Zarxio (filgrastim-sndz)

Adult Dosing .

Dosage forms:  INJ (pre-filled syringe): 300 mcg per 0.5 mL, 480 mcg per 0.8 mL

Special Note

[formulation clarification]

Info: nonproprietary name = filgrastim-sndz

febrile neutropenia prophylaxis, chemo-induced

[5 mcg/kg/dose SC/IV qd]

Start: >24h after chemo, may incr. dose by 5 mcg/kg/dose per chemo cycle; Info: for pts w/ non-myeloid malignancies or pts w/ AML receiving induction or consolidation chemo; SC route preferred; product not recommended for direct admin. of doses <180 mcg; cont. until ANC >10,000 or for up to 2wk; do not give w/in 24h before chemo

neutropenia, post-BMT

[10 mcg/kg/dose IV qd]

Start: >24h after chemo, >24h after BMT; Info: for pts w/ non-myeloid malignancies; product not recommended for direct admin. of doses <180 mcg; decr. dose by 50% if ANC >1000 x3 consecutive days, then D/C if ANC >1000 x3 more consecutive days; incr. dose back to 10 mcg/kg/day if ANC <1000 during 50% dose reduction; restart 5 mcg/kg/day if ANC <1000 after tx D/C

autologous peripheral blood progenitor cell mobilization

[10 mcg/kg/dose SC qd x6-7 days]

Start: at least 4 days before 1st leukapheresis, cont. through last leukapheresis; Info: product not recommended for direct admin. of doses <180 mcg; D/C if WBC >100,000

neutropenia, severe chronic

[congenital]

Start: 6 mcg/kg/dose SC bid; Info: product not recommended for direct admin. of doses <180 mcg; individualize dose based on ANC and clinical course

[idiopathic or cyclic]

Start: 5 mcg/kg/dose SC qd; Info: product not recommended for direct admin. of doses <180 mcg; individualize dose based on ANC and clinical course

hematopoietic syndrome of acute radiation syndrome

[10 mcg/kg/dose SC qd]

Start: ASAP after suspected or confirmed exposure to radiation doses >2 Gy; Info: product not recommended for direct admin. of doses <180 mcg; cont. until ANC >1000 x3 consecutive CBCs or ANC >10,000 after radiation-induced nadir

neutropenia, AIDS-associated (off-label)

[1-10 mcg/kg/dose SC qd]

Info: product not recommended for direct admin. of doses <180 mcg; refer to literature for dosing protocols

renal dosing

[see below]

renal impairment: no adjustment

HD/PD: not defined

hepatic dosing

[no adjustment]

Peds Dosing .

Dosage forms:  INJ (pre-filled syringe): 300 mcg per 0.5 mL, 480 mcg per 0.8 mL

Special Note

[formulation clarification]

Info: nonproprietary name = filgrastim-sndz

febrile neutropenia prophylaxis, chemo-induced

[7 mo and older]

Dose: 5 mcg/kg/dose SC/IV qd; Start: >24h after chemo, may incr. dose by 5 mcg/kg/dose per chemo cycle; Info: for pts w/ non-myeloid malignancies or pts w/ AML receiving induction or consolidation chemo; SC route preferred; product not recommended for direct admin. of doses <180 mcg; cont. until ANC >10,000 or for up to 2wk; do not give w/in 24h before chemo

neutropenia, post-BMT

[7 mo and older]

Dose: 10 mcg/kg/dose IV qd; Start: >24h after chemo, >24h after BMT; Info: for pts w/ non-myeloid malignancies; product not recommended for direct admin. of doses <180 mcg; decr. dose by 50% if ANC >1000 x3 consecutive days, then D/C if ANC >1000 x3 more consecutive days; incr. dose back to 10 mcg/kg/day if ANC <1000 during 50% dose reduction; restart 5 mcg/kg/day if ANC <1000 after tx D/C

autologous peripheral blood progenitor cell mobilization

[7 mo and older]

Dose: 10 mcg/kg/dose SC qd x6-7 days; Start: at least 4 days before 1st leukapheresis, cont. through last leukapheresis; Info: product not recommended for direct admin. of doses <180 mcg; D/C if WBC >100,000

neutropenia, severe chronic

[congenital, 7 mo and older]

Start: 6 mcg/kg/dose SC bid; Info: product not recommended for direct admin. of doses <180 mcg; individualize dose based on ANC and clinical course

[idiopathic or cyclic, 7 mo and older]

Start: 5 mcg/kg/dose SC qd; Info: product not recommended for direct admin. of doses <180 mcg; individualize dose based on ANC and clinical course

hematopoietic syndrome of acute radiation syndrome

[7 mo and older]

Dose: 10 mcg/kg/dose SC qd; Start: ASAP after suspected or confirmed exposure to radiation doses >2 Gy; Info: product not recommended for direct admin. of doses <180 mcg; cont. until ANC >1000 x3 consecutive CBCs or ANC >10,000 after radiation-induced nadir

renal dosing

[see below]

renal impairment: no adjustment

HD/PD: not defined

hepatic dosing

[no adjustment]