Granulocyte stimulating factor (Neupogen, filgrastim)

Article Translations: (Spanish)

How does this medicine work?

Granulocyte colony stimulating factor (G-CSF) stimulates production and development of neutrophils (white blood cells) in the bone marrow. Neutrophils are needed to fight infection.

How should I give it?

G-CSF is given into the vein or subcutaneously (an injection just under the skin). You may be taught how to give it at home. See the education sheet "Injections (subcutaneous)."

Are there any precautions about food or other medicines?

Check with the doctor, nurse practitioner, or pharmacist before giving any other prescription or non-prescription medicines, herbs, or vitamins.

There are no problems with food. Continue your child's regular diet.

What should I do if a dose is missed?

If a dose is missed, give it as soon as you remember. Call the clinic to let them know a dose was missed.

What are the side effects?

Common

• increased white blood cells
• reduced production of platelets
• reduced red blood cell recovery

Occasional

• headache
• pain in joints, muscles, or bones
• tiredness
• irritation at injection site

Rare

• fever
• low blood pressure
• lung disease
• kidney disease
• kidney stones
• skin rash
• enlarged spleen

When should I call the clinic?

Call right away if:

• signs of infection:
  
  • fever or chills
  • redness or pain at the injection site
  • sores on the skin
• allergic reaction, signs include:
  
  • fever or chills
  • rash or hives
  • wheezing
• rapid or irregular heartbeat
• trouble breathing - call 911

What else do I need to know?

Because your child's ability to fight infection is reduced, it is very important to call the doctor at the first signs of any infection so antibiotic treatment can be started right away.

A referral to home care may be made so that a nurse can help you learn to give this medicine at home. If this would be helpful to you, please talk with your doctor.

Your child will need blood tests to be sure the medicine is working.

You and your child should know the names of all the medicines he or she is taking. It is important to share this information with anyone involved in your child's care.

Store G-CSF in the refrigerator; do not freeze. An unopened vial at room temperature is good for 3 days. An opened vial should be disposed of immediately after the dose is drawn up. Pre-filled syringes have the expiration date on them and should be kept in the refrigerator until used.

Always make sure you have enough medicine on hand. Each time you refill your prescriptions, check to see how many refills are left. If no refills are left, the pharmacy will need 2 or 3 days to contact the doctor to renew the prescription.

Before giving the first dose, read the label. Be sure the medicine is what the doctor prescribed. After a refill, if the medicine looks different to you, ask your pharmacist or call the oncology clinic before giving it.

If the wrong dose of this medicine is given, please call the clinic.

Questions?

This is not specific to your child, but provides general information. If you have any questions, please call the clinic.

Children's Hospitals and Clinics of Minnesota
Last reviewed 8/2015 

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