Pegfilgrastim
Mechanism :
Pegfilgrastim binds to the G-CSF receptor. As a G-CSF analog, it controls proliferation of committed progenitor cells and influences their maturation into mature neutrophils. Pegfilgrastim also stimulates the release of neutrophils from bone marrow storage pools and reduces their maturation time. Pegfilgrastim acts to increase the phagocytic activity of mature neutrophils. In patients receiving cytotoxic chemotherapy, pegfilgrastim can accelerate neutrophil recovery, leading to a reduction in duration of the neutropenic phase
Indication :
- Acute leukemia receiving induction or consolidation chemotherapy
Contraindications :
Pegfilgrastim is contraindicated in conditions like Hypersensitivity to the drug.
Dosing :
1 to 12 years:
0.1 mg/kg SC (Maximum dose: 6 mg) once per chemotherapy cycle, beginning 24 to 72 hours after completion of chemotherapy.
13 to 18 years, >45 kg:
6 mg once per chemotherapy cycle, beginning 24 to 72 hours after completion of chemotherapy.
Adverse Effect :
Bone pain, allergic reactions, Respiratory distress syndrome, myalgia, arthralgia, leucocytosis.
Interaction :
Drug Interactions Not Available.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Unlikely to be dialysed. Dose as in normal renal function |
| CAV/VVHD | Not dialysed. Dose as in normal renal function |
Hepatic Dose :
No dose adjustment recommended. If aminotransferase levels rise to greater than 5 times the upper limit of normal, therapy should be temporarily stopped or dose should be reduced.