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Indication & Dosage |
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| Subcutaneous |
| MOBILISATION OF PERIPHERAL BLOOD PROGENITOR CELLS FOR AUTOLOGOUS PERIPHERAL BLOOD STEM CELL TRANSPLANTATION |
| Adult:
10 mcg/kg daily, as a single inj or by continuous infusion, for 4-7 days until the last leucapheresis procedure. If it is given after myelosuppressive chemotherapy: 5 mcg/kg daily by inj; given from the 1st day after chemotherapy completion until expected neutrophil nadir is passed and neutrophil count has returned to normal range, so that leucapheresis can be performed. |
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| Subcutaneous |
| CONGENITAL NEUTROPAENIA |
| Adult:
12 mcg/kg daily in single or divided doses. Adjust according to response. |
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| Subcutaneous |
| IDIOPATHIC OR CYCLIC NEUTROPAENIA |
| Adult:
5 mcg/kg daily in single or divided doses. Adjust according to response. |
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| Subcutaneous |
| HIV INFECTION AND PERSISTENT NEUTROPENIA |
| Adult:
Initially, 1 mcg/kg daily. Dose may be increased to 4 mcg/kg daily until normal neutrophil count is achieved. Maintenance: 300 mcg daily. Max: 4 mcg/kg daily. |
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| Parenteral |
| ADJUNCT TO ANTINEOPLASTIC THERAPY |
| Adult:
5 mcg/kg daily as a single daily SC inj, as a continuous IV or SC infusion, or as a daily IV infusion over 15-30 minutes, starting not <24 hr after the last dose of antineoplastic. Continue treatment until neutrophil count has stabilised within the normal range which may take up to 14 days or more. |
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| Parenteral |
| BONE MARROW TRANSPLANTATION |
| Adult:
10 mcg/kg daily by IV infusion over 30 min or 4 hr or continuous IV or SC infusion over 24 hr. Adjust according to response. |
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| Precautions |
Premalignant or malignant myeloid condition; sickle-cell disease; osteoporotic bone disease; withdraw treatment if there are signs of pulmonary infiltrates. Fluid retention or heart failure. Monitor CBC and platelet count during therapy. Monitor bone density in patients with osteoporosis (long-term treatment). Regular morphological and cytogenic bone-marrow examinations in severe congenital neutropenia. Pregnancy and lactation. |
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Potentially Life-threatening
Adverse Drug Reactions |
Musculoskeletal pain, bone pain, hypersensitivity reactions, splenic enlargement, hepatomegaly, thrombocytopaenia, anaemia, epistaxis, headache, nausea, vomiting, diarrhoea, urinary abnormalities (dysuria, proteinuria, haematuria), osteoporosis, exacerbation of rheumatoid arthritis, transient decrease in blood glucose, raised uric acid, cutaneous vasculitis, transient hypotension. |
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| Adverse Drug Reactions |
Pulmonary infiltrates leading to resp failure or acute resp distress syndrome. |
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| Interactions |
Myelosuppressive antineoplastic agents. Drugs which may potentiate the release of neutrophils e.g. lithium. |
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