Pharm

Pegfilgrastim

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Pegfilgrastim, Neulasta, Fulphilia, Udenyca

  • Indications
  1. Myelosuppressive Chemotherapy-Induced Neutropenia
  2. Acute Radiation Syndrome related myelosuppression
  • Mechanism
  1. Granulocyte Colony-Stimulating Factor (G-CSF)
    1. Endogenous Cytokine that modulates the production, differentiation and function Neutrophilic Granulocyte progenitors
    2. G-CSF is endogenously produced by Monocytes, fibroblasts, and endothelial cells
    3. G-CSF activates Granulocyte production via binding specific cell surface receptors
  2. Pegfilgrastim
    1. Pegfilgrastim is a recombinant, synthetic agent similar to the B isoform of G-CSF
      1. Like G-CSF, Pegfilgrastim stimulates the production of Neutrophils
      2. Used to counter Neutropenia secondary to anticancer drug induced myelosuppression
    2. Pegfilgrastim is the pegylated (conjugated to Polyethylene Glycol) form of Filgrastim
      1. Pegylation significantly increases the Half-Life of Filgrastim
  • Precautions
  1. Do NOT give 14 days before or 24 hours after cytotoxic/myelosuppressive Chemotherapy
    1. Unknown risk of cytotoxic agents on rapidly dividing myeloid cells
  2. Storage
    1. Store medication in refrigerator
    2. Use within 48 hours when at room Temperature
    3. Protect from light exposure
  • Dosing
  • Adult
  1. See other references for specific dosing
  2. Myelosuppressive Chemotherapy-Induced Neutropenia
    1. Give 6 mg SQ once per Chemotherapy cycle
  3. Acute Radiation Syndrome related myelosuppression
    1. Give 6 mg SQ for 2 doses, 1 week apart
  • Dosing
  • Child
  1. Weight-Based Dosing
    1. Weight <10 kg: 0.1 mg/kg
    2. Weight 10 to 20 kg: 1.5 mg
    3. Weight 21 to 30 kg: 2.5 mg
    4. Weight 31 to 44 kg: 4.0 mg
    5. Weight >=45 kg: Use adult dosing as above
  2. Myelosuppressive Chemotherapy-Induced Neutropenia
    1. Give weight-based dose SQ once per Chemotherapy cycle
  3. Acute Radiation Syndrome related myelosuppression
    1. Give weight-based dose SQ for 2 doses, 1 week apart
  • Adverse Effects
  1. Medullary bone pain
  2. Allergic Reaction
  3. Cutaneous Vasculitis
  • Safety
  1. Unknown safety in pregnancy
  2. Unknown safety in Lactation