Filgrastim

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Filgrastim
Filgrastim.jpg
Systematic (IUPAC) name
Human granulocyte colony stimulating factor
Clinical data
Trade names Neupogen
AHFS/Drugs.com monograph
Legal status ?
Identifiers
CAS number 143011-72-7
ATC code L03AA02
DrugBank DB00099
UNII PVI5M0M1GW YesY
ChEMBL CHEMBL1201567
Chemical data
Formula C845H1343N223O243S9 
Mol. mass 18802.8 g/mol

Filgrastim is a granulocyte colony-stimulating factor (G-CSF) analog used to stimulate the proliferation and differentiation of granulocytes;[1] it is a pharmaceutical analog of naturally occurring G-CSF. It is produced by recombinant DNA technology. The gene for human granulocyte colony-stimulating factor is inserted into the genetic material of Escherichia coli. The G-CSF then produced by E. coli is different from G-CSF naturally made in humans.

Filgrastim is marketed under several brand names, including Filcad (Cadila Pharmaceuticals), Imumax (Abbott Laboratories), Grafeel (Dr. Reddy's Laboratories), Neukine (Intas Biopharmaceuticals), Emgrast (Emcure Pharmaceuticals), Religrast (Reliance Life Sciences), Zarzio (Sandoz), Nufil (Biocon) and others.

Apricus Biosciences is currently developing and testing a product under the brand name Nupen which can deliver filgrastim through the skin to improve post-chemotherapy recovery of neutrophil counts.

Therapeutic uses[edit]

Filgrastim is used to treat neutropenia,[2] stimulating the bone marrow to increase production of neutrophils. Causes of neutropenia include chemotherapy and bone marrow transplantation.

Filgrastim is also used to increase the number of hematopoietic stem cells in the blood before collection by leukapheresis for use in hematopoietic stem cell transplantation.

Contraindications[edit]

Filgrastim should not be used in patients with known hypersensitivity to E. coli-derived proteins.[citation needed]

Adverse effects[edit]

The most commonly observed adverse effect is mild-to-moderate bone pain after repeated administration and local skin reactions at the site of injection.[3] Other observed adverse effects include serious allergic reactions (including a rash over the whole body, shortness of breath, wheezing, dizziness, swelling around the mouth or eyes, fast pulse, and sweating), ruptured spleen (sometimes resulting in death), alveolar hemorrhage, acute respiratory distress syndrome, and hemoptysis.[3] Severe sickle cell crises, in some cases resulting in death, have been associated with the use of filgrastim in patients with sickle cell disorders.[4]

Interactions[edit]

Drug interactions between filgrastim and other drugs have not been fully evaluated. Drugs which may potentiate the release of neutrophils‚ such as lithium‚ should be used with caution.

Increased hematopoietic activity of the bone marrow in response to growth factor therapy has been associated with transient positive bone imaging changes; this should be considered when interpreting bone-imaging results.[5]

Filgrastim has not been studied in pregnant women and its effects on unborn babies is unknown. If taking filgrastim while pregnant, it is possible that traces of the drug could be found in the baby's blood. It is not known if the drug can get into human breast milk.

References[edit]

  1. ^ Beveridge, R. A.; Miller, J. A.; Kales, A. N.; Binder, R. A.; Robert, N. J.; Harvey, J. H.; Windsor, K.; Gore, I.; Cantrell, J.; Thompson, K. A.; Taylor, W. R.; Barnes, H. M.; Schiff, S. A.; Shields, J. A.; Cambareri, R. J.; Butler, T. P.; Meister, R. J.; Feigert, J. M.; Norgard, M. J.; Moraes, M. A.; Helvie, W. W.; Patton, G. A.; Mundy, L. J.; Henry, D.; Sheridan, B.; Staddon, A.; Ford, P.; Katcher, D.; Houck, W.; Major, W. B. (1998). "A Comparison of Efficacy of Sargramostim (Yeast-Derived RhuGM-CSF) and Filgrastim (Bacteria-Derived RhuG-CSF) in the Therapeutic Setting of Chemotherapy-Induced Myelosuppression". Cancer Investigation 16 (6): 366–373. doi:10.3109/07357909809115775. PMID 9679526.  edit
  2. ^ Crawford, J.; Glaspy, J. A.; Stoller, R. G.; Tomita, D. K.; Vincent, M. E.; McGuire, B. W.; Ozer, H. (2005). "Final Results of a Placebo-Controlled Study of Filgrastim in Small-Cell Lung Cancer: Exploration of Risk Factors for Febrile Neutropenia". Supportive Cancer Therapy 3 (1): 36–46. doi:10.3816/SCT.2005.n.023. PMID 18632435.  edit
  3. ^ a b Neupogen "Neupogen: Patient Information Leaflet". Amgen. Retrieved 24 June 2013. 
  4. ^ "NEUPOGEN® Patient Guide". Amgen. Retrieved 24 June 2013. 
  5. ^ "Neupogen". RxList. 4 June 2012. Retrieved 23 June 2013. 

Further reading[edit]

  • Budiono Santoso; Chris J. van Boxtel; Boxtel, Christoffel Jos van (2001). Drug benefits and risks: international textbook of clinical pharmacology. New York: Wiley. ISBN 0-471-89927-5. 
  • "Neupogen information". Retrieved 20 October 2005.