Neupogen
® (
filgrastim) is a prescription medication used to stimulate the production of neutrophils, which are a certain type of white blood cell important for preventing infections. Specifically, it is approved to:
- Prevent infections in people undergoing chemotherapy
- Prevent infections in people receiving bone marrow transplants
- Aid in the collection of stem cells collected for use in stem cell transplantation
- Prevent infections and other problems in people with low neutrophils due to certain other causes.
Neupogen is made by Amgen, Inc.
Neupogen works by stimulating the production of a certain type of white blood cell called neutrophils. Neutrophils help protect the body from infection, and having a low neutrophil count (known medically as neutropenia) increases the risk of infection. Chemotherapy (including chemotherapy during bone marrow transplantation) often causes neutropenia and infections. Some people are born with a decreased ability to produce neutrophils or stop making neutrophils due to unknown reasons, and Neupogen is also useful for increasing neutrophils in such individuals. Lastly, the drug is useful for stimulating the production of stem cells in the blood that can be collected for stem cell transplantation.
Neupogen belongs to a group of medications called granulocyte colony-stimulating factors. Colony-stimulating factors bind to stem cells in the bone marrow, stimulating the production of blood cells. Granulocyte colony-stimulating factor (G-CSF) is a naturally occurring chemical in the body that stimulates the production of neutrophils. Neupogen is a synthetic version of G-CSF. It binds to stem cells and stimulates the production of neutrophils, helping to decrease the risk of infection.
Several studies have evaluated the safety and efficacy of Neupogen when used for different medical conditions and situations.
Chemotherapy
Neupogen has been studied for the prevention of infections in people undergoing chemotherapy for
lung cancer. In one study, only 40 percent of those taking the drug developed an infection, compared to 76 percent of those not taking it. In addition, people who took Neupogen had low neutrophils (neutropenia) less often, less severely, and for shorter periods of time, compared with those not taking it.
Neupogen has also been studied in people undergoing chemotherapy for various other cancers, including acute myeloid
leukemia (
AML), and was shown to help the neutrophil levels increase more quickly and decrease the duration of fever, antibiotic use, and hospitalization.
Bone Marrow Transplantation
Studies have also shown Neupogen to be useful during bone marrow transplantation. After the transplantation, it takes awhile for the new bone marrow to begin working, and this delay causes low neutrophils (neutropenia) and increases the risk of infection. In one study, those who took the drug had only 11 days of severe neutropenia, compared with 23 days in people not taking it.
Stem Cell Collection
Sometimes, instead of using bone marrow for transplantation, stem cells collected from the blood can be used for transplantations. Studies have shown that Neupogen can help in the process of collecting the stem cells since it can help release stem cells into the blood.
Severe Chronic Neutropenia
Studies have also shown that Neupogen can help with severe chronic neutropenia. In one study, about 20 percent of people taking the drug developed an infection, compared to 50 percent of those not taking it. Infections in those taking Neupogen were shorter and less likely to require hospitalization, compared to infections in people not taking the medicine.
When and How to Take Neupogen
General considerations for when and how to take Neupogen include the following:
- The medication comes as an injection that can be given just under the skin or by IV.
- Neupogen is usually given daily for a specific period of time or until your neutrophil levels increase, depending on the particular use. For severe chronic neutropenia, the medication is given continually on a daily basis.
- Neupogen should not be taken within 24 hours before or after chemotherapy or bone marrow transplantation.
- If you feel comfortable doing so, you (or a caregiver) may administer the injections just under the skin. If you would prefer, your healthcare provider can give the injection.
- In some situations, Neupogen may be given as a continuous infusion just under the skin. This is like an around-the-clock IV, except it goes just under the skin, not into a vein.
- Never shake Neupogen, as it is a delicate molecule that could be damaged by shaking.
- You will need regular blood tests during treatment to see if the drug is working.
- If you choose to give the injections yourself, make sure you know exactly how to inject Neupogen.
- For the medication to work properly, it must be taken as prescribed.
The dose of Neupogen your healthcare provider recommends will vary, depending on a number of factors, including:
- Your weight
- How you respond to the drug
- The condition being treated
- Other medical conditions you may have
- Other medications you may be taking.
As always, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
As with any medicine, side effects are possible with Neupogen. However, not everyone who takes the drug will experience side effects. In fact, most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
Common side effects include but are not limited to:
- Bone pain
- Bloody nose
- Nausea or vomiting.
(Click Neupogen Side Effects to learn more, including potentially serious side effects you should report to your healthcare provider.)
What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider prior to taking Neupogen if you have:
- Sickle cell anemia
- Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
What If I Take an Overdose?
Taking too much Neupogen can increase the white blood cells too much. Other than that, it is not known exactly what to expect from an overdose.
How Should Neupogen Be Stored?
Neupogen should be stored under refrigeration. However, it may be taken out of the refrigerator and allowed to reach room temperature before injection. It can be kept outside the refrigerator for up to 24 hours, but must be discarded after 24 hours.
Keep this and all medications out of the reach of children.
What Should I Do If I Miss a Dose?
If you do not take your Neupogen as scheduled, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose. If you have missed more than one dose, it is important that you contact your healthcare provider.
Neupogen comes in the following strengths:
- Neupogen 300 mcg single-dose vials
- Neupogen 480 mcg single-dose vials
- Neupogen 300 mcg single-dose prefilled syringes
- Neupogen 480 mcg single-dose prefilled syringes.
Is There a Generic Version of Neupogen?
Currently, there is no generic Neupogen licensed for sale
(see Generic Neupogen).
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