Grafeel Tablet
Filgrastim
5mg
Dr. Reddy's Laboratories.
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| Retail Price | 2193.17 NPR |
Indications
Grafeel Tablet is used for:
Myelosuppressive chemotherapy, Acute Myeloid Leukemia receiving induction or consolidation chemotherapy, Peripheral blood progenitor cell collection and therapy, Severe Neutropenia, Bone marrow transplantation, HIV infection.
Adult Dose
Parenteral
Chemotherapy-induced neutropenia
Adult: 5 mcg/kg daily as a single daily SC inj, as a continuous IV or SC infusion, or as a daily IV infusion over 15-30 minutes, starting not <24 hr after the last dose of antineoplastic. Continue treatment until neutrophil count has stabilised within the normal range which may take up to 14 days or more.
Bone marrow transplantation
Adult: 10 mcg/kg daily by IV infusion over 30 min or 4 hr or continuous IV or SC infusion over 24 hr. Adjust according to response.
Subcutaneous
Mobilisation of peripheral blood progenitor cells for autologous peripheral blood stem cell transplantation
Adult: 10 mcg/kg daily, as a single inj or by continuous infusion, for 4-7 days until the last leucapheresis procedure. If it is given after myelosuppressive chemotherapy: 5 mcg/kg daily by inj; given from the 1st day after chemotherapy completion until expected neutrophil nadir is passed and neutrophil count has returned to normal range, so that leucapheresis can be performed.
Congenital neutropenia
Adult: 12 mcg/kg daily in single or divided doses. Adjust according to response. In patients with cyclic or idiopathic neutropenia: 5 mcg/kg daily in single or divided doses. Adjust according to response.
HIV infection and persistent neutropenia
Adult: Initially, 1 mcg/kg daily. Dose may be increased to 4 mcg/kg daily until normal neutrophil count is achieved. Maintenance: 300 mcg daily. Max: 4 mcg/kg daily.
Child Dose
Renal Dose
Administration
IV Preparation
Vials may be diluted in D5W to >15 mcg/mL for infusion
5-15 mcg/mL dilution: Protect from adsorption to plastic materials by the addition of human albumin to a final concentration of 2 mg/mL
Do not dilute with saline at any time, because the product may precipitate
IV Administration
Short IV infusion over 15-30 min, OR
Continuous IV infusion
SC Administration
Administer undiluted by SC in the outer area of upper arms, abdomen, thighs, or upper outer areas of the buttock
Contra Indications
Hypersensitivity to E. coli derived proteins, Filgrastim or any component of the product. Myeloid malignancies. Not to be used within 24 hr of cytotoxic chemotherapy admin due to the sensitivity of rapidly dividing myeloid cells. Severe congenital neutropaenia (Kostman's syndrome) with abnormal cytogenetics.
Precautions
Filgrastim should not be administered within 24 hours before and after chemotherapy. Premalignant or malignant myeloid condition; sickle-cell disease; osteoporotic bone disease; withdraw treatment if there are signs of pulmonary infiltrates. Fluid retention or heart failure. Monitor CBC and platelet count during therapy. Monitor bone density in patients with osteoporosis (long-term treatment). Regular morphological and cytogenic bone-marrow examinations in severe congenital neutropenia. Pregnancy and lactation.
Lactation: excretion in milk unknown; use with caution
Pregnancy-Lactation
Interactions
Myelosuppressive antineoplastic agents. Drugs which may potentiate the release of neutrophils e.g. lithium.
Adverse Effects
Side effects of Filgrastim :
>10%
Nausea (57%),Vomiting (57%),Bone pain (22%-33%),Alopecia (18%),Diarrhea (14%),Fever (12%),Fatigue (11%)
1-10%
Headache,Anorexia,Chest pain,Cough,Dyspnea,Constipation,Stomatitis,Sore throat,Rash
Frequency Not Defined
Elevated uric acid,Elevated lactate dehydrogenase,Elevated alkaline phosphatase
Potentially Fatal: Pulmonary infiltrates leading to resp failure or acute resp distress syndrome.
Mechanism of Action
Filgrastim is a granulocyte-colony stimulating factor which binds to cell surface receptors on haemetopoietic cells thus stimulating the development of granulocytes to increase their migration and cytotoxicity.
Note
Grafeel 5mg Tablet manufactured by Dr. Reddy's Laboratories.. Its generic name is Filgrastim. Grafeel is availble in Nepal.
Farmaco Nepal drug index information on Grafeel Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.