Neupogen (Filgrastim) Drug Information: Overdosage and Contraindications

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May 27, 2012

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Hepatitis C »

Hepatitis C infection facts

HCV is one of several viruses that cause hepatitis (inflammation of the liver).
Up to 85% of individuals who are initially (acutely) infected with HCV will fail to eliminate the virus and will become chronically infected.
HCV is spread most commonly through inadvertent exposure to infected blood. Intravenous drug abuse is the most common mode of transmission. The risk of acquiring HCV through sexual contact is low.
Generally, patients do not develop symptoms of chronic infection with HCV until they have extensive scarring of the liver (cirrhosis). Some individuals, however, may have fatigue and other non-specific symptoms in the absence of cirrhosis. A minority of patients with HCV have symptoms from organs outside of the liver.
In the U.S., Infection with HCV is the most common cause of chronic hepatitis and the most common reason for liver transplantation.
...

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OVERDOSE

In cancer patients receiving NEUPOGEN® (filgrastim) as an adjunct to myelosuppressive chemotherapy‚ it is recommended‚ to avoid the potential risks of excessive leukocytosis‚ that NEUPOGEN® (filgrastim) therapy be discontinued if the ANC surpasses 10‚000/mm³ after the chemotherapy-induced ANC nadir has occurred. Doses of NEUPOGEN® (filgrastim) that increase the ANC beyond 10‚000/mm³ may not result in any additional clinical benefit.

The maximum tolerated dose of NEUPOGEN® (filgrastim) has not been determined. Efficacy was demonstrated at doses of 4 to 8 mcg/kg/day in the phase 3 study of nonmyeloablative chemotherapy. Patients in the BMT studies received up to 138 mcg/kg/day without toxic effects‚ although there was a flattening of the dose response curve above daily doses of greater than 10 mcg/kg/day.

In NEUPOGEN® (filgrastim) clinical trials of cancer patients receiving myelosuppressive chemotherapy‚ WBC counts > 100‚000/mm³ have been reported in less than 5% of patients‚ but were not associated with any reported adverse clinical effects.

In cancer patients receiving myelosuppressive chemotherapy‚ discontinuation of NEUPOGEN® (filgrastim) therapy usually results in a 50% decrease in circulating neutrophils within 1 to 2 days‚ with a return to pretreatment levels in 1 to 7 days.

CONTRAINDICATIONS

NEUPOGEN® (filgrastim) is contraindicated in patients with known hypersensitivity to E coli-derived proteins‚ Filgrastim‚ or any component of the product.

Last reviewed on RxList: 4/18/2008
This monograph has been modified to include the generic and brand name in many instances.