Grastim
Form: Injection
Strength: 30MIU/.5ml
Generic Name: Filgrastim
Company: Square Pharmaceuticals Ltd.
MRP:৳ 2800.0 (0.5ml pre-filled syringe)
Is Antibiotic: No
Indications
Grastim is used for cancer patients receiving chemotherapy that affects the bone marrow, patients with Acute Myeloid Leukemia who are getting induction or consolidation chemotherapy, cancer patients receiving a bone marrow transplant, patients with severe neutropenia, and for the collection and therapy of peripheral blood progenitor cells.
Pharmacology
Grastim is a granulocyte-colony stimulating factor that binds to cell receptors on blood-forming cells, stimulating the development of granulocytes to improve their movement and effectiveness in fighting infection.
Grastim is a glycoprotein that controls the production and release of neutrophils (a type of white blood cell) from the bone marrow. Grastim causes a significant increase in neutrophils in the blood within 24 hours. The increase in neutrophil count is dependent on the dose. After stopping the therapy, the neutrophil count drops by half within 1 to 2 days and returns to normal levels in 1 to 7 days.
Dosage & Administration
Parenteral:
For chemotherapy-induced neutropenia: 5 mcg/kg daily via a single subcutaneous injection, continuous IV or subcutaneous infusion, or daily IV infusion over 15-30 minutes, starting as directed.
For bone marrow transplantation: 10 mcg/kg daily via IV infusion over 30 minutes to 4 hours or continuous IV or subcutaneous infusion over 24 hours. Adjust based on response.
Subcutaneous:
For mobilizing peripheral blood progenitor cells for autologous stem cell transplantation: 10 mcg/kg daily for 4-7 days until the last leucapheresis procedure.
If given after chemotherapy: 5 mcg/kg daily from the first day after chemotherapy until neutrophil count returns to normal for leucapheresis.
For congenital neutropenia: 12 mcg/kg daily in single or divided doses, adjusting based on response.
For HIV infection and persistent neutropenia: Start with 1 mcg/kg daily, increase up to 4 mcg/kg daily until normal neutrophil count is reached. Maintenance dose: 300 mcg daily. Maximum: 4 mcg/kg daily.
Interaction
Drug interactions with Grastim and other medications have not been fully studied. Caution should be used with drugs like lithium, which may increase neutrophil release.
Contraindications
Grastim should not be used in patients who are allergic to Grastim, any of its ingredients, or proteins from Escherichia coli.
Side Effects
Possible side effects include musculoskeletal pain, bone pain, allergic reactions, spleen enlargement, liver enlargement, low platelet count, anemia, nosebleeds, headaches, nausea, vomiting, diarrhea, urinary issues (like pain, protein or blood in urine), osteoporosis, worsening rheumatoid arthritis, temporary drop in blood sugar, increased uric acid, skin inflammation, and low blood pressure.
Pregnancy & Lactation
Category C: Studies in animals have shown harm to the fetus, and there are no controlled studies in pregnant women. Grastim should only be used if the potential benefit outweighs the risk to the fetus.
Precautions & Warnings
Grastim should not be used within 24 hours before or after chemotherapy. There is a possibility that Grastim could stimulate tumor growth. To prevent issues from excessive neutrophils, blood counts should be checked twice a week during treatment. Grastim is administered by subcutaneous or intravenous infusion as needed.
Overdose Effects
In case of overdose, there is a risk of Grastim acting as a growth factor for tumors and causing problems due to excessive neutrophils.
Therapeutic Class
Haematopoietic Agents
Storage Conditions
Keep Grastim refrigerated between 2-8°C. Do not freeze.
Similar Brands of Filgrastim (Injection – 30MIU/.5ml)
| Brand Name | Form | Strength | Company | MRP (৳) |
|---|---|---|---|---|
| Filastin 30 | Injection | 30MIU/.5ml | Incepta Pharmaceuticals Ltd. | 1200.0 |
| Filgen | Injection | 30MIU/.5ml | Aristopharma Limited | 3500.0 |
| Filgrast | Injection | 30MIU/.5ml | Beacon Pharmaceuticals Ltd. | 3200.0 |
| Neufil | Injection | 30MIU/.5ml | Healthcare Pharmaceuticals Ltd. | 3920.0 |
| Ropenia prefilled syringe | Injection | 30MIU/.5ml | ACI Limited | 3400.0 |