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Precautions and Warnings With Filgrastim

Before starting a new medication, make sure you are aware of the drug's precautions and warnings. With filgrastim, it's important to watch for potentially dangerous drug interactions and take blood tests regularly to measure neutrophil levels in your blood. It is also important to know that filgrastim may potentially worsen sickle cell anemia, cause adult respiratory distress syndrome, or stimulate the growth of cancer cells.

Filgrastim: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking filgrastim (Neupogen®) if you have:
 
  • Sickle cell anemia
  • Any allergies, including allergies to food, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Specific Warnings and Precautions for Filgrastim

Warnings and precautions to be aware of prior to taking filgrastim include the following:
 
  • Very rarely, filgrastim may cause enlargement and rupture of the spleen. Tell your healthcare provider if you have symptoms of an enlarged spleen, such as upper abdominal or shoulder pain.
     
  • Filgrastim can cause adult respiratory distress syndrome (ARDS), a lung problem that can quickly become fatal. Tell your healthcare provider immediately if you develop any breathing problems.
     
  • Filgrastim can make sickle cell anemia worse. If you have sickle cell anemia, make sure your healthcare provider has specialty training or experience in the treatment of sickle cell anemia before you take filgrastim.
     
  • If filgrastim is taken any time within 24 hours before or after chemotherapy, the risk of infection is actually increased. Usually, filgrastim is given the day after chemotherapy (at least 24 hours afterwards).
     
  • Filgrastim stimulates the growth of cells. There is a possibility that it may stimulate the growth of cancer cells. When used to collect stem cells for transplantation, theoretically, there is a possibility that filgrastim may increase the risk of collecting cancer cells, as well as stem cells.
     
  • Some people taking filgrastim long-term for treating severe chronic neutropenia have developed leukemia. However, since people with severe chronic neutropenia seem to have a higher risk for leukemia anyway, it is not known whether filgrastim actually increases the risk of leukemia.
     
  • Your healthcare provider should regularly perform blood tests to measure the level of neutrophils in your blood to make sure the medicine is working and to make sure your neutrophil levels do not get too high.
     
  • Filgrastim has not been approved to be used in people undergoing radiation treatments.
     
  • Filgrastim can interact with a few other medications (see Drug Interactions With Filgrastim).
     
  • Filgrastim is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy. Talk to your healthcare provider about the risks and benefits of the drug during pregnancy (see Neupogen and Pregnancy).
     
  • It is not known if filgrastim passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Neupogen and Breastfeeding).
     
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