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Filgrastim Side Effects

Medically reviewed by Last updated on Feb 17, 2024.

Applies to filgrastim: injection solution. Other dosage forms:

Serious side effects of Filgrastim

Along with its needed effects, filgrastim may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking filgrastim:

More common

Less common

Incidence not known

Other side effects of Filgrastim

Some side effects of filgrastim may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Less common

For Healthcare Professionals

Applies to filgrastim: injectable solution.


Very common (10% or more): Decreased platelet counts (up to 97%), increase in white blood cell counts between 10 x 10(9)/L and 70 x 10(9)/L (up to 88%), decreased hemoglobin (up to 65%), mild to moderate decreases in hemoglobin (up to 59%), leukocytosis (up to 41%), thrombocytopenia (up to 38%), transient thrombocytopenia (up to 35%), palpable splenomegaly (up to 30%), splenomegaly (up to 30%), anemia (up to 10%)

Common (1% to 10%): Spleen disorder, splenic rupture/fatal splenic rupture

Uncommon (0.1% to 1%): Sickle cell anemia with crisis/sickle cell crisis

Rare (0.01% to 0.1%): Cytopenia

Postmarketing reports: Sickle cell disorders[Ref]


Very common (10% or more): Mild to moderate musculoskeletal symptoms (up to 44%), medullary bone pain (up to 38%), mild to moderate bone pain (up to 33%), bone pain (up to 30%), back pain (up to 15%), musculoskeletal pain (up to 14%), flank pain (up to 12%), myalgia (up to 12%)

Common (1% to 10%): Arthralgia, extremity pain, muscle spasms, osteoporosis, severe musculoskeletal pain

Uncommon (0.1% to 1%): Pseudogout/chondrocalcinosis pyrophosphate, rheumatoid arthritis exacerbation

Rare (0.01% to 0.1%): Decreased bone density

Frequency not reported: Musculoskeletal chest pain, neck pain[Ref]


Very common (10% or more): Pyrexia (up to 48%), fatigue (up to 20%), pain (up to 12%)

Common (1% to 10%): Asthenia, generalized weakness, malaise, mucosal inflammation, mucositis[Ref]


Very common (10% or more): Epistaxis (up to 15%), cough (up to 14%), dyspnea (up to 13%)

Common (1% to 10%): Bronchitis, hemoptysis, sore throat, upper respiratory tract infection

Uncommon (0.1% to 1%): Acute respiratory distress syndrome (ARDS), hypoxia, interstitial lung disease, pulmonary edema, pulmonary hemorrhage, pulmonary infiltrates/lung infiltration, respiratory failure

Very rare (less than 0.01%): Pulmonary adverse events

Frequency not reported: Interstitial pneumonia, serious pulmonary adverse events

Postmarketing reports: Alveolar hemorrhage[Ref]


Very common (10% or more): Spontaneously reversible elevations in lactate dehydrogenase (up to 56%), spontaneously reversible elevations in uric acid (up to 56%)

Common (1% to 10%): Anorexia, blood glucose decreased, blood lactate dehydrogenase increased, blood uric acid increased, decreased appetite, hyperuricemia

Uncommon (0.1% to 1%): Fluid volume disturbances[Ref]


Very common (10% or more): Spontaneously reversible elevations in alkaline phosphatase (up to 56%), blood alkaline phosphatase increased (up to 11%)

Common (1% to 10%): Gamma glutamyltransferase increased, hepatomegaly

Uncommon (0.1% to 1%): AST increased[Ref]


Very common (10% or more): Nausea (up to 43%), abdominal pain (up to 12%)

Common (1% to 10%): Constipation, diarrhea, oral pain, oropharyngeal pain, pharyngolaryngeal pain, vomiting

Frequency not reported: Stomatitis[Ref]

Nervous system

Very common (10% or more): Dizziness (up to 14%), headache (up to 10%)

Common (1% to 10%): Hypoesthesia, paresthesia[Ref]


Very common (10% or more): Rash/skin rash (up to 14%)

Common (1% to 10%): Alopecia, cutaneous/leukocytoclastic vasculitis, erythema

Uncommon (0.1% to 1%): Acute febrile neutrophilic dermatosis/Sweet's syndrome, maculopapular rash, pre-existing skin disorder exacerbation, psoriasis exacerbation

Frequency not reported: Urticaria[Ref]


Very common (10% or more): Chest pain (up to 13%)

Common (1% to 10%): Hypertension, hypotension, peripheral edema

Uncommon (0.1% to 1%): Capillary leak syndrome, veno-occlusive disease

Rare (0.01% to 0.1%): Aortitis, vascular disorder[Ref]


Common (1% to 10%): Dysuria, hematuria, urinary tract infection

Uncommon (0.1% to 1%): Proteinuria,

Rare (0.01% to 0.1%): Urine abnormality[Ref]


Common (1% to 10%): Injection site pain, injection site reaction, transfusion reaction[Ref]


Common (1% to 10%): Antibody formation, sepsis

Uncommon (0.1% to 1%): Graft versus Host Disease (GvHD)/fatal GvHD[Ref]


Common (1% to 10%): Drug hypersensitivity

Uncommon (0.1% to 1%): Anaphylactic reaction, hypersensitivity/hypersensitivity reactions, severe allergic reaction

Very rare (less than 0.01%): Allergic reaction

Frequency not reported: Anaphylaxis, angioedema[Ref]


Common (1% to 10%): Glomerulonephritis[Ref]


Common (1% to 10%): Insomnia[Ref]


Transformation to MDS/AML and cytogenetic abnormalities appeared to be confined to patients with congenital neutropenia. The cumulative risk in this population in the eighth year of treatment was predicted to be 16.5%, or approximately 2% per year.[Ref]

Frequency not reported: cytogenetic abnormalities, transformation to myelodysplastic syndromes (MDS), transformation to acute myeloid leukemia (AML)[Ref]

Frequently asked questions


1. Product Information. Neupogen (filgrastim). Amgen. 2002;PROD.

2. Cerner Multum, Inc. UK Summary of Product Characteristics.

3. Cerner Multum, Inc. Australian Product Information.

4. Product Information. Nivestym (filgrastim). Pfizer U.S. Pharmaceuticals Group. 2018.

5. Product Information. Zarxio (filgrastim). Sandoz Inc. 2018.

Further information

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

Some side effects may not be reported. You may report them to the FDA.