Description
Filgrastim-aafi injection is used to treat neutropenia (low white blood cells) that is caused by cancer medicines. It is a synthetic (man-made) form of a substance that is naturally produced in your body called a colony stimulating factor. Filgrastim-aafi helps the bone marrow to make new white blood cells.
When certain cancer medicines are used to fight cancer cells, they also affect the white blood cells that fight infections. Filgrastim-aafi is used to prevent or reduce the risk of infections while you are being treated with cancer medicines. This medicine is also used to help the bone marrow recover after a bone marrow transplantation, for a process called peripheral blood progenitor cell collection in cancer patients.
This medicine is available only with your doctor's prescription.
Before Using
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Pediatric
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of filgrastim-aafi injection in children. Safety and efficacy have been established in children with severe chronic neutropenia.
Geriatric
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of filgrastim-aafi injection in the elderly.
Breastfeeding
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Drug Interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Vincristine
- Vincristine Sulfate Liposome
Other Interactions
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Bleeding problems or
- Cutaneous vasculitis (skin disorder) or
- Glomerulonephritis (kidney disease) or
- Leukocytosis (high white blood cell count) or
- Lung disease or breathing problems or
- Sickle cell disease (red blood cell disease) or
- Thrombocytopenia (low platelets in the blood)—Use with caution. May make these conditions worse.
Proper Use
A nurse or other trained health professional may give you this medicine. It is given as a shot under your skin or into a vein.
You may be taught how to give this medicine at home. Make sure you understand all of the instructions before giving yourself an injection. Use this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. You will also be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. This will help prevent skin problems from the injections. Do not inject into skin areas that are tender, red, bruised, hard, or has scars or stretch marks.
This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions about:
- How to prepare the injection.
- The proper use of disposable syringes.
- How to give the injection.
- How long the injection can be stored at home.
Start using the medicine 24 hours or more after you finish your chemotherapy. However, do not use it within 24 hours before you begin another chemotherapy.
Allow the medicine to warm to room temperature before you inject it. If the liquid in the prefilled syringe or vial has changed color, looks cloudy, or if you see particles in it, do not use it.
Do not shake the prefilled syringe. Use the syringe or vial only once. Do not save leftover medicine.
If you use the prefilled syringe, make sure you know how to use the needle guard. After giving an injection, slide the needle guard forward over the needle until you hear a "click." The needle guard will safely cover the used needle.
Each syringe or vial of medicine is good for only one dose. Throw the syringe or vial away after your dose. Do not save unused medicine from an opened vial or syringe. Do not shake the medicine.
Dosing
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For injectable dosage form (solution):
- For neutropenia:
- Adults—Dose is based on body weight and must be determined by your doctor. The dose is usually 5 to 10 microgram per kilogram (mcg/kg) of body weight injected under the skin per day. Your doctor may adjust your dose as needed.
- Children—Use and dose must be determined by your doctor.
- For neutropenia:
Missed Dose
This medicine needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.
Storage
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Store in the refrigerator. Do not freeze.
Do not leave this medicine in direct sunlight. If it is frozen, thaw it in the refrigerator before using it. You may store the medicine at room temperature for up to 24 hours. Throw this medicine away if it has been frozen more than once or if it has been left at room temperature for longer than 24 hours.
Throw away used needles in a hard, closed container where the needles cannot poke through. Keep this container away from children and pets.
Precautions
It is very important that your doctor check your or your child's progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.
Check with your doctor right away at the first sign of an infection, such as fever, chills, cough, sore throat, or unusual tiredness or weakness.
Check with your doctor right away if you or your child are having pain in the upper left part of your stomach or at the tip of the left shoulder. This could be a symptom of a serious side effect with the spleen.
Check with your doctor right away if you or your child develop a fever, chest pain or tightness, or trouble breathing. These could be symptoms of a serious lung condition called acute respiratory distress syndrome (ARDS).
This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you or your child has a rash, itching skin, dizziness, lightheadedness, or fainting, swelling of the face, tongue, or throat, trouble breathing, or chest pain after you receive the medicine.
This medicine may cause kidney problems. Call your doctor right away if you or your child has swelling in your face or ankles, blood in the urine, or decrease in how much or how often you urinate.
This medicine may cause bleeding in the lungs. Check with your doctor right away if you or your child cough up blood or have blood in your sputum (spit).
This medicine may cause blood or bone marrow problems (eg, myelodysplastic syndrome, acute myeloid leukemia) in patients with breast or lung cancer. Check with your doctor right away if you have chest pain, chills, cough or hoarseness, fever, lower back or side pain, painful or difficult urination, sores, ulcers, or white spots on the lips or in the mouth, swollen glands, unusual bleeding or bruising, or unusual tiredness or weakness.
This medicine may cause a condition called capillary leak syndrome. It can cause fluid to leak from the blood vessels into your body's tissues. Call your doctor right away if you have swelling or puffiness and are urinating less often, trouble breathing, feeling of fullness, dizziness, or feeling faint.
This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed more easily. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers. Check with your doctor right away if you or your child has black or tarry stools, bleeding gums, blood in the urine or stools, pinpoint red spots on the skin, or unusual bleeding or bruising after receiving this medicine.
This medicine may cause aortitis (inflammation of the aorta, the largest artery in the body). Check with your doctor right away if you have fever, stomach pain, unusual tiredness or weakness, or back pain.
Before you have any medical tests, tell the medical doctor in charge that you are using this medicine. The results of some tests may be affected by this medicine.
Side Effects
Along with its needed effects, a medicine 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:
More common
- Black, tarry stools
- bladder pain
- bleeding gums
- blood in the urine or stools
- blurred vision
- body aches or pain
- bone pain
- chest pain or tightness
- chills
- cloudy urine
- confusion
- cough
- cough producing mucus
- difficult, burning, or painful urination
- difficulty or trouble breathing
- difficulty in moving
- dizziness
- ear congestion
- fainting
- fast heartbeat
- fever
- frequent urge to urinate
- headache
- hives, itching, skin rash
- hoarseness
- irritation
- joint pain, stiffness or swelling
- lightheadedness
- loss of voice
- lower back or side pain
- muscle pain or stiffness
- nervousness
- pain in the arms or legs
- painful or difficult urination
- pale skin
- pinpoint red spots on the skin
- pounding in the ears
- rapid, shallow breathing
- redness of the skin
- runny or stuffy nose
- slow or fast heartbeat
- sneezing
- sore throat
- sores, ulcers, or white spots on the lips or in the mouth
- swelling of the eyelids, face, lips, hands, or feet
- trouble swallowing
- unusual bleeding or bruising
- unusual tiredness or weakness
Less common
- Nausea
- nosebleed
- vomiting
Incidence not known
- Blisters on the skin
- blue lips, fingernails, or skin
- coughing up blood
- decrease in height
- decrease or increase in the amount of urine
- eye pain
- fast breathing
- feeling of fullness
- fever sores on the skin
- general feeling of illness
- pain in the ribs
- pain spreading to the left shoulder
- stomach pain
- swollen glands
- weight gain
Some side effects 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
- Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- constipation
- decreased appetite
- diarrhea
- general feeling of discomfort or illness
- hair loss or thinning of hair
- lack or loss of strength
- mouth or throat pain
- trouble sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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