Filgrastim
Granulocyte Colony Stimulating Factor; GCSF; recombinant methionyl human GCS-F
También conocido como: Neupogen · Filgen · Granulen · Granulokine · Neulasta · Neutromax · granulocyte colony-stimulating factor · GCSF · recombinant methionyl human GCS-F · r-metHuG-CSF · rhG-CSF
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Adjunctive therapy of neutropenia (secondary to drug induced aplastic pancytopenia) | 5 micrograms/kg SC daily | SC | daily | Pulse therapy of no more than 5 days | 🌎 NA |
| Neutropenia | 1-5 micrograms/kg SC daily | SC | daily | Pulse therapy of no more than 5 days | 🌎 NA |
| Neutropenia | 100,000-500,000 IU (1-5 micrograms)/kg | SC | q24h | 3-5 days | 🌍 EU |
- Adjunctive therapy of neutropenia (secondary to drug induced aplastic pancytopenia): To avoid autoantibody formation, pulse therapy is recommended.
- Neutropenia: To avoid autoantibody formation, pulse therapy is recommended.
- Neutropenia: Neutrophil counts typically rise within 24 hours.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Neutropenia secondary to drug toxicity, infectious diseases, FeLV associated cyclic neutropenia or idiopathic causes | 5 micrograms/kg SC twice daily | SC | twice daily | Pulse therapy of no more than 5 days | 🌎 NA |
| Neutropenia | 1-5 micrograms/kg SC daily | SC | daily | Pulse therapy of no more than 5 days | 🌎 NA |
| Adjunctive therapy of neutropenia | 5 micrograms/kg SC daily until neutrophil count exceeds 3,000/mcl for 2 days | SC | daily | Until neutrophil count exceeds 3,000/mcl for 2 days (ideally ≤ 5 days) | 🌎 NA |
| Neutropenia | 100,000-500,000 IU (1-5 micrograms)/kg | SC | q24h | 3-5 days | 🌍 EU |
- Neutropenia secondary to drug toxicity, infectious diseases, FeLV associated cyclic neutropenia or idiopathic causes: Cost and/or development of antibodies usually limit usefulness to a few weeks, but often it is effective for acute or lifethreatening neutropenia.
- Neutropenia: To avoid autoantibody formation, pulse therapy is recommended.
- Adjunctive therapy of neutropenia: To avoid autoantibody formation, pulse therapy is recommended.
- Neutropenia: Neutrophil counts typically rise within 24 hours.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El filgrastim es un factor estimulante de colonias de granulocitos (G-CSF) humano recombinante utilizado en medicina veterinaria para estimular la médula ósea a producir neutrófilos.
Puntos clínicos clave:
- Indicación principal: Se utiliza para la neutropenia grave que pone en peligro la vida (p. ej., secundaria a parvovirus, mielosupresión inducida por quimioterapia o neutropenia cíclica asociada al virus de la leucemia felina) cuando la respuesta intrínseca es insuficiente.
- Riesgo de inmunogenicidad: Debido a que el filgrastim se deriva de ADN humano, no es específico de la especie y puede ser altamente inmunogénico en perros y gatos. Los pacientes pueden desarrollar anticuerpos neutralizantes tanto contra el fármaco exógeno como contra su propio G-CSF endógeno, lo que conduce a una neutropenia profunda, prolongada y potencialmente mortal.
- Estrategia clínica: Para minimizar la formación de anticuerpos, generalmente se administra como una terapia de "pulso" corta (de 3 a 5 días) solo durante el nadir crítico de la neutropenia.
- Costo: El tratamiento es extremadamente costoso, lo que a menudo limita su uso en la práctica veterinaria rutinaria.
Mecanismo de acción
Filgrastim acts as a hematopoietic growth factor.
- It binds specifically to G-CSF receptors located on the surface of myeloid progenitor cells in the bone marrow.
- Receptor activation triggers intracellular signaling pathways (such as the JAK/STAT pathway) → stimulates the proliferation, differentiation, and activation of progenitor cells exclusively within the neutrophil-granulocyte lineage.
- Clinical Pearl: In addition to increasing the absolute number of circulating mature neutrophils, filgrastim also enhances the functional capacity of these cells, including their phagocytic and bactericidal activities, thereby improving the patient's ability to fight off bacterial infections during periods of severe immunosuppression.
Seguridad y advertencias
Contraindicaciones
- Hypersensitivity to filgrastim
- Patients that have previously developed antibodies to filgrastim with resultant neutropenia
Efectos adversos
- Severe neutropenia (due to autoantibody formation against G-CSF)
- Myelofibrosis (theoretical/reported concern)
- Medullary histiocytosis (theoretical/reported concern)
- Injection site irritation
- Bone pain
- Splenomegaly
- Hypotension
Precauciones
High Risk of Immunogenicity: The development of neutralizing antibodies can cause severe, prolonged neutropenia. Use should generally be restricted to short pulse therapy (≤ 5 days).
- Pregnancy: FDA Category C. High doses have shown adverse effects in pregnant laboratory animals. Use only when benefits clearly outweigh risks.
- Nursing: Unknown if excreted in milk, but unlikely to pose significant risk to nursing offspring.
- Efficacy vs. Risk: Use is controversial due to cost, antibody potential, and lack of definitive evidence showing reduced mortality compared to aggressive broad-spectrum antibiotic therapy alone.
Interacciones farmacológicas
Avoid using filgrastim within 24 hours of administering antineoplastic agents that target rapidly proliferating cells, as it may exacerbate toxicity to the newly stimulated myeloid cells.
May potentiate the release of neutrophils during G-CSF therapy.
May potentiate the release of neutrophils during G-CSF therapy.
Concurrent administration may increase the incidence of adverse effects. The stimulatory effects of G-CSF on haemopoietic precursors render them more susceptible to the effects of chemotherapy.
Monitorización
- CBC with platelets, routinely (to monitor neutrophil response and detect potential antibody-induced neutropenia)
Farmacocinética
Absorción
Rapidly absorbed after subcutaneous injection.
Distribución
Highest concentrations found in the bone marrow, liver, kidneys, and adrenal glands. It is unknown if it crosses the blood-brain barrier, placenta, or enters maternal milk.
Metabolismo
Pathways are still under investigation.
Eliminación
Elimination pathways are still under investigation.
Sobredosis
Limited information is available regarding acute toxicity. Because of the high expense of the drug and its apparent limited acute toxic potential, clinically significant overdoses are considered unlikely. If an overdose occurs, monitor CBC closely and provide supportive care.
Productos disponibles
Formulaciones
- Injection
Etiquetado para humanos
- Filgrastim Injection: 300 micrograms/mL preservative free in 1 mL and 1.6 mL single dose vials
- Filgrastim Injection: 300 micrograms/0.5 mL preservative free in 0.5 mL and 0.8 mL prefilled syringes; Neupogen (Amgen)
Estado regulador
Human POM (Prescription Only Medicine) used off-label under the cascade.
Human POM used off-label under the cascade.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store in the refrigerator (2-8°C). Do not freeze or shake the vial. Never dilute with saline as a precipitate may form. If necessary, it may be diluted into 5% dextrose for injection. If diluted to concentrations between 5 and 15 micrograms/mL, it is recommended to add albumin to a concentration of 2 mg/mL to reduce adsorption to plastic IV tubing. Do not dilute to a concentration of less than 5 micrograms/mL.
Información para el cliente
Su veterinario ha recetado filgrastim para ayudar a que la médula ósea de su mascota produzca más glóbulos blancos (específicamente neutrófilos), los cuales son fundamentales para combatir infecciones graves.
- Costo: Este medicamento es un producto recombinante humano y es muy costoso.
- Riesgos importantes: Debido a que es una proteína humana, el sistema inmunológico de su mascota puede reconocerla como extraña y crear anticuerpos contra ella. Si esto sucede, el sistema inmunológico puede destruir tanto el medicamento como los glóbulos blancos naturales de su mascota, lo que provocaría una caída de la inmunidad que pone en peligro la vida.
- Uso a corto plazo: Para minimizar este riesgo, el filgrastim generalmente solo se administra durante un período muy corto (de 3 a 5 días) para ayudar a su mascota a superar la fase más crítica de su enfermedad.
- Monitoreo: Se requerirán análisis de sangre frecuentes para asegurar que el medicamento esté funcionando y para vigilar cualquier reacción inmunológica adversa.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.