Products
Pegfilgrastim is commercially available as a solution for injection in the form of prefilled syringes (Neulasta). It has been approved in many countries since 2003. Biosimilars have been approved.
Structure and properties
Pegfilgrastim is a conjugate of filgrastim with a single 20-kDa polyethylene glycol (PEG) molecule. Filgrastim is a protein of 175 amino acids that is biotechnologically produced. The sequence corresponds to human granulocyte colony-stimulating factor (G-CSF, Mr = 18,800 Da) with the exception of the -terminal methionine.
Effects
Pegfilgrastim (ATC L03AA13) promotes neutrophil granulocyte generation and release from the bone marrow. A significant increase in neutrophils and monocytes can be detected in the blood after only 24 hours. It thus reduces the risk of infectious diseases and neutropenic fever. Unlike filgrastim, pegfilgrastim has a much longer duration of action due to pegylation.
Indications
For the treatment of neutropenia associated with cytotoxic chemotherapy.
Dosage
According to the SmPC. The drug is administered as a subcutaneous injection with a prefilled syringe. Unlike the precursor filgrastim, only one injection is needed per chemotherapy cycle because of its longer duration of action.
Contraindications
- Hypersensitivity
For complete precautions, see the drug label.
Interactions
Cytotoxic chemotherapy should not be administered on the same day. There is a possibility of interaction with lithium.
Adverse effects
The most common potential adverse effects include pain, eg, muscle, joint, limb, and headache.