非格司亭 (Filgrastim)

用途

• Adjunctive therapy of neutropenia (secondary to drug induced aplastic pancytopenia)
• Neutropenia
• Neutropenia
• Neutropenia secondary to drug toxicity, infectious diseases, FeLV associated cyclic neutropenia or idiopathic causes
• Neutropenia
• Adjunctive therapy of neutropenia
• Neutropenia

給藥方式

可能的副作用

• Severe neutropenia (due to autoantibody formation against G-CSF)
• Myelofibrosis (theoretical/reported concern)
• Medullary histiocytosis (theoretical/reported concern)
• Injection site irritation
• Bone pain
• Splenomegaly
• Hypotension

注意事項與禁忌

• Hypersensitivity to filgrastim
• Patients that have previously developed antibodies to filgrastim with resultant neutropenia
• > **High Risk of Immunogenicity:** The development of neutralizing antibodies can cause severe, prolonged neutropenia. Use should generally be restricted to short pulse therapy (≤ 5 days). * **Pregnancy:** FDA Category C. High doses have shown adverse effects in pregnant laboratory animals. Use only when benefits clearly outweigh risks. * **Nursing:** Unknown if excreted in milk, but unlikely to pose significant risk to nursing offspring. * **Efficacy vs. Risk:** Use is controversial due to cost, antibody potential, and lack of definitive evidence showing reduced mortality compared to aggressive broad-spectrum antibiotic therapy alone.

藥物相互作用

• Antineoplastics: Avoid using filgrastim within 24 hours of administering antineoplastic agents that target rapidly proliferating cells, as it may exacerbate toxicity to the newly stimulated myeloid cells.
• Corticosteroids: May potentiate the release of neutrophils during G-CSF therapy.
• Lithium: May potentiate the release of neutrophils during G-CSF therapy.
• Cytotoxic Chemotherapy: Concurrent administration may increase the incidence of adverse effects. The stimulatory effects of G-CSF on haemopoietic precursors render them more susceptible to the effects of chemotherapy.

常見問題