Select a medication above to begin.
Granix
tbo-filgrastim (G-CSF)
Adult Dosing .
Dosage forms: INJ (pre-filled syringe): 300 mcg per 0.5 mL, 480 mcg per 0.8 mL; INJ (vial): 300 mcg per mL
febrile neutropenia prophylaxis, chemo-induced
- [5 mcg/kg/dose SC qd]
- Start: >24h after chemo; Info: for pts w/ non-myeloid malignancies; do not give w/in 24h before chemo
renal dosing
- [see below]
- CrCl >60: no adjustment; CrCl <60: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: INJ (pre-filled syringe): 300 mcg per 0.5 mL, 480 mcg per 0.8 mL; INJ (vial): 300 mcg per mL
febrile neutropenia prophylaxis, chemo-induced
- [1 mo and older]
- Dose: 5 mcg/kg/dose SC qd; Start: >24h after chemo; Info: for pts w/ non-myeloid malignancies; do not give w/in 24h before chemo
renal dosing
- [see below]
- CrCl >60: no adjustment; CrCl <60: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hypersensitivity to E. coli protein
- chemotherapy use w/in 24h
- XRT w/in 24h
- caution: female pts of reproductive potential
- caution: sickle cell dz
- caution: myelodysplasia
- caution: myeloid malignancy
- caution: breast CA
- caution: lung CA
Drug Interactions .
Overview
filgrastim (G-CSF)
colony stimulating factor
- immunomodulatory effects (colony stimulating factor)
Avoid/Use Alternative
- betibeglogene autotemcel
- lovotibeglogene autotemcel
Monitor/Modify Tx
- abemaciclib
- acalabrutinib
- ado-trastuzumab emtansine
- aldesleukin
- alemtuzumab
- arsenic trioxide
- asciminib
- azacitidine
- belantamab mafodotin
- belinostat
- bendamustine
- bevacizumab
- blinatumomab
- bortezomib
- bosutinib
- brentuximab vedotin
- brexucabtagene autoleucel
- busulfan
- cabazitaxel
- capecitabine
- carboplatin
- carfilzomib
- carmustine
- chlorambucil
- ciltacabtagene autoleucel
- cisplatin
- cladribine injection
- clofarabine
- copanlisib
- crizotinib
- cyclophosphamide
- cytarabine
- dacarbazine
- dactinomycin
- daratumumab
- dasatinib
- daunorubicin
- decitabine
- docetaxel
- dostarlimab
- doxorubicin
- duvelisib
- eflornithine
- elranatamab
- enfortumab vedotin
- entrectinib
- epcoritamab
- epirubicin
- eribulin
- etoposide
- everolimus
- fam-trastuzumab deruxtecan
- fedratinib
- floxuridine
- fludarabine
- fluorouracil
- gemcitabine
- gemtuzumab ozogamicin
- glasdegib
- glofitamab
- hydroxyurea
- ibritumomab tiuxetan
- ibrutinib
- idarubicin
- idecabtagene vicleucel
- idelalisib
- ifosfamide
- imatinib
- inotuzumab ozogamicin
- iobenguane I 131
- irinotecan
- isatuximab
- ivosidenib
- ixabepilone
- lenalidomide
- lifileucel
- lisocabtagene maraleucel
- lomustine
- loncastuximab tesirine
- lurbinectedin
- lutetium Lu 177 dotatate
- lutetium Lu 177 vipivotide tetraxetan
- melphalan
- mercaptopurine
- methotrexate
- midostaurin
- mitomycin
- mitotane
- mitoxantrone
- mogamulizumab
- momelotinib
- mosunetuzumab
- nelarabine
- niraparib
- obinutuzumab
- ofatumumab
- olaparib
- omacetaxine mepesuccinate
- osimertinib
- oxaliplatin
- paclitaxel
- pacritinib
- palbociclib
- panobinostat
- pemetrexed
- pentostatin
- pirtobrutinib
- polatuzumab vedotin
- pomalidomide
- ponatinib
- pralatrexate
- procarbazine
- quizartinib
- ramucirumab
- ribociclib
- rituximab
- rucaparib
- ruxolitinib
- sacituzumab govitecan
- selinexor
- selumetinib
- sirolimus albumin-bound
- streptozocin
- tafasitamab
- tagraxofusp
- talazoparib
- talquetamab
- tazemetostat
- teclistamab
- temozolomide
- temsirolimus
- thalidomide
- thioguanine
- thiotepa
- tisagenlecleucel
- topotecan
- trabectedin
- trastuzumab
- trifluridine
- umbralisib
- venetoclax
- vinblastine
- vincristine
- vinorelbine
- zanubrutinib
- ziv-aflibercept
Caution Advised
- bleomycin
Adverse Reactions .
Serious Reactions
- splenic rupture
- ARDS
- anaphylaxis
- hypersensitivity rxn
- sickle cell crisis
- myelodysplastic syndrome
- AML
- thrombocytopenia
- glomerulonephritis
- capillary leak syndrome
- aortitis
- alveolar hemorrhage
- cutaneous vasculitis
- acute febrile neutrophilic dermatosis
Common Reactions
- bone pain
- myalgia
- headache
- vomiting
- thrombocytopenia
- fever
- extremity pain
- diarrhea
Safety/Monitoring .
Monitoring Parameters
CBC w/ diff before chemo, then 2x/wk
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available though risk of fetal harm low based on human data w/ filgrastim
Individuals of Reproductive Potential
avoid pregnancy by using effective contraception during tx in female pts
Lactation
Clinical Summary
avoid breastfeeding during tx and x2wk after D/C; no human data available to assess risk of infant harm, though possible risk based on drug's mechanism of action; no human data available to assess effects on milk production
Pharmacology .
Metabolism: other; CYP450: unknown
Excretion: other; Half-life: 3-3.5h
Subclass: Colony Stimulating Factors (CSFs) ; Supportive Care: Myelosuppression
Mechanism of Action
binds to receptors on hematopoietic cells, increasing neutrophil production and activation
Formulary .
No Formulary Selected
Manufacturer/Pricing .
Manufacturer: Teva Pharmaceuticals USA, Inc.
DEA/FDA: Rx
Approximate Retail Price
from http://www.goodrx.com/granix
subcutaneous solution:
- 480 mcg (2 syringe, 0.8 mL): $983.00
subcutaneous solution:
- 300 mcg/1 mL (1 package, 10 vials): $2,558.00
- 480 mcg/1.6 mL (1 package, 10 vials): $2,559.00
subcutaneous solution:
- 300 mcg (5 syringe, 0.5 mL): $1,538.00
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.