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Generic Name: tbo-filgrastim (TBO fil GRAS tim)
Brand Name: Granix

Medically reviewed on February 14, 2017.

What is tbo-filgrastim?

Tbo-filgrastim is a man-made form of a protein that stimulates the growth of white blood cells in your body. White blood cells help your body fight against infection.

Tbo-filgrastim is used to treat neutropenia, a lack of certain white blood cells caused by receiving chemotherapy with certain cancer medications.

Tbo-filgrastim may also be used for purposes not listed in this medication guide.

Important Information

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

You should not use this medicine if you are allergic to filgrastim (Neupogen) or pegfilgrastim (Neulasta).

To make sure tbo-filgrastim is safe for you, tell your doctor if:

Using a G-CSF such as tbo-filgrastim can cause your spleen to rupture, which can be fatal. Talk with your doctor if you have concerns about this risk.

It is not known whether tbo-filgrastim will harm an unborn baby. Avoid pregnancy while you are being treated with this medicine.

It is not known whether tbo-filgrastim passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is tbo-filgrastim given?

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Tbo-filgrastim is injected under the skin. You may be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and syringes.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

The first dose of tbo-filgrastim is usually given within 24 hours after your chemotherapy dose. You will receive daily injections until your blood cell counts return to normal.

You should not inject this medicine within 24 hours before your next chemotherapy dose.

Do not stop using tbo-filgrastim or change your medication schedule without your doctor's advice.

If this medicine accidentally gets on your skin, wash it thoroughly with soap and warm water.

Do not shake the prefilled syringe. Do not use if the medicine looks cloudy or has particles in it. Call your pharmacist for new medicine.

Each single-use prefilled syringe is for one use only. Throw away after one use, even if there is still some medicine left in it after injecting your dose.

Bone pain is a common side effect of tbo-filgrastim. Your doctor may recommend you take acetaminophen (Tylenol), ibuprofen (Advil, Motrin) other other medications to relieve pain. Take only the dosage your doctor recommends.

You will need frequent medical tests to help your doctor determine how long to treat you with tbo-filgrastim.

Store in the refrigerator, do not freeze. Protect from light.

Take the medicine out of the refrigerator and allow it to reach room temperature for 30 minutes before injecting your dose. Do not leave the medicine at room temperature for longer than 5 days.

You may store a prefilled syringe for up to 5 days at room temperature. If you do not use the syringe within 5 days, put it back into the refrigerator.

Do not use a prefilled syringe after the expiration date on the medicine label has passed.

Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose, or miss an appointment for your tbo-filgrastim injection.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using tbo-filgrastim?

Avoid getting this medicine in your eyes. If this occurs, rinse your eyes with water and call your doctor right away.

Tbo-filgrastim side effects

Get emergency medical help if you have signs of an allergic reaction: hives; wheezing, difficult breathing; fast heart rate, sweating, feeling light-headed; swelling in your face, lips, tongue, or throat.

A rare but serious side effect of tbo-filgrastim is called capillary leak syndrome. Call your doctor right away if you have signs of this condition, which may include: weakness or tired feeling, nausea, feeling full, sudden dizziness or light-headed feeling, and sudden swelling in your arms, legs and other parts of the body.

Call your doctor at once if you have:

  • signs of a kidney problem--blood in your urine, swelling in your face or ankles, little or no urination;

  • signs of infection--fever, redness, or swelling;

  • signs of acute respiratory distress syndrome--fever with shortness of breath or trouble breathing; or

  • signs of a ruptured spleen--pain in your upper stomach spreading to your left shoulder.

Common side effects may include:

  • bone pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Tbo-filgrastim dosing information

Usual Adult Dose for Neutropenia Associated with Chemotherapy:

5 mcg/kg/day as a single daily subcutaneous bolus injection.

Duration of therapy: Daily dosing should continue until the expected neutrophil nadir is
passed and the neutrophil count has recovered to the normal range.

-Avoid administration during the period 24 hours before through 24 hours after the administration of cytotoxic chemotherapy.
-Monitor complete blood count (CBC) prior to chemotherapy and twice per week until recovery.

Use: Reduction in the duration of severe neutropenia in patients with nonmyeloid malignancies receiving myelosuppressive anticancer drugs associated with a clinically significant incidence of febrile neutropenia.

What other drugs will affect tbo-filgrastim?

Other drugs may interact with tbo-filgrastim, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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