- Clinician Information:
Tbo-filgrastim Side Effects Center
Medical Editor: John P. Cunha, DO, FACOEP
Tbo-filgrastim is a recombinant methionyl human granulocyte colony-stimulating growth factor (r-metHuG-CSF) used to reduce the duration of severe neutropenia in patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a clinically significant incidence of febrile neutropenia. Common side effects include bone pain.
The recommended dose of Tbo-filgrastim is 5 mcg/kg per day administered as a subcutaneous injection. Administer the first dose of Tbo-filgrastim no earlier than 24 hours following myelosuppressive chemotherapy. Tbo-filgrastim may interact with lithium. Tell your doctor all medications and supplements you use. During pregnancy, Tbo-filgrastim should be taken only if prescribed. It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.
Our Tbo-filgrastim Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What is Prescribing information?
The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.
Tbo-filgrastim FDA Prescribing Information: Side Effects
The following potential serious adverse reactions are discussed in greater detail in other sections of the labeling:
- Splenic Rupture [see WARNINGS AND PRECAUTIONS]
- Acute Respiratory Distress Syndrome [see WARNINGS AND PRECAUTIONS]
- Serious Allergic Reactions [see WARNINGS AND PRECAUTIONS]
- Use in Patients with Sickle Cell Disorders [see WARNINGS AND PRECAUTIONS]
- Potential for Tumor Growth Stimulatory Effects on Malignant Cells [see WARNINGS AND PRECAUTIONS]
The most common treatment-emergent adverse reaction that occurred at an incidence of at least 1% or greater in patients treated with tbo-filgrastim t the recommended dose and was numerically two times more frequent than in the placebo group was bone pain.
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.
Tbo-filgrastim clinical trials safety data are based upon the results of three randomized clinical trials in patients receiving myeloablative chemotherapy for breast cancer (N=348), lung cancer (N=240) and Non- Hodgkin's lymphoma (N=92). In the breast cancer study, 99% of patients were female, the median age was 50 years, and 86% of patients were Caucasian. In the lung cancer study, 80% of patients were male, the median age was 58 years, and 95% of patients were Caucasian. In the Non-Hodgkin's lymphoma 52% of patients were male, the median age was 55 years, and 88% of patients were Caucasian. In all three studies a placebo (Cycle 1 of the breast cancer study only) or a non-US-approved filgrastim product were used as controls. Both tbo-filgrastim and the non-US-approved filgrastim product were administered at 5 mcg/kg subcutaneously once daily beginning one day after chemotherapy for at least five days and continued to a maximum of 14 days or until an ANC of ≥ 10,000 x106/L after nadir was reached.
Bone pain was the most frequent treatment-emergent adverse reaction that occurred in at least 1% or greater in patients treated with tbo-filgrastim at the recommended dose and was numerically two times more frequent than in the placebo group. The overall incidence of bone pain in Cycle 1 of treatment was 3.4% (3.4% tbo-filgrastim, 1.4% placebo, 7.5% non-US-approved filgrastim product ).
In clinical studies, leukocytosis (WBC counts > 100,000 x 106/L) was observed in less than 1% patients with non-myeloid malignancies receiving tbo-filgrastim. No complications attributable to leukocytosis were reported in clinical studies.
As with all therapeutic proteins, there is a potential for immunogenicity. The incidence of antibody development in patients receiving tbo-filgrastim has not been adequately determined.
Read the entire FDA prescribing information for Tbo-filgrastim (Tbo-filgrastim Injection) »
Additional Tbo-filgrastim Information
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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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