Pegfilgrastim is a covalent conjugate of recombinant human granulocyte colony-stimulating factor (G-CSF) and a 20 kDa polyethylene glycol (PEG) molecule. It is a long-acting, pegylated form of filgrastim designed to stimulate the production, maturation, and activation of neutrophils. The 6mg dose is a single, fixed-dose subcutaneous injection, primarily used to decrease the incidence of infection, as manifested by febrile neutropenia, in patients with non-myeloid malignancies receiving myelosuppressive anticancer drugs associated with a clinically significant incidence of febrile neutropenia.
Adult: 6 mg administered subcutaneously as a single injection per chemotherapy cycle. Administer approximately 24 hours after completion of chemotherapy. Do not administer between 14 days before and 24 hours after chemotherapy.
Note: For subcutaneous use only. Administer in the abdomen (except 2-inch area around navel), front of middle thighs, back of upper arms, or upper outer area of buttocks. Rotate injection sites. Use pre-filled syringe or auto-injector. Allow to reach room temperature for 30 minutes before injection. Do not shake. Inspect for particulate matter or discoloration. Discard any unused portion.
Pegfilgrastim binds to specific cell surface receptors on hematopoietic cells, predominantly committed progenitor cells of the neutrophil-granulocyte lineage. This binding activates intracellular signaling pathways (primarily JAK/STAT and MAPK), leading to proliferation, differentiation, commitment, and enhanced functional activity (including phagocytosis and antibody-dependent cellular cytotoxicity) of neutrophils. The pegylation reduces renal clearance, prolonging its half-life and duration of action.
Pregnancy: Category C. Animal studies have shown fetal toxicity. There are no adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus.
Driving: Pegfilgrastim may cause fatigue, dizziness, or headache. Patients should be cautioned about driving or operating machinery if they experience these effects.
| Lithium | May potentiate the release of neutrophils; monitor for excessive neutrophilia. | Moderate |
| Chemotherapeutic Agents (e.g., 5-FU, Anthracyclines, Alkylating agents) | Concurrent administration can increase sensitivity of myeloid cells to chemotherapy; STRICT timing must be followed (not 14 days before to 24 hours after). | High |
| Corticosteroids | Theoretical potential for increased bone pain; clinical significance unknown. | Low |
Same composition (Pegfilgrastim (6mg)), different brands: