Filastin

Indications

Filastin is specifically recommended for:

• Patients undergoing myelosuppressive chemotherapy for cancer
• Individuals with Acute Myeloid Leukemia (AML) who are receiving induction or consolidation chemotherapy
• Cancer patients preparing for or recovering from a bone marrow transplant
• Those experiencing severe neutropenia
• Patients undergoing peripheral blood progenitor cell collection and therapy

Consult a registered healthcare professional before using this medication.

Description

Filastin is a recombinant human granulocyte colony-stimulating factor (G-CSF) generated through advanced DNA technology. It plays a crucial role in the regulation of neutrophil production within the bone marrow, promoting the proliferation and differentiation of neutrophil progenitors, and enhancing their phagocytic activity.

Pharmacology

Filgrastim, a granulocyte-colony-stimulating factor, interacts with specific receptors on hematopoietic cells, stimulating granulocyte development and boosting their migration and cytotoxic functions. This glycoprotein modulates the production and release of functional neutrophils from the bone marrow, leading to a significant increase in peripheral blood neutrophil counts within 24 hours, accompanied by minor rises in monocyte levels. The elevation in neutrophil counts is dose-dependent. After discontinuation of Filgrastim, circulating neutrophil levels typically decline by 50% within 1 to 2 days, returning to normal levels in 1 to 7 days.

Dosage & Administration

Parenteral Use:

• For Chemotherapy-Induced Neutropenia: Administer 5 mcg/kg daily via a single subcutaneous injection, continuous IV, or SC infusion, or as a daily IV infusion over 15-30 minutes, starting after chemotherapy.
• For Bone Marrow Transplantation: Administer 10 mcg/kg daily via IV infusion over 30 minutes to 4 hours, or continuous IV or SC infusion over 24 hours, adjusting according to patient response.

Subcutaneous Use:

• For Mobilization of Peripheral Blood Progenitor Cells: Administer 10 mcg/kg daily, either as a single injection or continuous infusion for 4-7 days until the last leukapheresis procedure. If administered after myelosuppressive chemotherapy, use 5 mcg/kg daily starting from the first day post-chemotherapy until neutrophil counts return to normal.
• For Congenital Neutropenia: Administer 12 mcg/kg daily in single or divided doses, adjusting as needed.
• For Cyclic or Idiopathic Neutropenia: Administer 5 mcg/kg daily in single or divided doses, adjusting based on patient response.
• For HIV and Persistent Neutropenia: Start with 1 mcg/kg daily, increasing to 4 mcg/kg daily until achieving normal neutrophil counts. Maintenance dosage is 300 mcg daily, with a maximum of 4 mcg/kg daily.

Consult a registered healthcare professional before using this medication.

Interactions

The interactions between Filastin and other drugs are not fully studied. Use caution with medications that may enhance neutrophil release, such as lithium.

Contraindications

Filgrastim should not be used in patients with known hypersensitivity to the drug, its components, or proteins derived from Escherichia coli.

Side Effects

Potential side effects may include musculoskeletal pain, bone pain, hypersensitivity reactions, splenic enlargement, hepatomegaly, thrombocytopenia, anemia, epistaxis, headache, nausea, vomiting, diarrhea, urinary abnormalities (such as dysuria, proteinuria, hematuria), osteoporosis, exacerbation of rheumatoid arthritis, transient decreases in blood glucose levels, elevated uric acid, cutaneous vasculitis, and transient hypotension.

Pregnancy & Lactation

Category C: Animal studies indicate potential adverse effects on the fetus, and there are no controlled studies available in humans. Use Filastin only if the potential benefits justify the risks to the fetus.

Precautions & Warnings

Filastin should not be administered within 24 hours before or after chemotherapy. The potential for Filastin to act as a growth factor for any tumor type cannot be ruled out. To prevent adverse effects related to elevated neutrophil levels, it is recommended to perform a complete blood count twice a week during treatment. Filastin can be administered via subcutaneous or intravenous infusion as needed.

Use in Special Populations

Pediatric Precautions: Filastin has been safely used in children aged 3 months to 18 years without unusual adverse effects. However, its safety and efficacy have not been established in neonates or patients with autoimmune neutropenia of infancy.

Overdose Effects

Overdose may lead to increased risks of Filastin acting as a growth factor for any tumor type and adverse effects associated with excessive neutrophils.

Therapeutic Class

Hematopoietic Agents

Reconstitution

Dilution of Filastin to concentrations below 5 mcg/ml is not advised. Filastin may be diluted in 5% dextrose if necessary.

Storage Conditions

Store in a refrigerator at 2-8°C. Do not freeze.