Subcutaneous Injection Site for Filgrastim
Filgrastim should be administered subcutaneously in areas with adequate subcutaneous tissue, such as the outer upper arms, abdomen (avoiding the 2-inch area around the navel), front of the thighs, or upper outer buttocks. 1
Recommended Injection Sites
The FDA-approved prescribing information for filgrastim specifies the following acceptable subcutaneous injection sites:
- Outer upper arms 1
- Abdomen (excluding a 2-inch radius around the navel) 1
- Front of the thighs 1
- Upper outer buttocks 1
Route of Administration
The subcutaneous route is the preferred method of administration for filgrastim. 2 While intravenous administration is technically possible, guidelines consistently emphasize subcutaneous injection as the standard approach. 2
Injection Technique
The proper technique involves:
- Gently pinch the skin at the injection site with one hand 1
- Insert the needle at a 45 to 90 degree angle 1
- Push the needle all the way in to ensure full dose delivery 1
- Slowly press down on the plunger completely 1
Site Rotation
When administering multiple doses over several days, rotate injection sites to prevent local tissue irritation. 1 This is particularly important since filgrastim is typically given daily at 5 mcg/kg until neutrophil recovery. 2
Important Considerations
Do not inject into areas where the skin is tender, bruised, red, or hard, or where there are scars or stretch marks. 1 The cleaned injection area should be allowed to dry completely before injection, and should not be touched again after cleaning. 1
After injection, there may be a small amount of blood at the site. 1 Apply gentle pressure with a cotton ball or gauze for 10 seconds without rubbing the area. 1