Filgrastim, Injection

________________________________________________________________________

KEY POINTS

• This medicine is given by injection or IV to treat neutropenia.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may increase the risk of certain cancers. This medicine may also cause serious lung or spleen problems or other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

________________________________________________________________________

What are other names for this medicine?

Type of medicine: granulocyte colony stimulating factor; G-CSF

Generic and brand names: filgrastim, injection; Neupogen; Zarxio

What is this medicine used for?

This medicine is given by injection (shot) to treat neutropenia (a condition where the body makes too few white blood cells). Neutropenia can be caused by drugs used to treat cancer.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine or to latex
• Bone marrow problems
• Sickle cell anemia

Also tell your provider if you have recently had any kind of infection or if you are taking radiation therapy or chemotherapy.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant while receiving this medicine. It is not known whether this medicine will harm an unborn baby. Do not breast-feed without your healthcare provider's approval.

How do I use it?

This medicine comes in the form of a liquid in vials or in prefilled syringes. The strength of the medicine in the vial is different from the strength of the medicine in the vial. Your healthcare provider will determine the exact dosage. Make sure you understand how much medicine you should use.

It may be given by subcutaneous injection (shot just under the skin) or by IV infusion (slow drip through a needle into a vein). Try to have the injection at the same time each day.

Sometimes you can give yourself these shots or have someone at home give them to you. Check the label on the medicine for directions about your specific dose. Be sure you know when to take the medicine and how much medicine you should take. Use this medicine exactly as your healthcare provider prescribes. Carefully follow the instructions for using this medicine. If you are not sure how to use this medicine, ask your healthcare provider or pharmacist for help.

Check with your healthcare provider before using this medicine in babies under age 7 months.

If your healthcare provider is giving you the shots, keep all your appointments.

What if I miss a dose?

Contact your healthcare provider if you miss a dose.

What if I overdose?

Symptoms of an acute overdose have not been reported.

What should I watch out for?

You will need to have lab tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may cause bone or muscle pain. Talk to your healthcare provider about which pain reliever you should use.

This medicine may increase the risk of certain cancers. Talk with your provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are using this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Pain in the upper belly or left shoulder; severe bone pain; severe vomiting or diarrhea; trouble breathing; fast breathing; coughing up blood; continuing fever; fatigue; chest pain; irritation of the mouth; purple or red spots on your skin; unexplained swelling; dark urine or blood in the urine; decreased urination; severe dizziness or feeling faint.

Other: Nausea; loss of hair; diarrhea; vomiting; constipation; loss of appetite; muscle or bone pain; weakness; trouble sleeping; mild dizziness; flushing; headache; bruising; nosebleeds; hair loss; redness, pain or swelling at the injection site.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Cancer medicines
• Lithium (Lithobid)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Keep this medicine in the refrigerator. Do not let it freeze. If accidentally frozen, allow the medicine to thaw in the refrigerator before using. Discard any medicine that is frozen a second time. Do not leave the medicine in direct sunlight.

You may warm the medicine to room temperature before you give yourself the shot, but do not keep it out of the refrigerator for longer than 24 hours. Discard medicine that has been left at room temperature for more than 24 hours.

---

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicines in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.