White blood cell disorders:

Indications for: NEUPOGEN

See full labeling. To decrease incidence of infection in patients with nonmyeloid malignancies receiving certain myelosuppressive anti-cancer drugs. To reduce time to neutrophil recovery and fever duration after induction or consolidation chemotherapy treatment of adults with AML. To reduce duration of neutropenia and related sequelae in patients with nonmyeloid malignancies undergoing myeloablative chemotherapy followed by bone-marrow transplantation (BMT). To mobilize hematopoietic progenitor cells (PBPC) into peripheral blood for collection by leukapheresis. To reduce the incidence and duration of neutropenia sequelae in severe chronic neutropenia (SCN).

Adult Dosage:

See full labeling. Do not give for at least 24hrs before or after cytotoxic chemotherapy dose. BMT: Give 1st dose at least 24hrs after bone marrow infusion. SCN: Give on a daily basis.

Children Dosage:

See full labeling.

NEUPOGEN Contraindications:

Hypersensitivity to E. coli-derived products.

NEUPOGEN Warnings/Precautions:

Monitor blood, including CBCs, differentials, and platelets, before and during therapy (myelosuppressive chemotherapy: monitor twice weekly; BMT: at least 3 times weekly; SCN: twice per week during initial 4 weeks of therapy and during 2 weeks after dose adjustment). Discontinue if post nadir absolute neutrophil count (ANC) reaches 10,000/mm3 for patients receiving myelosuppressive chemotherapy; other indications: see full labeling. Monitor for splenomegaly/splenic rupture and for acute respiratory distress syndrome (ARDS); discontinue if ARDS occurs. Confirm diagnosis and do appropriate pretreatment hematological workup in SCN. Preexisting cardiac or hyperplastic skin conditions. Sickle cell disease: may cause severe sickle cell crisis (discontinue if occurs). Monitor for MDS/AML in those with severe chronic neutropenia, breast or lung cancer. Monitor for aortitis; discontinue if suspected. Possible transient (+) bone imaging changes in nuclear imaging. Pregnancy. Nursing mothers.

See Also:

NEUPOGEN Classification:

Granulocyte colony stimulating factor.

NEUPOGEN Interactions:

Avoid simultaneous use with chemo- and radiation therapy. Caution with mitomycin C, and with concomitant (same day) drugs that decrease platelets, or increase release of neutrophils (eg, lithium), or cause delayed myelosuppression, or with myelosuppressive doses of antimetabolites (eg, nitrosoureas, 5-FU).

Adverse Reactions:

Bone pain, pyrexia, rash, cough, dyspnea, epistaxis, headache, anemia, diarrhea, hypoesthesia, alopecia; splenomegaly, capillary leak syndrome, cutaneous vasculitis, thrombocytopenia, leukocytosis, others (see full labeling).

Drug Elimination:

  • Renal.

  • Half-life: ~3.5 hours (IV); ~210 minutes (SC).

  • Clearance rate: 0.5 to 0.7 mL/minute/kg.

How Supplied:

Prefilled syringes (0.5mL, 0.8mL)—1, 10; Vials (1mL, 1.6mL)—10