From the Guidelines
Medications similar to Neupogen (filgrastim) include Zarxio and Nivestym, which are biosimilar versions of filgrastim, as well as Granix (tbo-filgrastim), and Neulasta (pegfilgrastim), a longer-acting version that typically requires only one injection per chemotherapy cycle rather than daily injections. These drugs all work as granulocyte colony-stimulating factors (G-CSFs) that stimulate the bone marrow to produce neutrophils. Another similar medication is Leukine (sargramostim), which works slightly differently as a granulocyte-macrophage colony-stimulating factor (GM-CSF) 1. These medications are primarily used to reduce the risk of infection in patients receiving chemotherapy that may cause neutropenia, to treat severe chronic neutropenia, or to help with stem cell mobilization before collection for transplantation. The typical adult dose for filgrastim is 5-10 mcg/kg/day as a subcutaneous injection, with duration depending on the specific indication, as outlined in the dosing guidelines by the American Society of Clinical Oncology 2. Some key points to consider when prescribing these medications include:
- Starting filgrastim 1 to 3 days after administration of myelotoxic chemotherapy
- Continuing filgrastim until reaching ANC 2 to 3 x 10^9/L
- Using a preferred route of subcutaneous administration
- Considering alternatives such as self-administered filgrastim or tbo-filgrastim for patients who cannot return for a dose of pegfilgrastim Side effects commonly include bone pain, which can be managed with non-narcotic pain relievers. These medications work by binding to specific receptors on hematopoietic cells, stimulating proliferation, differentiation, and activation of neutrophils to help prevent infections when white blood cell counts are low 1, 2. It's essential to follow the guidelines and recommendations from reputable organizations, such as the American Society of Clinical Oncology, to ensure the safe and effective use of these medications. Key considerations for the use of G-CSF and GM-CSF in patients receiving chemotherapy include:
- Identifying patients at high risk for fever and infections
- Using validated risk factors to guide treatment decisions
- Considering the use of colony-stimulating factors to prevent febrile neutropenia in patients at a >20% risk for fever 1.
From the FDA Drug Label
ZARXIO (filgrastim-sndz) is biosimilar* to NEUPOGEN (filgrastim). FULPHILA® (pegfilgrastim-jmdb) is biosimilar* to NEULASTA® (pegfilgrastim). Medications similar to Neupogen (Filgrastim) are:
- Zarxio (filgrastim-sndz), a biosimilar to Neupogen
- Pegfilgrastim, which is used for similar indications as Neupogen, although it is not identical, it has a similar mechanism of action and is used to decrease the incidence of infection in patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs. 3, 4, 4
From the Research
Medications Similar to Neupogen (Filgrastim)
- Pegfilgrastim (Neulasta, Amgen, Inc.) is a medication similar to Neupogen (Filgrastim) as it is also a granulocyte colony-stimulating factor (G-CSF) used to reduce chemotherapy-induced neutropenia 5, 6, 7, 8.
- Sargramostim is another G-CSF that has been compared to filgrastim and pegfilgrastim in terms of effectiveness in preventing hospitalization for neutropenic complications 9.
- Balugrastim and lipegfilgrastim are other long-acting G-CSFs that have been evaluated for their efficacy and safety in preventing chemotherapy-induced neutropenia, with efficacy and safety profiles comparable to pegfilgrastim 8.
Comparison of Medications
- Studies have shown that pegfilgrastim has a similar or greater efficacy than filgrastim in reducing chemotherapy-induced neutropenia 5, 6, 7, 8.
- Pegfilgrastim has been found to have a lower risk of hospitalization for neutropenic complications compared to filgrastim and sargramostim 9.
- The efficacy and safety profiles of balugrastim and lipegfilgrastim are similar to pegfilgrastim, making them potential alternatives to Neupogen (Filgrastim) 8.