Pegfilgrastim

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Pegfilgrastim Brand Name– Fulphila | Neulasta | Ziextenzo

What is Pegfilgrastim

Pegfilgrastim is a leukocyte growth factor that binds to cell surface receptors on hematopoietic cells stimulating proliferation, differentiation, commitment, and end cell functional activation.

It is indicated to increase survival in patients acutely exposed to myelosuppressive doses of radiation. Efficacy for this indication was based on animal data in monkeys.

Pegfilgrastim and biosimilar products (i.e., pegfilgrastim-bmez, pegfilgrastim-jmdb, and pegfilgrastim-cbqv) are indicated to decrease the incidence of infection, as manifested by febrile neutropenia, in patients with non-myeloid malignancies receiving myelosuppressive anticancer drugs associated with a clinically significant incidence of febrile neutropenia.

None of these products are indicated for the mobilization of peripheral blood progenitor cells for hematopoietic stem-cell transplantation.

Acute respiratory distress syndrome, fatal splenic rupture, and glomerulonephritis have occurred with pegfilgrastim products

Indications

  • chemotherapy-induced neutropenia
  • radiation exposure

For chemotherapy-induced neutropenia prophylaxis, to decrease the incidence of febrile neutropenia, in patients with nonmyeloid malignancies receiving myelosuppressive chemotherapy associated with a clinically significant incidence of febrile neutropenia

Side Effects

  1. abdominal pain
  2. acute respiratory distress syndrome (ARDS)
  3. anaphylactoid reactions
  4. antibody formation
  5. aortitis
  6. azotemia
  7. back pain
  8. bleeding
  9. bone pain
  10. capillary leak syndrome
  11. contact dermatitis
  12. edema
  13. erythema
  14. fever
  15. flushing
  16. glomerulonephritis
  17. hematuria
  18. hypoalbuminemia
  19. hypotension
  20. injection site reaction
  21. leukocytosis
  22. malaise
  23. proteinuria
  24. pruritus
  25. rash
  26. sickle-cell crisis
  27. splenic rupture
  28. splenomegaly
  29. urticaria
  30. vasculitis

Monitoring Parameters

  • CBC with differential
  • platelet count

Contraindications

  • breast-feeding
  • E. coli protein hypersensitivity
  • leukemia
  • leukocytosis
  • pregnancy
  • sickle cell disease

Interactions

  • Abemaciclib
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Alpha interferons
  • Altretamine
  • Antimetabolites
  • Antitumor antibiotics
  • Bexarotene
  • Busulfan
  • Clofarabine
  • Cyclophosphamide
  • Dacarbazine, DTIC
  • Denileukin Diftitox
  • Ibritumomab Tiuxetan
  • Lithium
  • Methotrexate
  • Mitoxantrone
  • Natural Antineoplastics
  • Nelarabine
  • Nitrosoureas
  • Procarbazine
  • Purine analogs
  • Temozolomide
  • Thiotepa
  • Tositumomab
  • Tretinoin, ATRA

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