Lenograstim

Drugs used in Neutropenia · Recombinant G-CSF (Recombinant human granulocyte-colony stimulating factor)

Indications

Reduction in duration of neutropenia and associated complications following bone-marrow transplantation for non-myeloid malignancy or following treatment with cytotoxic chemotherapy associated with significant incidence of febrile neutropenia. Mobilisation of peripheral blood progenitor cells.

Dosage

Following bone-marrow transplantation: By IV infusion. Adults & Children over 2 yr: 19.2 million units/m² daily started the day after transplantation, continued until neutrophil count stable in acceptable range (max 28 days). Cytotoxic induced neutropenia: By SC injection. Adults & Children over 2 yr: 19.2 million units/m² daily, started the day after completion of chemotherapy, continued until neutrophil count stable in acceptable range (max 28 days).

Administration

Intermittent in NS: Initially reconstitute with 1 mL WFI provided (do not shake vigorously) then dilute with up to 50 mL+AE372 infusion fluid for each vial of 105 mcg or up to 100 mL infusion fluid for 263 mcg, give over 30 min.

Adverse Effects

Musculoskeletal pain, transient hypotension, disturbances in liver enzymes and serum uric acid; thrombocytopenia; urinary abnormalities including dysuria; allergic reactions (more common after intravenous infusion), proteinuria, haematuria and transient decrease in blood glucose; on long-term use cutaneous vasculitis, splenic enlargement, hepatomegaly, headache, diarrhoea, anaemia, epistaxis, alopecia, osteoporosis, rash, raised lactate dehydrogenase, leukocytosis, asthaenia, bone pain, back pain, abdominal pain, inj site reaction, capillary leak syndrome, pulmonary adverse effects, aortitis.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Severe congenital neutropenia (Kostmann's syndrome) with abnormal cytogenetics. Myeloid malignancy, AML, myelodysplasia, secondary AML, chronic myelogenous leukaemia. Precautions: Tumours with myeloid characteristics (risk of tumour growth), pre-malignant myeloid conditions; reduced myeloid precursors; monitor leucocyte count (discontinue treatment if leukocytosis); monitor platelet count and haemoglobin; regular morphological and cytogenetic bone marrow examinations recommended in severe congenital neutropenia (possible risk of myelodysplastic syndromes or leukaemia); monitor spleen size; osteoporotic bone disease (monitor bone density if given for more than 6 months); does not prevent other toxic effects of high-dose chemotherapy. Phenylketonuria, latex allergy. History of…

Interactions

Mitomycin.

Advice to Patient

Contact prescriber immediately if any unusual effects occur. Inform prescriber if any surgery is due or you are going to have medicines that treat cancer.

Pharmacokinetics

Metabolism: Metabolized to peptides. Bioavailability: Absolute: 30%. Half-life elimination: SC: 2.3-3.3 hrs (volunteers); 2.8-7.5 hrs (cancer patients). IV: 0.8-2.1 hrs (volunteers); 1.1-4.0 hrs (cancer patients). Time to peak, serum: During repeated dosing (IV and SC routes), peak serum concentrations (at the end of IV inf or after SC inj) are proportional to the injected dose. Excretion: Poorly excreted in urine as intact compound (<1% of the dose).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.