Pegfilgrastim Dosage

Medically reviewed by Drugs.com. Last updated on Jan 13, 2023.

Usual Adult Dose for Febrile Neutropenia

6 mg subcutaneously ONCE per chemotherapy cycle, beginning at least 24 hours after completion of chemotherapy

Comment: Do not administer between 14 days before and 24 hours after the administration of cytotoxic chemotherapy.

Use: To decrease the incidence of infection, as manifested by febrile neutropenia, in patients with non-myeloid malignancies receiving myelosuppressive anticancer drugs associated with a clinically significant incidence of febrile neutropenia

Usual Adult Dose for Neutropenia Associated with Chemotherapy

6 mg subcutaneously ONCE per chemotherapy cycle, beginning at least 24 hours after completion of chemotherapy

Comment: Do not administer between 14 days before and 24 hours after the administration of cytotoxic chemotherapy.

Use: To decrease the incidence of infection, as manifested by febrile neutropenia, in patients with non-myeloid malignancies receiving myelosuppressive anticancer drugs associated with a clinically significant incidence of febrile neutropenia

Usual Adult Dose for Neutropenia Associated with Radiation

6 mg subcutaneously once a week

• Duration of treatment: 2 weeks

Comments:

• Administer the first dose as soon as possible after suspected or confirmed exposure to radiation levels greater than 2 gray (Gy) and administer the second dose one week after the first dose.
• A baseline complete blood count (CBC) should be obtained before dosing; however, therapy should not be delayed if a CBC is not readily available.
• The healthcare provider should estimate the level of radiation exposure in the patient based on information from public health authorities, biodosimetry if available, or clinical findings such as time to onset of vomiting or lymphocyte depletion kinetics.

Use: To increase survival in patients acutely exposed to myelosuppressive doses of radiation

Usual Pediatric Dose for Febrile Neutropenia

Pediatric patients:

• Body weight less than 10 kg: 0.1 mg/kg subcutaneously once per chemotherapy cycle, beginning at least 24 hours after completion of chemotherapy
• Body weight 10 to 20 kg: 1.5 mg subcutaneously ONCE per chemotherapy cycle, beginning at least 24 hours after completion of chemotherapy
• Body weight 21 to 30 kg: 2.5 mg subcutaneously ONCE per chemotherapy cycle, beginning at least 24 hours after completion of chemotherapy
• Body weight 31 to 44 kg: 4 mg subcutaneously ONCE per chemotherapy cycle, beginning at least 24 hours after completion of chemotherapy
• Body weight 45 kg or greater: 6 mg subcutaneously ONCE per chemotherapy cycle, beginning at least 24 hours after completion of chemotherapy

Comments:

• The prefilled syringe is not designed to allow administration of doses less than 0.6 mL (6 mg) because it does not have graduation marks, which are necessary to accurately measure doses less than 0.6 mL; therefore, administration to patients requiring less than 0.6 mL is not recommended.
• Do not administer between 14 days before and 24 hours after administration of cytotoxic chemotherapy.

Use: To decrease the incidence of infection, as manifested by febrile neutropenia, in patients with non-myeloid malignancies receiving myelosuppressive anticancer drugs associated with a clinically significant incidence of febrile neutropenia

Usual Pediatric Dose for Neutropenia Associated with Chemotherapy

Pediatric patients:

• Body weight less than 10 kg: 0.1 mg/kg subcutaneously once per chemotherapy cycle, beginning at least 24 hours after completion of chemotherapy
• Body weight 10 to 20 kg: 1.5 mg subcutaneously ONCE per chemotherapy cycle, beginning at least 24 hours after completion of chemotherapy
• Body weight 21 to 30 kg: 2.5 mg subcutaneously ONCE per chemotherapy cycle, beginning at least 24 hours after completion of chemotherapy
• Body weight 31 to 44 kg: 4 mg subcutaneously ONCE per chemotherapy cycle, beginning at least 24 hours after completion of chemotherapy
• Body weight 45 kg or greater: 6 mg subcutaneously ONCE per chemotherapy cycle, beginning at least 24 hours after completion of chemotherapy

Comments:

• The prefilled syringe is not designed to allow administration of doses less than 0.6 mL (6 mg) because it does not have graduation marks, which are necessary to accurately measure doses less than 0.6 mL; therefore, administration to patients requiring less than 0.6 mL is not recommended.
• Do not administer between 14 days before and 24 hours after administration of cytotoxic chemotherapy.

Use: To decrease the incidence of infection, as manifested by febrile neutropenia, in patients with non-myeloid malignancies receiving myelosuppressive anticancer drugs associated with a clinically significant incidence of febrile neutropenia

Usual Pediatric Dose for Neutropenia Associated with Radiation

Children:

• Body weight less than 10 kg: 0.1 mg/kg subcutaneously once a week
• Body weight 10 to 20 kg: 1.5 mg subcutaneously once a week
• Body weight 21 to 30 kg: 2.5 mg subcutaneously once a week
• Body weight 31 to 44 kg: 4 mg subcutaneously once a week
• Body weight 45 kg or greater: 6 mg subcutaneously once a week

Duration of treatment: 2 weeks

Comments:

• Administer the first dose as soon as possible after suspected or confirmed exposure to radiation levels greater than 2 Gy and administer the second dose one week after the first dose.
• A baseline CBC should be obtained before dosing; however, therapy should not be delayed if a CBC is not readily available.
• The healthcare provider should estimate the level of radiation exposure in the patient based on information from public health authorities, biodosimetry if available, or clinical findings such as time to onset of vomiting or lymphocyte depletion kinetics.

Use: To increase survival in patients acutely exposed to myelosuppressive doses of radiation

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

Data not available

Precautions

CONTRAINDICATIONS:

• Hypersensitivity to the active component, filgrastim, or any of the ingredients

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Avoid shaking; this drug should be allowed to come to room temperature prior to administration.
• Manually-administered injections should be given into the abdomen, thigh, or upper arm.
• On-body injectors (OBI) should be applied to intact, non-irritated skin on the back of the arm or abdomen.

Storage requirements:

• Store refrigerated (2C to 8C) and protect from light.
• The manufacturer product information should be consulted regarding the specific duration of room temperature excursions.

Reconstitution/preparation techniques:

• OBIs: The manufacturer product information should be consulted regarding preparation.

General:

• Therapy should be initiated and supervised by physicians experienced in oncology and/or hematology.
• Limitation of use: This drug is not indicated for the mobilization of peripheral blood progenitor cells for hematopoietic stem cell transplantation.
• Formulation limitation of use: OBI is not recommended for use in patients with hematopoietic subsyndrome of acute radiation syndrome and/or in pediatric patients.

Monitoring:

• GENITOURINARY: Urinalysis in patients who develop glomerulonephritis
• HEMATOLOGIC: Complete blood counts (including platelet and hematocrit counts)

Patient advice:

• Inform patients that this drug may cause dizziness, and they should avoid driving or operating machinery if these side effects occur.
• Patients who miss a dose should be instructed to contact their healthcare provider.
• Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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