Class Name(s):

• 20:16 Hematopoietic Agents

Pronunciation:

• (fil gra' stim)

Brand Name(s):

• Filkri^®(filgrastim-laha)
• Granix^® (tbo-filgrastim)
• Neupogen^® (filgrastim)
• Nivestym^® (filgrastim-aafi)
• Releuko^® (filgrastim-ayow)
• Zarxio^® (filgrastim-sndz)

Other Name(s):

• Granulocyte Colony-Stimulating Factor
• G-CSF

IMPORTANT NOTICE:

Filgrastim injection is available as different products that are biologic medications (medications made from living organisms). These biologic products are considered to be "biosimilar" to filgrastim injection which means they work as well and are just as safe to use as filgrastim injection. Filgrastim injection, mentioned in the monograph below, refers to any of these products.

WHY is this medicine prescribed?

Filgrastim injection is used

• to increase white blood cells and decrease the risk of infection in patients receiving chemotherapy for certain types of cancer
• to increase white blood cells 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).
• to prepare the blood for leukapheresis (a treatment in which certain blood cells are removed from the body).
• to increase the chance of survival in people who have been exposed to harmful amounts of radiation, which can cause severe and life-threatening damage to your bone marrow.

Filgrastim is in a class of medications called colony-stimulating factors. It works by helping the body make more neutrophils.

HOW should this medicine be used?

Filgrastim injection comes as a solution (liquid) in vials and prefilled syringes to be injected subcutaneously (under the skin) or to be slowly or continuously injected intravenously (into a vein). It is given 1 to 2 times a day depending on what condition is being treated. The length of your treatment depends on the condition that you have and how well your body responds to the medication.

Filgrastim injection may be given to you by a nurse or other healthcare provider, or you may be told to inject the medication under the skin at home. If you or a caregiver will be giving filgrastim injection at home, a healthcare provider will show you or your caregiver how to inject the medication. Be sure that you understand these directions. Ask your healthcare provider if you have any questions. Use filgrastim injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Do not shake vials or syringes containing filgrastim solution. Always look at filgrastim injection before injecting. Do not use if the expiration date has passed, or if the filgrastim solution has particles or looks foamy, cloudy, or discolored.

Use each syringe or vial only once. Even if there is still some solution left in the syringe or vial, do not use it again. Dispose of used needles, syringes, and vials in a puncture-resistant container. Talk to your doctor or pharmacist about how to dispose of the puncture-resistant container.

Your doctor may start you on a low dose of filgrastim injection 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 injection to treat severe chronic neutropenia, you should know that this medication will control your condition but will not cure it. Continue to use filgrastim injection even if you feel well. Do not stop using filgrastim injection without talking to your doctor.

Are there OTHER USES for this medication?

Filgrastim injection are 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 aplastic anemia (a condition in which the bone marrow does not make enough blood cells). Filgrastim injection are 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.

What SPECIAL PRECAUTIONS should I follow?

Before using filgrastim injection,

• tell your doctor or pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you are being treated with radiation therapy and if you have or have ever had chronic myeloid leukemia (a slowly progressing disease in which too many white blood cells are made in the bone marrow), myelodysplasia (problems with bone marrow cells that may develop into leukemia), or kidney problems.
• tell your doctor if you have sickle cell disease (a blood disease that may cause painful crises, a low number of red blood cells, infection, and damage to the internal organs). If you have sickle cell disease, you may be more likely to have a crisis during your treatment with filgrastim injection Drink plenty of fluids during your treatment with filgrastim injection and call your doctor right away if you have a sickle cell crisis during your treatment.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using filgrastim injection call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using filgrastim injection.
• you should know that filgrastim injection decrease the risk of infection, but do not prevent all infections that may develop during or after chemotherapy. Call your doctor if you develop signs of infection such as fever or chills, or redness, swelling, or pain around a cut or sore.
• if you get filgrastim solution on your skin, wash the area with soap and water. If filgrastim solution gets in your eye, flush your eye thoroughly with water.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

If you will be injecting filgrastim injection product at home, talk to your doctor about what you should do if you forget to inject the medication on schedule.

What SIDE EFFECTS can this medicine cause?

Filgrastim injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• redness, swelling, bruising, itching or a lump in the place where the medication was injected
• bone, joint, back, arm, leg, mouth, throat, or muscle pain
• headache
• rash
• constipation
• diarrhea
• nausea
• vomiting
• loss of appetite
• difficulty falling asleep or staying asleep
• decreased sense of touch
• hair loss
• nosebleeds
• tiredness, lack of energy
• feeling unwell
• dizziness

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• pain in the left upper part of the stomach or the tip of the left shoulder
• fever, shortness of breath, trouble breathing, fast breathing
• trouble breathing, coughing up blood
• fever, abdominal pain, back pain, neck pain, headache, feeling tired or unwell
• swelling of stomach area or other swelling, decreased urination, trouble breathing, dizziness, tiredness
• rash, hives, itching, swelling of the face, eyes, or mouth, wheezing, shortness of breath
• unusual bleeding or bruising, purple markings under the skin, red skin
• decreased urination, dark or bloody urine, swelling of the face or ankles

Some people who used filgrastim injection 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 injection increase the chance that people with severe chronic neutropenia will develop leukemia. Talk to your doctor about the risks of using this medication.

Filgrastim injection may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at http://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store filgrastim injection in the refrigerator. If you accidentally freeze filgrastim (Filkri^®, Neupogen^®, Nivestym^®, Zarxio^®), you may allow it to thaw in the refrigerator. However, if you freeze the same syringe or vial of filgrastim a second time, you should dispose of that syringe or vial. Filgrastim (Filkri^®, Neupogen^®, Nivestym^®, Nypozi^®, Releuko^®, Zarxio^®) may be kept at room temperature for up to 24 hours but should be kept away from direct sunlight. Filgrastim (Granix^®) can be removed and returned to the refrigerator, but should not be out of the refrigerator for a total time of up to 5 days and should be protected from light.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website http://goo.gl/c4Rm4p for more information.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to filgrastim injection.

Before having a bone imaging study, tell your doctor and the technician that you are using filgrastim injection Filgrastim injection 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.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™ Copyright, 2026. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: October 15, 2026.