Sickle Cell Anemia
Contraindicated
Textbook
Precipitates severe crises and even death in patients with sickle cell anemia.
Patients with sickle cell anemia should not receive filgrastim.
Source: G&G 14e · p905
Drug reference
Filgrastim
Colony-Stimulating Factor · Treatment of Neutropenia
Also known as NEUPOGEN, GRAFEEL, G-CSF
Colony-Stimulating FactorTreatment of Neutropenia
CDSCO approvedSchedule H
EXCRETION
—
not curated
INTERACTIONS
2 major
incl. contraindicated
PREGNANCY
—
not curated
Top interactions
- Sickle Cell AnemiaContraindicatedTextbookG&G 14e · p905
- CladribineSevereDatabaseDDInter
Mechanism
Filgrastim is a recombinant human granulocyte-colony stimulating factor (G-CSF). Its principal action is the stimulation of CFU-G (colony-forming unit-granulocyte) to increase neutrophil production in the bone marrow. It also enhances the phagocytic and cytotoxic functions of neutrophils.
Indications
Severe neutropenia after autologous hematopoietic stem cell transplantationNeutropenia associated with high-dose cancer chemotherapyTo decrease the frequency of hospitalization for febrile neutropenia and interruptions in chemotherapy protocolsSevere congenital neutropeniasCyclic neutropenia (to increase neutrophil levels and shorten cycle length to prevent recurrent bacterial infections)Improve neutrophil counts in patients with myelodysplasiaImprove neutrophil counts in patients with marrow damage (moderately severe aplastic anemia or tumor infiltration of the marrow)Reverse neutropenia in AIDS patients receiving zidovudinePatients recovering from bone marrow transplantationMobilization of peripheral blood progenitor cells (PBPCs) in donors for allogeneic or autologous transplantationTo hasten recovery from cytotoxic drug induced myelosuppressionFebrile neutropenia (consider with broad-spectrum antibiotics)severe neutropenia after high-dose cancer chemotherapymyelodysplasiamarrow damage (e.g., moderately severe aplastic anemia or tumor infiltration)neutropenia in patients with AIDS receiving zidovudinemobilization of peripheral blood stem cells for transplantationShorten recovery time from neutropenia after myelosuppressive chemotherapy
Dosing
- Adult
- 5 μg/kg daily, injected subcutaneously (s.c.) or intravenously (i.v.), starting one day after myelosuppressive chemotherapy until neutrophil count normalizes.
- Pediatric
- Not explicitly given, but likely similar to adult dosing for relevant indications like severe congenital neutropenia.
Pharmacokinetics
Half-life
3.5 h
Contraindications
- hypersensitivity to proteins produced by Escherichia coli
- sickle cell anemia
Side effects
Common
mild-to-moderate bone pain (with high doses over protracted period)local skin reactions (following subcutaneous injection)
Serious
- rare cutaneous necrotizing vasculitis
- severe crises and death (in patients with sickle cell anemia)
- mild-to-moderate splenomegaly (with long-term therapy)
Drug interactions
Cladribine
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
10 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.
Related guidelines
Other Colony-Stimulating Factor drugs
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Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-10 · House clinical team