Granulokine Filgrastim 30 MU/0.5 mL – Prefilled Syringe

Granulokine filgrastim 30 MU/0.5 mL is a prescription white-blood-cell growth factor supplied as a single-use prefilled syringe containing 300 micrograms of filgrastim. It is used only under an oncology or haematology team because the dose, timing and duration depend on the reason for treatment, body weight and blood-count results.

Important: This page supports—not replaces—the local package leaflet and instructions from your doctor, pharmacist or nurse. Do not start, stop, repeat or change a dose without the treating team.

What is Granulokine filgrastim?

Filgrastim is a recombinant granulocyte-colony stimulating factor (G-CSF). It encourages the bone marrow to produce and release neutrophils, a type of white blood cell that helps the body respond to infection. It is not chemotherapy and it does not treat cancer itself. Its role is to help manage specific low-neutrophil situations and support an agreed treatment plan.

Each 0.5 mL prefilled syringe contains 30 million units (30 MU), equivalent to 300 micrograms of filgrastim at a concentration of 0.6 mg/mL. The solution should be clear and colourless. The pictured carton is a market-specific presentation; label language, safety device and pack size can vary, so the physical pack supplied to you always takes priority.

When may a specialist prescribe it?

• To reduce the duration of neutropenia and the risk of febrile neutropenia after established cytotoxic chemotherapy, except in conditions specifically excluded by the prescribing information.
• After myeloablative treatment followed by bone-marrow transplantation when prolonged severe neutropenia is expected.
• To mobilise peripheral-blood progenitor cells before collection and transplantation.
• For severe congenital, cyclic or idiopathic chronic neutropenia with recurrent or serious infections.
• For persistent neutropenia in advanced HIV infection when other management options are inappropriate.

These indications have different dosing schedules. A 300-microgram syringe is a presentation, not a universal daily dose. Never calculate a filgrastim dose from this page or from another person’s prescription.

Dose, timing and blood monitoring

For established cytotoxic chemotherapy, the current reference SmPC gives a usual dose of 0.5 MU (5 micrograms)/kg/day and states that the first dose should be administered at least 24 hours after chemotherapy. Other indications use different starting doses, schedules and stopping rules. Treatment generally continues until the expected neutrophil low point has passed and the neutrophil count has recovered as judged by the specialist.

Regular blood tests are central to safe use. The team may monitor absolute neutrophil count (ANC), total white cells, platelets, red-cell measures and other tests appropriate to the indication. Very high white-cell counts, low platelets or an inadequate response can require a dose change or temporary or permanent discontinuation. Do not interpret one blood result without the clinical team.

How is the prefilled syringe used?

Granulokine may be given as a subcutaneous injection or, in selected settings, as an intravenous infusion. Most patients who inject at home use the subcutaneous route, but only after hands-on training. The prescriber decides the route and whether the complete syringe or another measured dose is required.

1. Remove the tray from the refrigerator and allow it to reach room temperature for about 30 minutes, or warm it gently in your hands. Do not use a microwave, hot water or another heat source.
2. Do not shake the syringe. Check the expiry date, tray seal and solution. Do not use it if damaged, cloudy, discoloured or visibly particulate.
3. Wash your hands and prepare a clean, well-lit area. Keep the needle cover on until ready to inject.
4. Use the injection site and technique demonstrated by the nurse. Common subcutaneous sites are the upper thighs and abdomen; the back of the upper arm may be used when another trained person gives the injection.
5. Use each syringe for one injection only. Do not recap a used needle. Place it immediately in an approved sharps container and follow local disposal instructions.

A small air bubble may be present in the prefilled syringe. The official patient leaflet says it does not need to be removed before a subcutaneous injection. Do not alter the syringe or attempt to expel liquid unless your healthcare professional has specifically trained you to do so.

Common and important side effects

Muscle or bone pain is a common effect of filgrastim. Headache, nausea, vomiting, diarrhoea, fatigue, fever and injection-related discomfort can also occur. Many patients are receiving chemotherapy or transplant treatment, so some symptoms and laboratory changes may have more than one cause. Ask the treating team which pain relief is suitable rather than choosing a medicine yourself.

Contact the treatment team promptly for unusual bruising or bleeding, blood in the urine, persistent fever, a new rash, marked weakness or symptoms that are worsening. Urgent medical assessment is required for any of the following:

• Difficulty breathing, facial or throat swelling, faintness or a severe allergic reaction.
• New cough, fever and breathlessness, which can signal a serious lung reaction.
• Pain in the left upper abdomen, below the left ribs or at the left shoulder tip, which can signal an enlarged or ruptured spleen.
• Rapid swelling, reduced urination, abdominal fullness and breathlessness, possible signs of capillary leak syndrome.
• Fever with severe chills, confusion, rapid heart rate, clammy skin or extreme discomfort, possible signs of sepsis.
• Persistent fever with abdominal or back pain and raised inflammatory markers, which can occur with aortitis.

Who needs extra caution?

Tell the specialist about every medical condition and medicine, particularly sickle-cell trait or disease, bone disease, previous lung problems, kidney or urinary problems, blood cancers or suspected myelodysplastic disease. Filgrastim can precipitate a sickle-cell crisis in susceptible patients. People treated long term for severe chronic neutropenia require condition-specific monitoring.

The syringe formulation contains sorbitol. Tell the team if you or your child has hereditary fructose intolerance. Depending on the presentation, the needle cover may contain a latex derivative. Filgrastim is not recommended during pregnancy unless the specialist judges that it is necessary. The patient leaflet advises stopping breastfeeding during treatment unless the doctor directs otherwise.

Storage and transport

• Store refrigerated at 2°C to 8°C.
• Keep the syringe in the outer carton to protect it from light.
• Do not use after the stated expiry date.
• Use only a clear, colourless solution without particles.
• Keep out of the sight and reach of children.
• Do not dispose of a used syringe in household waste; use a sharps container.

The current reference leaflet notes that accidental freezing does not harm the product, but deliberate freezing or uncontrolled transport is not recommended. Follow the supplied label and pharmacist’s cold-chain instructions, especially if the pack was obtained through a different country.

Granulokine, Neupogen and market names

Official European reference information explains that filgrastim from Amgen is marketed under the name Neupogen in many countries and Granulokine in some markets. Packaging language, registration holder and safety-device design may therefore differ. Record the exact brand and strength you receive, and do not switch between products without the oncology or haematology team.

Safe-use checklist

• Confirm the exact product, strength, dose and date with the treatment plan.
• Ensure the required interval from chemotherapy or transplant has passed.
• Review the latest ANC and other blood results as directed.
• Check the syringe, expiry date and solution before every injection.
• Never shake, share or reuse the syringe.
• Know the urgent spleen, breathing, allergy and sepsis warning signs.
• Maintain the refrigerated cold chain and protect the pack from light.

Granulokine filgrastim safety summary

• Granulokine filgrastim dosing is individualized by the treating specialist.
• Granulokine filgrastim is not started until at least 24 hours after cytotoxic chemotherapy.
• Granulokine filgrastim treatment requires scheduled blood-count monitoring.
• Granulokine filgrastim syringes are single use and are stored refrigerated at 2–8°C.

Official references

Medical details were checked against the current Amgen reference information: the Neupogen Singleject 30 MU/0.5 mL SmPC, the official patient leaflet, and the Granulokine product information. For more health and pharmacy products, visit No Style Like.