Filgrastim Dosage

Usual Adult Dose for Neutropenia Associated with Chemotherapy

Initial dose: 5 mcg/kg subcutaneously or IV once a day for up to 2 weeks, until the absolute neutrophil count reaches 10,000/mm³. Administer no earlier than 24 hours after the administration of cytotoxic chemotherapy. May be increased after 5 to 7 days if the neutrophil response is inadequate by 5 mcg/kg increments with each chemotherapy cycle. Efficacy has been observed at doses of 4-8 mcg/kg/day.

Usual Adult Dose for Myelodysplastic Syndrome

5 mcg/kg subcutaneously or IV once a day. If after 5 to 7 days the neutrophil count is not adequate, the dose may be increased by 5 mcg/kg.

Usual Adult Dose for Bone Marrow Transplantation

10 mcg/kg/day by continuous subcutaneous infusion or IV infusion once a day. Therapy is generally started 24 hours after bone marrow transplantation and continued for 2 to 4 weeks. When ANC >1000/mm³ for 3 days, reduce dose to 5 mcg/kg/day. If after 5 to 7 days the neutrophil count is not adequate, the dose may be increased by 5 mcg/kg.

Usual Adult Dose for Neutropenia Associated with AIDS or Zidovudine

1 to 5 mcg/kg subcutaneously or IV once a day. If after 5 to 7 days the neutrophil count is not adequate, the dose may be increased by 5 mcg/kg.

Usual Adult Dose for Peripheral Progenitor Cell Transplantation

10 mcg/kg subcutaneously or IV once a day for at least 4 days before the first leukapheresis procedure and continued until the last leukapheresis; 5 to 24 mcg/kg/day, with 5 mcg/kg/day being an effective dose for most patients. Myeloid recovery dosages are continued until a consistent absolute neutrophil count of >500 cells/mm² is reached. Dose modification should be considered with a white blood cell count >10,000 cells/mm³.

Usual Adult Dose for Neutropenia

6 mcg/kg subcutaneously twice a day. Chronic administration is required.

Usual Pediatric Dose for Neutropenia

>3 m:
Neonatal: 5 to 10 mcg/kg once daily.

Congenital: 6 mcg/kg/dose twice daily.

Idiopathic or Cyclic: 5 mcg/kg once daily.

Usual Pediatric Dose for Neutropenia Associated with Chemotherapy

Initial dose: 5 mcg/kg subcutaneously or IV once a day for up to 2 weeks, until the absolute neutrophil count reaches 10,000/mm³. Administer no earlier than 24 hours after the administration of cytotoxic chemotherapy. May be increased after 5 to 7 days if the neutrophil response is inadequate by 5 mcg/kg increments with each chemotherapy cycle. Efficacy has been observed at doses of 4 to 8 mcg/kg/day.

Usual Pediatric Dose for Aplastic Anemia

Study (n=4)
400 mcg/m² per day by IV infusion.

Usual Pediatric Dose for Sepsis

10 mcg/kg daily

Dose Adjustments

Dosing adjustments are based on patient's neutrophil count. The dose should be based on actual weight.

Precautions

Clinical monitoring should include a complete blood count (CBC), with white blood cell (WBC) differential and platelet count at least twice weekly during filgrastim therapy. Following marrow transplantation CBC and platelet counts are recommended at least three times per week.

Filgrastim may act as a growth factor for any tumor with myeloid characteristics.

Other Comments

Before initiation of filgrastim therapy and biweekly thereafter, a CBC with differential and platelet count should be performed.

Filgrastim should not be given within 24 hours before or after chemotherapy. An increase in the absolute neutrophil count >10,000/mm³ is not recommended.

Filgrastim may be administered by IV, subcutaneous, IV infusion over 15 to 60 minutes, or continuous subcutaneous or IV infusion over 24 hours.

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