From the Guidelines
Patients receiving filgrastim should report bone pain, fever, chest pain, shortness of breath, rash, allergic reactions, and unusual bleeding or bruising to their physician. According to the most recent study 1, bone pain is the most common side effect, affecting a significant number of patients, and can often be managed with nonnarcotic analgesics. Patients should seek immediate medical attention for severe allergic reactions (swelling, difficulty breathing), signs of splenic rupture (left upper abdominal or shoulder pain), or symptoms of acute respiratory distress syndrome (severe breathing problems, fever). Other reportable side effects include injection site reactions, headache, muscle aches, and nausea.
Common Side Effects
- Bone pain
- Fever
- Chest pain
- Shortness of breath
- Rash
- Allergic reactions
- Unusual bleeding or bruising
- Injection site reactions
- Headache
- Muscle aches
- Nausea
Serious Side Effects
- Severe allergic reactions (swelling, difficulty breathing)
- Signs of splenic rupture (left upper abdominal or shoulder pain)
- Symptoms of acute respiratory distress syndrome (severe breathing problems, fever)
Filgrastim works by stimulating the bone marrow to produce neutrophils, which explains why bone pain is common as the marrow expands its activity. Regular monitoring of blood counts is necessary during treatment, so patients should keep all scheduled laboratory appointments 1. The meta-analysis by Kuderer et al. 1 confirmed a heightened risk of musculoskeletal pain associated with CSF, and patients should be aware of this potential side effect.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Side Effects of Filgrastim
The patient administered filgrastim should report the following side effects to the physician:
- Acute allergic reactions, such as urticaria and swelling 2
- Abdominal cramping 2
- Respiratory issues, including respiratory collapse 2
- Anaphylaxis and anaphylactic shock, which are severe and life-threatening forms of allergic reactions 2
- Any other symptoms that may indicate an allergic reaction or anaphylaxis, as these conditions require urgent medical attention 2
Importance of Reporting Side Effects
It is crucial for the patient to inform the physician about any side effects experienced after filgrastim administration, as prompt treatment can help prevent severe complications 2. The physician can then assess the symptoms, determine the severity of the reaction, and provide appropriate treatment, which may include epinephrine, corticosteroids, antihistamines, or other therapies 2.