Adult Dosing
Hematopoietic stem cell mobilization
- 0.24 mg/kg SC daily up to 4 days [Max: 40 mg/day]
- Start after 4 days of G-CSF treatment; administer 11 hrs prior to initiation of apheresis for up to 4 consecutive days
- Use the patients actual body weight to calculate the dose
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
Renal Dose Adjustment (Based on CrCl)
50 mL/min: 0.16 mg/kg SC daily [Max: 27 mg/day]- Hemodialysis: Dose adjustments not defined
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined
See Supplemental Patient Information
- Induces mobilization of leukemic cells and subsequent contamination of the apheresis product; not intended for HSC mobilization and harvest in patients with leukemia
- Increase in circulating leukocytes as well as HSC populations have occurred on administration in conjunction with G-CSF. Monitor WBC counts during use of this drug. Exercise clinical judgment when administering to patients with peripheral blood neutrophil counts >50,000/mcL
- Thombocytopenia has occurred in patients receiving this drug. Monitor platelet counts in all patients receiving this therapy and then undergo apheresis
- On using this drug in combination with G-CSF for HSC mobilization, tumor cells are released from the marrow and subsequently collected in the leukapheresis product. Effect of potential reinfusion of tumor cells has not been evaluated
- Splenic enlargement and potential for rupture exists. Evaluate individuals complaining for left upper abdominal pain and/or scapular or shoulder pain for splenic integrity
- Induces fetal harm on administering to a pregnant woman. Advise women of childbearng potential to avoid becoming pregnant while receiving therapy with this drug. Apprise patients about the potential hazard to the fetus if this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug
- Potentially life-threatening hypersensitivity reaction including anaphylactic shock has been reported in patients taking the therapy, hence carefully monitor the patient during and after dose administration
Caution: Use cautiously in:
Supplemental Patient Information
- Advise female patients with child bearing potential to use effective contraceptive methods
Pregnancy Category:D
Breastfeeding: Safety unknown; potential for serious adverse reactions in nursing infants exist. Manufacturer advises to make a decision for discontinuing nursing or to discontinue the drug taking into account the importance of the drug to the mother.
