Filgrastim: Difference between revisions

Filgrastim
Clinical data
Trade names	Neupogen
AHFS/Drugs.com	Monograph
ATC code	L03AA02 (WHO) ;
Identifiers
	IUPAC name Human granulocyte colony stimulating factor;
CAS Number	143011-72-7;
DrugBank	DB00099;
UNII	PVI5M0M1GW;
ChEMBL	ChEMBL1201567;
ECHA InfoCard	100.167.401
Chemical and physical data
Formula	C845H1343N223O243S9
Molar mass	18802.8 g/mol g·mol−1

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Revision as of 06:23, 18 August 2014

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.

Commercialization

Filgrastim is marketed under several brand names, including:

Company	Brand
Cadila Pharmaceuticals	Filcad
Abbott Laboratories	Imumax
Dr. Reddy's Laboratories	Grafeel
Intas Biopharmaceuticals	Neukine
Amgen	Neupogen^[2]
Emcure Pharmaceuticals	Emgrast
Reliance Life Sciences	Religrast
Sandoz	Zarzio
Biocon	Nufil

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

Filgrastim is used to treat neutropenia,^[3] 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.

Mechanism of Action: Filgrastim is a human granulocyte colony stimulating factor (G-CSF) produced by recombinant DNA technology. G-CSF regulates the production of neutrophils within the bone marrow; endogenous G-CSF is a glycoprotein produced by monocytes, fibroblasts, and endothelial cells.

G-CSF is a colony stimulating factor which has been shown to have minimal direct in vivo or in vitro effects on the production of other haematopoietic cell types.NEUPOGEN (filgrastim) is the name for recombinant methionyl human granulocyte colony stimulating factor (r-metHuG-CSF). ref: www.amgen.ca/Neupogen_PM.pdf

Contraindications

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

Adverse effects

The most commonly observed adverse effect is mild-to-moderate bone pain after repeated administration and local skin reactions at the site of injection.^[4] 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.^[4] Severe sickle cell crises, in some cases resulting in death, have been associated with the use of filgrastim in patients with sickle cell disorders.^[5]

Interactions

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.^[6]

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

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^ "FDA Reviews What Could Be First Biosimilar". Discov. Dev. Mag. Rockaway, New Jersey, United States. Associated Press. 25 July 2014. {{cite news}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
^ Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.3816/SCT.2005.n.023, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.3816/SCT.2005.n.023 instead.
^ ^a ^b Neupogen "Neupogen: Patient Information Leaflet". Amgen. Retrieved 24 June 2013.
^ "NEUPOGEN® Patient Guide" (PDF). Amgen. Retrieved 24 June 2013.
^ "Neupogen". RxList. 4 June 2012. Retrieved 23 June 2013.