- Decrease the incidence of infection (i.e. febrile neutropenia) in patients with non-myeloid malignancies receiving myelosuppressive antineoplastic drugs.
- Fulphila, Lapelga, Nyvepriat, and Ziextenzo are subsequent entry biologic drugs. Comparability has been established with the reference product, Neulasta; however Fulphila, Lapelga, Nyvepriat, and Ziextenzo are not interchangeable with the reference product
- Different pegfilgrastim products are not interchangeable
- Commercially available as a pre-filled syringe (6 mg/0.6 mL); preservative free.
- Protect from light. Store in refrigerator. Do NOT shake vigorously.
- Freezing should be avoided. For information regarding accidental one-time exposure to temperatures greater than 25ºC or exposure to freezing temperatures, please consult individual product monograph
- Neulasta® (peg-filgrastim): Stable at room temperature for up to 72 hours. Needle cover on the single-use prefilled syringe contains dry natural rubber (a derivative of latex)
- Fulphila (peg-filgrastim biosimilar): Stable at room temperature for up to 72 hours.
- Nyvepria (peg-filgrastim biosimilar): Stable at room temperature for up to 15 days (single period). Syringe plunger stopper and needle cover are not made with natural rubber latex.
- Lapelga (peg-filgrastim biosimilar): Stable at room temperature for up to 15 days (single period). Needle cover on the single-use prefilled syringe contains dry natural rubber (a derivative of latex)
- Ziextenzo (peg-filgrastim biosimilar): Stable at room temperature room temperature for up to 120 hours (single period)
- Solutions Compatible: D5W ONLY
- Y-site Compatible:
- Incompatible: SALINE SOLUTIONS
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
|IV Intermittent Infusion||NO|
|IV Continuous Infusion||NO|
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Give subcutaneously once per chemotherapy cycle, beginning at least 24 hours after completion of chemotherapy.
- Patients < 10 kg: 0.1 mg/kg
- Patients 10 to 20 kg: 1.5 mg
- Patients 21 to 30 kg: 2.5 mg
- Patients 31 to 44 kg: 4 mg
- Patients > 45 kg: 6 mg
** Dosage may differ according to protocol
Different filgrastim products are not interchangeable
- Minor bruising or inflammation at subcutaneous injection sites
- Transient bone pain, most commonly in sternum, pelvis and/or lower back (can be treated with acetaminophen)
- Allergic-type reactions; dyspnea, wheezing, hypotension, syncope, urticaria, facial edema and anaphylaxis have occurred
- Glomerulonephritis, splenomegaly and splenic rupture, acute respiratory distress syndrome (possibly due to the influx of neutrophils to the inflammation sites on the lungs), antibody development and Capillary leak syndrome have occurred
- Do not administer pegfilgrastim within 14 days of next course of chemotherapy.
- Amgen Canada. "Neulasta (pegfilgrastim)" product monograph. Version January 8, 2021
- Lexicomp. "Neulasta". Accessed 31Oct2018: 11Feb2021
- BGP Pharma ULC. Fulphila (pegfilgrastim) product monograph. Version June 7th 2019
- Apotex Inc. Lapelga. Product Monograph. Version April 5th 2018
- Pfizer. Nyvepria Product Monograph. Version October 28th 2020
- Sandoz. ZIEXTENZ. Product Monograph. Version October 19th 2020