Filastin 300 mcg/0.5 ml is a granulocyte-colony stimulating factor (G-CSF) used to stimulate the production of neutrophils in the bone marrow. It is a hematopoietic agent that binds to cell surface receptors on hematopoietic cells, enhancing the development, migration, and cytotoxic activity of granulocytes. By increasing circulating neutrophil counts, Filastin helps reduce the risk of infections in patients with neutropenia, a common complication in cancer therapy, bone marrow transplantation, and other hematological disorders.

Filastin is especially useful in managing chemotherapy-induced neutropenia, congenital neutropenia, cyclic or idiopathic neutropenia, and in mobilizing peripheral blood progenitor cells for autologous transplantation. The injection acts rapidly, with a significant rise in neutrophil counts often observed within 24 hours of administration.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

Haematopoietic Agents

Indications

Filastin 300 mcg/0.5 ml is indicated for:

• Cancer patients receiving myelosuppressive chemotherapy to prevent or treat neutropenia

• Acute Myeloid Leukemia (AML) patients receiving induction or consolidation chemotherapy

• Patients undergoing bone marrow transplantation

• Severe neutropenia of various etiologies

• Mobilization of peripheral blood progenitor cells for autologous stem cell transplantation

Pharmacology

Filastin is a glycoprotein that regulates the production and release of functional neutrophils from the bone marrow. It increases peripheral blood neutrophil counts dose-dependently, with minor effects on monocytes. Upon discontinuation, neutrophil counts typically return to baseline within 1 to 7 days. Filastin enhances neutrophil migration and cytotoxicity, supporting immune defense against infections.

Mode of Action

Filastin binds to G-CSF receptors on hematopoietic stem and progenitor cells, stimulating proliferation, differentiation, and activation of neutrophils. This accelerates the recovery of neutrophil counts following chemotherapy or other bone marrow-suppressing treatments, reducing the risk of febrile neutropenia and infections.

Dosage & Administration

Chemotherapy-Induced Neutropenia:

• 5 mcg/kg daily as a single subcutaneous injection (SC) or intravenous infusion (IV) over 15–30 minutes. Start after chemotherapy completion.

Bone Marrow Transplantation:

• 10 mcg/kg daily by IV infusion over 30 min–4 hr or continuous SC/IV infusion over 24 hr. Adjust according to response.

Mobilization of Peripheral Blood Progenitor Cells:

• 10 mcg/kg daily SC or IV for 4–7 days until the last leukapheresis procedure.

• If after chemotherapy: 5 mcg/kg daily from day 1 after chemotherapy until neutrophil recovery.

Congenital Neutropenia:

• 12 mcg/kg daily, single or divided doses; adjust based on response.

Cyclic/Idiopathic Neutropenia:

• 5 mcg/kg daily, single or divided doses; adjust based on response.

HIV-Associated Neutropenia:

• Start at 1 mcg/kg daily, increase to 4 mcg/kg until normal neutrophil counts. Maintenance: 300 mcg daily; maximum 4 mcg/kg daily.

Administration:

• Subcutaneous or intravenous infusion only. Do not administer within 24 hours of chemotherapy.

• Monitor complete blood count twice weekly to avoid excessive neutrophil counts.

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Drug Interactions

• Interactions are not fully evaluated.

• Use caution with drugs that potentiate neutrophil release, such as lithium.

Contraindications

• Hypersensitivity to filgrastim, formulation excipients, or proteins derived from Escherichia coli.

Side Effects

Common side effects include:

• Bone pain, musculoskeletal pain

• Headache, nausea, vomiting, diarrhea

• Splenic enlargement, hepatomegaly

• Thrombocytopenia, anemia

• Urinary abnormalities (dysuria, proteinuria, hematuria)

• Osteoporosis, exacerbation of rheumatoid arthritis

Rare effects:

• Hypersensitivity reactions, cutaneous vasculitis, transient hypotension, transient decrease in blood glucose, raised uric acid

Pregnancy & Lactation

• Category C: Animal studies show adverse fetal effects. Use only if benefits outweigh risks. Safety in lactation is not established.

Pediatric Use

• Safe in children 3 months to 18 years.

• Safety and efficacy in neonates or infants with autoimmune neutropenia have not been established.

Overdose

• Overproduction of neutrophils and potential tumor growth stimulation may occur. Monitor blood counts carefully.

Storage Conditions

• Refrigerate at 2–8°C.

• Do not freeze.

Reconstitution

• Dilution below 5 mcg/ml is not recommended.

• Can be diluted in 5% dextrose as needed for infusion.