Filgrastim (By injection)

Filgrastim (fil-GRA-stim)

Helps your body make white blood cells after you receive cancer medicines. Also used to improve survival in people who have been exposed to radiation.

Brand Name(s):

Neupogen, Nivestym, Zarxio

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

This medicine is not right for everyone. Do not use it if you had an allergic reaction to filgrastim or pegfilgrastim.

How to Use This Medicine:


  • A nurse or other health provider will give you this medicine. This medicine is given as a shot under your skin or through a needle placed in a vein.
  • You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
  • Start using the medicine 24 hours or more after you finish your chemotherapy. However, do not use it within 24 hours before you begin another chemotherapy treatment.
  • You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. Do not inject into skin areas that are tender, red, bruised, hard, or has scars or stretch marks.
  • Allow the medicine to warm to room temperature for 30 minutes before using it. Do not warm it in any other way.
  • Check the liquid in the prefilled syringe or vial. It should be clear and colorless. Do not use it if it is cloudy, discolored, or has particles in it.
  • Do not shake the medicine. Use the syringe or vial only once. Do not save leftover medicine.
  • Use a new needle and syringe each time you inject your medicine.
  • Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
  • Missed dose: This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.
  • If you store this medicine at home, keep it in the refrigerator. Do not freeze. If the medicine is accidently frozen, let it thaw out in the refrigerator before you use it. If the medicine freezes a second time, do not use it.
  • Keep the medicine in the carton and away from heat or direct light. The medicine can stay out of the refrigerator for up to 24 hours. Throw away any medicine that has been out of the refrigerator for more than 24 hours.
  • Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Warnings While Using This Medicine:

  • Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, lung disease, breathing problems, or sickle cell disease. Tell your doctor if you have an allergy to latex.
  • This medicine may cause the following problems:
    • Spleen problems
    • Serious lung problems (including acute respiratory distress syndrome)
    • Kidney problems
    • Capillary leak syndrome
    • Cutaneous vasculitis (inflammation of blood vessels in the skin)
    • Aortitis (inflammation of the largest artery in the body)
  • Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
  • Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Coughing up blood
  • Decrease in how much or how often you urinate, red or dark brown urine, lower back or side pain
  • Fever, chills, cough, sore throat, body aches, stomach pain
  • Lightheadedness, dizziness, fainting
  • Pain in your left side or shoulder, feeling unusually full
  • Skin redness, blisters, or sores, red or purple spots on your skin
  • Swelling in your face, ankles, or feet
  • Trouble breathing or fast breathing
  • Unusual bleeding, bruising, tiredness, or weakness

If you notice these less serious side effects, talk with your doctor:

  • Bone, joint, or muscle pain
  • Nausea

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 11/6/2020

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