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pegfilgrastim (Neulasta, Fulphila)
Tradename: Neulasta
Indications:
1) myelosuppression in cancer patients
a) adults with AML or myelodysplastic syndrome
- no effect on disease-free time
- decreased fevers, antibiotics, hospitalization
- decreased need for antifungal therapy
b) pediatric patients with ALL
- shorter hospitalizations & fewer infections
- no change in 3 year survival
2) myelosuppression in stem cell transplantation or bone marrow transplantation (BMT)
3) HIV therapy-induced myelosuppression when a change in medication regimen is contraindicated
4) prevention of chemotherapy-induced neutropenia [1]
Contraindications:
- little benefit in patients with febrile neutropenia (benefit is largely prophylactic) [1]
Pregnancy category C
Safety in lactation ?
Dosage:
- see filgrastim
Pharmacokinetics:
- action for several weeks [1]
Adverse effects:
- see filgrastim
Mechanism of action:
- pegfilgrastim (Neulasta) is a polyethylene glycol (PEG) congugate of G-CSF (filgrastim)
- see filgrastim
General
filgrastim [G-CSF] (Neupogen, Lenograstim, Granulokine)
References
- Medical Knowledge Self Assessment Program (MKSAP) 17, 18.
American College of Physicians, Philadelphia 2015, 2018