非格司亭 (Filgrastim)
Filgrastim
Granulocyte Colony Stimulating Factor; GCSF; recombinant methionyl human GCS-F
別名: Neupogen · Filgen · Granulen · Granulokine · Neulasta · Neutromax · granulocyte colony-stimulating factor · GCSF · recombinant methionyl human GCS-F · r-metHuG-CSF · rhG-CSF
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
非格司亭 (Filgrastim) 是一種重組人類顆粒球群落刺激因子 (G-CSF)，在獸醫學中用於刺激骨髓產生嗜中性白血球。
關鍵臨床重點：
- 主要適應症： 用於治療嚴重且危及生命的嗜中性白血球低下症（例如：繼發於小病毒感染、化療引起的骨髓抑制，或貓白血病病毒相關的週期性白血球低下）。
- 免疫原性風險： 由於非格司亭源自人類 DNA，它在犬貓體內具有高度免疫原性。病患可能會產生中和抗體，不僅對抗外源性藥物，還會對抗自體產生的 G-CSF，導致嚴重、長期且可能致命的嗜中性白血球低下。
- 臨床策略： 為了減少抗體形成，通常只在白血球最低谷的關鍵期進行短期的「脈衝」治療（3至5天）。
- 成本： 治療費用非常昂貴，這通常限制了它在常規獸醫臨床上的使用。
作用機制
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.
安全性與警告
禁忌症
- Hypersensitivity to filgrastim
- Patients that have previously developed antibodies to filgrastim with resultant neutropenia
不良反應
- 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
注意事項
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.
藥物相互作用
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.
監測
- CBC with platelets, routinely (to monitor neutrophil response and detect potential antibody-induced neutropenia)
藥物動力學
吸收
Rapidly absorbed after subcutaneous injection.
分佈
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.
代謝
Pathways are still under investigation.
排除
Elimination pathways are still under investigation.
過量
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.
可用產品
劑型
- Injection
人用標示
- 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)
各地核准狀態
Human POM (Prescription Only Medicine) used off-label under the cascade.
Human POM used off-label under the cascade.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
您的獸醫開立了非格司亭 (Filgrastim) 來幫助您寵物的骨髓產生更多的白血球（特別是嗜中性白血球），這對於抵抗嚴重感染至關重要。
- 費用： 這是一種人類重組基因產品，價格非常昂貴。
- 重要風險： 因為這是人類蛋白質，您寵物的免疫系統可能會將其視為外來物並產生抗體。如果發生這種情況，免疫系統可能會同時破壞藥物和寵物自體天然的白血球，導致危及生命的免疫力下降。
- 短期使用： 為了將這種風險降到最低，非格司亭通常只會給予非常短的時間（3到5天），以幫助您的寵物度過疾病最危險的階段。
- 監測： 需要頻繁進行血液檢查，以確保藥物發揮作用並觀察是否有任何不良的免疫反應。
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