for signs of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) while receiving Zarxio along with chemo or radiation therapy.
- Patients should also be monitored for sickle cell crisis and thrombocytopenia (low platelet count) while on this medication.
Zarxio drug interactions
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.
Zarxio side effects
Some common side effects of Zarxio include:
- Bone pain
- Hair loss
- Low platelet count
- Excessive tiredness
- Injection site reactions
- Trouble breathing
- Back pain
Zarxio can sometimes cause more serious side effects, including:
- Life-threatening allergic reactions (hives, swelling of the face or throat, and shortness of breath)
- Capillary leak syndrome
- Enlarged or ruptured spleen
- Sickle cell crisis in people with sickle cell anemia
- Kidney damage
- Vasculitis or other blood vessel damage
- Increased risk of blood cancers, especially in people with severe chronic neutropenia
Contact your healthcare professional for medical advice about any possible side effects you experience while taking Zarxio. You can report your adverse reactions to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Your doctor can prescribe other medications if Zarxio is not right for you. They will vary by factors such as side effects and cost. Some FDA-approved alternatives to Zarxio include:
- Neupogen (filgrastim)
- Neulasta (pegfilgrastim)
- Nivestym (filgrastim-aafi)
- Granix (tbo-filgrastim)
- Udenyca (filgrastim-cbqv)
- Releuko (filgrastim-ayow)
Can you take Zarxio while you are pregnant or breastfeeding?
Several observational studies showed no major differences in adverse events between women treated with Zarxio and those who were not. No birth defects were observed during animal studies involving Zarxio. Zarxio may be found in breast milk. However, no adverse effects in breastfed infants were noted. 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 do you store Zarxio?
You should store Zarxio in the refrigerator between 36°F to 46°F (2°C to 8°C) in the original packaging. Take the Zarxio syringe out of the fridge 30 minutes before you intend to use it so it can warm up to room temperature. Throw away any unused Zarxio that has been at room temperature for 24 hours in an FDA-cleared sharps container. Do not throw away your Zarxio syringe in the household trash.
Is Zarxio the same as Neupogen?
While these 2 medications are highly similar, Zarxio and Neupogen are not the same and are not interchangeable. Zarxio was the first biosimilar that provided a less expensive alternative to Neupogen.
Is Zarxio a biosimilar?
Zarxio is the first biosimilar approved by the FDA. A biosimilar is a medicine that is very similar to a previously approved biological medication. They may be available at a lower cost than the original biological medicine.
RELATED: What is a biosimilar drug?
Is there a generic for Zarxio?
Currently, there is no generic Zarxio available on the market. However, you can still save on brand-name drugs like Zarxio through NiceRx if eligible for assistance.