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pegfilgrastim

L03AA13

Forms & Strengths

Solution for injection in pre-filled syringe: 6 mg / 0.6 mL
Solution for injection in pre-filled auto-injector (On-body injector): 6 mg / 0.6 mL

Adult Dosing

6 mg subcutaneously once per chemotherapy cycle
Administer at least 24 hours after cytotoxic chemotherapy
Do not administer within 14 days before the next chemotherapy cycle

Pediatric Dosing

Weight >= 45 kg: 6 mg subcutaneously once per cycle
Weight 31 to 44 kg: 4 mg subcutaneously once per cycle
Weight 15 to 30 kg: 2.5 mg subcutaneously once per cycle
Weight < 15 kg: 0.1 mg/kg subcutaneously once per cycle

Indications

Decrease the incidence of infection, manifested by febrile neutropenia, in patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs
Increase survival in patients acutely exposed to myelosuppressive doses of radiation (Hematopoietic Syndrome of Acute Radiation Syndrome)

Mechanism of Action

Covalent conjugate of recombinant methionyl human G-CSF and polyethylene glycol (PEG)
Binds to G-CSF receptors, stimulating proliferation, differentiation, and commitment of neutrophil progenitor cells
PEG moiety decreases renal clearance, prolonging half-life and duration of action compared to filgrastim

Contraindications

History of serious allergic reactions to human granulocyte colony-stimulating factors such as pegfilgrastim or filgrastim

Adverse Reactions

Bone pain
Pain in extremity
Splenic rupture (including fatal cases)
Acute respiratory distress syndrome (ARDS)
Severe allergic reactions, including anaphylaxis
Sickle cell crises (in patients with sickle cell disorders)
Glomerulonephritis
Capillary leak syndrome

Drug Interactions

Lithium: May potentiate the release of neutrophils; monitor neutrophil counts
Cytotoxic chemotherapy: Concomitant use within 24 hours before or after chemotherapy is not recommended due to potential increased sensitivity of rapidly dividing myeloid cells

Curated Content: Needs Vetting Before Put to Clinical Use