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Zarxio Disease Interactions

There are 6 disease interactions with Zarxio (filgrastim).

Major

CSF (applies to Zarxio) glomerulonephritis

Major Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction

Although it has been reported that renal dysfunction has no effect on the pharmacokinetics of colony stimulating factors (CSF), filgrastim and pegfilgrastim may cause glomerulonephritis. Symptoms include swelling of the face or ankles, dark colored urine, or blood in the urine, or a decrease in urine production. Advise patients to report signs or symptoms of glomerulonephritis immediately. Monitoring of patients with renal dysfunction is recommended.

References

  1. "Product Information. Neupogen (filgrastim)." Amgen PROD (2002):
  2. "Product Information. Neulasta (pegfilgrastim)." Amgen (2002):
  3. "Product Information. Granix (tbo-filgrastim)." Teva Pharmaceuticals USA (2013):
Major

CSF (applies to Zarxio) myeloid tumors

Major Potential Hazard, Moderate plausibility. Applicable conditions: Myeloproliferative Disorder

Colony stimulating factors primarily stimulates the proliferation of neutrophils but may also, theoretically, enhance tumor growth, particularly in myeloid malignancies. Therapy with these drugs should be administered cautiously in patients with myeloid tumors. Additionally, if used for PBPC (peripheral blood progenitor cell) collection in such patients, tumor cells may be released from the marrow and collected in the leukapheresis product. The effect of reinfusion of tumor cells is uncertain at this time.

References

  1. "Product Information. Neupogen (filgrastim)." Amgen PROD (2002):
  2. "Product Information. Neulasta (pegfilgrastim)." Amgen (2002):
Major

CSF- leukocytosis

Major Potential Hazard, Moderate plausibility.

Filgrastim and pegfilgrastim are growth factors for neutrophil progenitor cells. Therefore, these should not be used in patients with leukocytosis. If excessive white blood cell counts occur during CSF therapy, treatment should be interrupted or the dosage reduced.

References

  1. Hollingshead LM, Goa KL "Recombinant granulocyte colony-stimulating factor (rG-CSF). A review of its pharmacological properties and prospective role in neutropenic conditions." Drugs 42 (1991): 300-30
  2. "Product Information. Neupogen (filgrastim)." Amgen PROD (2002):
  3. "Product Information. Neulasta (pegfilgrastim)." Amgen (2002):
Moderate

Filgrastim (applies to Zarxio) sepsis

Moderate Potential Hazard, Moderate plausibility.

When filgrastim is used in septic patients, clinicians should be alerted to the theoretical possibility of adult respiratory distress syndrome, which may occur as a result of the influx of neutrophils at the site of inflammation. Monitoring of respiratory status may be appropriate in these patients.

References

  1. Hollingshead LM, Goa KL "Recombinant granulocyte colony-stimulating factor (rG-CSF). A review of its pharmacological properties and prospective role in neutropenic conditions." Drugs 42 (1991): 300-30
  2. "Product Information. Neupogen (filgrastim)." Amgen PROD (2002):
Moderate

Filgrastim (applies to Zarxio) thrombocytopenia

Moderate Potential Hazard, Moderate plausibility.

Filgrastim may occasionally lower platelet counts. Thrombocytopenia has been reported, although most often the effects are mild or moderate and not associated with serious hemorrhagic sequelae. Nevertheless, therapy with filgrastim should be administered cautiously in patients with preexisting thrombocytopenia. Frequent blood counts are recommended, and the dosage of filgrastim adjusted if necessary.

References

  1. Wun T "The Felty syndrome and G-CSF-associated thrombocytopenia and severe anemia ." Ann Intern Med 118 (1993): 318-9
  2. Balmer CM "Clinical use of biologic response modifiers in cancer treatment: an overview. Part II. Colony-stimulating factors and interleukin-2." DICP 25 (1991): 490-8
  3. Momin F, Kraut M, Lattin P, Valdivieso M "Thrombocytopenia in patients receiving chemoradiotherapy and G-CSF for locally advanced non-small cell lung cancer (NSCLC) (meeting abstract)." Proc Annu Meet Am Soc Clin Oncol 11 (1992): a983
  4. "Product Information. Neupogen (filgrastim)." Amgen PROD (2002):
  5. Kawachi Y, Watanabe A, Uchida T, Yoshizawa K, Kurooka N, Setsu K "Acute arterial thrombosis due to platelet aggregation in a patient receiving granulocyte colony-stimulating factor." Br J Haematol 94 (1996): 413-6
View all 5 references
Moderate

Tbo-filgrastim (applies to Zarxio) sickle cell disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Sickle Cell Anemia

Severe and sometimes fatal sickle cell crises have been reported in sickle cell disease patients receiving filgrastim products. Consider the potential risks and benefits prior to initiating therapy in these patients.

References

  1. "Product Information. Neupogen (filgrastim)." Amgen PROD (2002):
  2. "Product Information. Granix (tbo-filgrastim)." Teva Pharmaceuticals USA (2013):

Zarxio drug interactions

There are 168 drug interactions with Zarxio (filgrastim).

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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