Medication Search​ - Grastofil

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How does Grastofil work? What will it do for me?

Filgrastim belongs to the family of medications known as granulocyte colony stimulating factors (G-CSF). It helps the bone marrow produce white blood cells, which help the body fight infection.

Filgrastim is used to prevent infections that appear as febrile neutropenia (a condition of low counts of a certain type of white blood cells known as neutrophils, accompanied by fever) or to reduce the duration of neutropenia for people who:

  • are receiving a type of chemotherapy that slows down white blood cell production,
  • are receiving bone marrow or stem cell transplants,
  • have acute myeloid leukemia, or
  • have severe chronic neutropenia

This medication is also used by people with HIV infection (the virus that causes AIDS), to keep the number of white blood cells within the normal range. Filgrastim may also be used to increase the numbers of certain types of blood cells.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does Grastofil come in?

300 μg/0.5 mL
Each single-use, pre-filled syringe of sterile, clear, colourless, preservative-free liquid for parenteral administration contains 300 μg of filgrastim. Nonmedicinal ingredients: sodium acetate buffer, sorbitol, polysorbate 80, and water for injection. The syringe system contains latex.

480 μg/0.8 mL
Each single-use, pre-filled syringe of sterile, clear, colourless, preservative-free liquid for parenteral administration contains 480 μg of filgrastim. Nonmedicinal ingredients: sodium acetate buffer, sorbitol, polysorbate 80, and water for injection. The syringe system contains latex.

How should I use Grastofil?

The recommended starting dose of filgrastim is based on body weight and varies depending on the condition being treated. For people who are being treated with chemotherapy, treatment should start no sooner than 24 hours after the chemotherapy has been given.

Filgrastim is given by subcutaneous (under the skin) or intravenous (into a vein) injection once daily. Your dose may be adjusted depending on your response to this medication, and therapy is usually continued until neutrophil counts reach an acceptable level. For some conditions, filgrastim will be needed indefinitely.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Filgrastim is usually given under medical supervision. If you are giving filgrastim to yourself, your doctor or health care professional will instruct you on how to use filgrastim properly. It is important that this medication be used exactly as prescribed by your doctor.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

If you are receiving this medication in a clinic or at your doctor’s office and you miss an appointment to receive filgrastim, contact your doctor as soon as possible to reschedule your appointment.

Store this medication in the refrigerator, but do not allow it to freeze. Avoid shaking filgrastim. Store it in the carton it is packaged in to protect it from light. This medication may be stored out of the refrigerator, at room temperature, for a single period of up to 7 days. Keep this medication out of the reach of children. Do not use this medication if it is cloudy or there are particles in it.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take Grastofil?

Do not take filgrastim if you:

  • are allergic to filgrastim or to any of the ingredients of the medication
  • are allergic to products made using the E. coli bacteria

What side effects are possible with Grastofil?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • cough
  • diarrhea
  • fatigue
  • headache
  • joint swelling and pain
  • loss of appetite
  • a lump, redness, swelling, or bruising at the injection site
  • muscle pain
  • sore throat

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • acute respiratory distress syndrome (e.g., fever, shortness of breath, cough, lung congestion)
  • bone pain
  • enlarged spleen (increased tenderness or swelling in the left upper stomach area)
  • inflammation of the blood vessels in the skin
  • raised, painful, plum-coloured sores on the limbs, face or neck
  • signs of bleeding (such as nosebleeds, blood in the urine, black tarry stools, bleeding gums, coughing or throwing up of blood, easy bruising)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
  • symptoms of capillary leak syndrome (e.g., swelling or puffiness, decreased urine production or need to pass water, difficulty breathing, abdominal swelling, general feeling of tiredness)
  • symptoms of a ruptured spleen (e.g., pain in the left upper stomach area or left shoulder tip area)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for Grastofil?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Capillary leak syndrome (CLS): Filgrastim has been reported to cause CLS, a condition where blood leaks out of the small blood vessels into the tissues of the body. If you experience symptoms of CLS, such as swelling or puffiness, decreased need to urinate, trouble breathing, swelling in the abdominal area, or a general feeling of tiredness, contact your doctor immediately. The symptoms often develop quickly and the severity of each episode is different. In severe episodes, CLS can be fatal.

Chronic use: When used for long periods of time, filgrastim may increase the risk of myelodysplasia (bone marrow disorders) and certain types of leukemia. It is not known if this increased risk is directly related to filgrastim or to the conditions filgrastim is being used to treat. If you are receiving long-term treatment with filgrastim, your doctor will monitor your blood regularly and check your bone marrow annually.

Cytotoxic chemotherapy: The safety of using filgrastim at the same time as cytotoxic chemotherapy (a type of chemotherapy that kills cells, especially cancer cells) has not been established. Filgrastim should not be used within 24 hours before or 24 hours after chemotherapy is administered.

Heart conditions: Heart-related conditions such as heart attacks and abnormal heart rhythms have been observed in rare cases with filgrastim. If you have a heart condition before starting filgrastim, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Lung problems: Filgrastim may cause acute respiratory distress syndrome (ARDS), a serious lung condition. It is thought that this is caused by the movement of white blood cells to an area of the lung that is inflamed, as a result of infection. If you experience difficulty breathing, fever, or coughing blood while using filgrastim, contact your doctor immediately.

Osteoporosis: Long-term use of filgrastim may increase the risk of osteoporosis in some people. If you have osteoporosis or chronic neutropenia, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to check your bone density regularly while you are receiving this medication.

Sickle cell disease: Filgrastim may cause sickle cell crisis when used by people who have sickle cell disease. You and your doctor should carefully consider the benefits and risks of using filgrastim in these circumstances if you have sickle cell disease.

Splenic rupture: Using filgrastim can cause the spleen to enlarge and in some cases rupture, causing internal bleeding. A ruptured spleen is a medical emergency. Symptoms of a ruptured spleen include pain on the left side of the abdomen, under the rib cage, or pain at the tip of your left shoulder. Other symptoms include symptoms of shock, including lightheadedness or fainting, blurred vision, confusion, anxiety, nausea, or paleness. If you experience any of these, seek immediate medical help.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known whether filgrastim passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of filgrastim have not been established for newborn babies.

What other drugs could interact with Grastofil?

There may be an interaction between filgrastim and any of the following:

  • bleomycin
  • cyclophosphamide
  • lithium
  • other cytokine medications (e.g., growth factors)
  • topotecan

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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