eflapegrastim

Contraindicated in:

Serious allergic reactions to eflapegrastim, pegfilgrastim, or filgrastim.

Use Cautiously in:

Sickle cell disease (↑ risk of sickle cell crisis);
Patients with breast or lung cancer receiving chemotherapy and/or radiotherapy (↑ risk of myelodysplastic syndrome or acute myeloid leukemia);
Malignancy with myeloid characteristics;
OB: Safety not established in pregnancy;
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

CV: peripheral edema, aortitis

Derm: flushing, rash

GI: abdominal pain, diarrhea, ↓appetite, nausea

GU: glomerulonephritis

Hemat: anemia, thrombocytopenia, ACUTE MYELOID LEUKEMIA, excessive leukocytosis, MYELODYSPLASTIC SYNDROME, sickle cell crises

Local: injection site reactions

MS: arthralgia, bone pain, myalgia

Neuro: dizziness, fatigue, headache

Resp: cough, ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)

Misc: fever, CAPILLARY LEAK SYNDROME, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), SPLENIC RUPTURE, splenomegaly, TUMOR GROWTH

Interactions ⬆ ⬇

Drug-drug:

None reported

Availability ⬆ ⬇

Solution for injection: 13.2 mg/0.6 mL

Route/Dosage ⬆ ⬇

SC (Adults ): 13.2 mg administered once per chemotherapy cycle (should be administered ~24 hr after receiving chemotherapy; should not be administered from 14 days before to 24 hr after administration of chemotherapy).

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Binds to granulocyte colony-stimulating factor (G-CSF) receptors on immature neutrophils, stimulating them to divide and differentiate. Also activates mature neutrophils.

Therapeutic effects:

Decreased incidence of febrile neutropenia in patients who are neutropenic from chemotherapy.

Classifications ⬆ ⬇

Therapeutic Classification: colony-stimulating factors

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed after SUBQ administration.

Distribution: Minimal distribution to tissues.

Metabolism/Excretion: Metabolized inside cells that contain G-CSF receptors. Excretion pathway unknown.

Half-Life: 16–115 hr.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
SUBQ	unknown	6–144 hr	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication to patient. Advise patient to notify health care professional regarding when to give next dose if a dose is missed. Advise patient to read Patient Information before starting therapy.
Instruct patient to notify health care professional immediately if signs and symptoms of spleen enlargement or rupture (left upper abdominal or shoulder pain), allergic reaction (rash, fever, dizziness, swelling of mouth, shortness of breath), ARDS (fever, fast or difficulty breathing), glomerulonephritis (swelling of face or ankles; bloody, dark, or ↓ urination), myelodysplastic syndrome (easy bruising or bleeding), acute myeloid leukemia, or aortitis (abdominal or back pain, fatigue) occur.
Discuss risk of sickle cell crisis with patients with sickle cell disease before administering.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other medications.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Home Care Issues: Instruct on correct technique for injection, care, and disposal of equipment. Caution patient not to reuse needle or syringe. Provide patient with a puncture-proof container for needle disposal.

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Indications ⬇

Contraind./Precautions ⬆ ⬇