From the Research
Grafil CSF (filgrastim) can cause several side effects, with bone pain being the most common, affecting approximately 20% of cancer patients, and up to 84% of healthy donors, as reported in a study published in Critical reviews in oncology/hematology 1.
Common Side Effects
- Bone pain
- Muscle aches
- Headache
- Fatigue
- Nausea
- Injection site reactions
Serious Side Effects
- Allergic reactions (rash, itching, swelling)
- Spleen enlargement or rupture (causing left upper abdominal or shoulder pain)
- Acute respiratory distress syndrome (breathing difficulties)
- Severe skin reactions
- Elevated white blood cell counts
- Increased liver enzymes
- Decreased platelet counts
- Capillary leak syndrome (causing symptoms like swelling, low blood pressure, and thickened blood)
Management of Side Effects
The management of bone pain, a common side effect of Grafil CSF, can be achieved with acetaminophen and nonsteroidal anti-inflammatory agents as first-line treatment, while antihistamines, opioids, and dose reduction of G-CSFs are considered as second-line therapy, as suggested in a study published in Critical reviews in oncology/hematology 1. Additionally, a case report published in the Journal of oncology pharmacy practice found that loratadine may be a promising option for severe, resistant pegfilgrastim-induced bone pain 2.
Monitoring and Precautions
It is essential to monitor blood counts regularly while taking Grafil CSF, as it can cause changes in white blood cell counts, liver enzymes, and platelet counts, and seek immediate medical attention if severe or persistent side effects occur, especially difficulty breathing, chest pain, or severe abdominal pain.