Filastin Uses

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What is Filastin?

Filastin injection is used to treat neutropenia (low white blood cells) that is caused by cancer medicines. It is a synthetic (man-made) form of a substance that is naturally produced in your body called a colony stimulating factor. Filastin helps the bone marrow to make new white blood cells.

When certain cancer medicines are used to fight cancer cells, they also affect the white blood cells that fight infections. Filastin is used to prevent or reduce the risk of infection while you are being treated with cancer medicines. Filastin is also used to help the bone marrow recover after a bone marrow transplantation, for a process called peripheral blood progenitor cell collection in cancer patients, and to improve survival in cancer patients who have been exposed to radiation.

Filastin is available only with your doctor's prescription.

Filastin indications

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Established Cytotoxic Chemotherapy: Filastin is indicated for reduction in the duration of neutropenia and the incidence of febrile neutropenia in patients treated with established cytotoxic chemotherapy for malignancy (with the exception of chronic myeloid leukemia and myelodysplastic syndromes) and for the reduction in the duration of neutropenia and its clinical sequelae in patients undergoing myeloablative therapy followed by bone marrow transplantation.

Peripheral Blood Progenitor Cell Mobilization (PBPC): Filastin is indicated for the mobilization of autologous peripheral blood progenitor cells alone, or following myelosuppressive chemotherapy in order to accelerate hematopoetic recovery by infusion of such cells, after myelosuppressive or myeloablative therapy. The safety and efficacy of Filastin are similar in adults and children receiving cytotoxic chemotherapy. Filastin is indicated for the mobilization of peripheral blood progenitor cells in normal volunteers for use in allogeneic peripheral blood progenitor cell transplantation.

Severe Chronic Neutropenia (SCN): In patients, children or adults, with severe congenital, cyclic or idiopathic neutropenia with an ANC of ≤0.5x109/L, and a history of severe or recurrent infections, long-term administration of Filastin is indicated to increase neutrophil counts and to reduce the incidence and duration of infection-related events.

HIV Infection: Filastin is indicated for the treatment of persistent neutropenia (ANC ≤1.0 x 109/L) in patients with advanced HIV infection, in order to reduce risk of bacterial infections, when other options to manage neutropenia are inappropriate.

Patients with Acute Myeloid Leukemia (AML): Filastin is indicated to reduce the duration of neutropenia and related clinical sequelae in patients undergoing induction or consolidation chemotherapy.

How should I use Filastin?

Use Filastin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Filastin.

Uses of Filastin in details

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Use: Labeled Indications

Chemotherapy-induced myelosuppression in nonmyeloid malignancies:

Filastin and Filastin biosimilars: To decrease the incidence of infection (neutropenic fever) in patients with nonmyeloid malignancies receiving myelosuppressive chemotherapy associated with a significant incidence of severe neutropenia with fever

Tbo-Filastin: To decrease the duration of severe neutropenia in adult and pediatric patients ≥1 month of age with nonmyeloid malignancies receiving myelosuppressive chemotherapy associated with a clinically significant incidence of neutropenic fever

Acute myeloid leukemia (AML) following induction or consolidation chemotherapy (Filastin and Filastin biosimilars): To reduce the time to neutrophil recovery and the duration of fever following induction or consolidation chemotherapy in adults with AML

Bone marrow transplantation (Filastin and Filastin biosimilars): To reduce the duration of neutropenia and neutropenia-related events (eg, neutropenic fever) in patients with nonmyeloid malignancies receiving myeloablative chemotherapy followed by marrow transplantation

Hematopoietic radiation injury syndrome, acute (Filastin only): To increase survival in patients acutely exposed to myelosuppressive doses of radiation

Peripheral blood progenitor cell collection and therapy (Filastin and Filastin biosimilars): Mobilization of autologous hematopoietic progenitor cells into the peripheral blood for apheresis collection

Severe chronic neutropenia (Filastin and Filastin biosimilars): Long-term administration to reduce the incidence and duration of neutropenic complications (eg, fever, infections, oropharyngeal ulcers) in symptomatic patients with congenital, cyclic, or idiopathic neutropenia

Note: Filastin (Filastin-aafi) and Zarxio (Filastin-sndz) are approved as biosimilars to Filastin (Filastin). In Canada, Grastofil is a biosimilar to Filastin (Filastin).

Off Label Uses

Alcoholic hepatitis (severe)

Data from a small randomized, non-blinded pilot study suggest Filastin may be safe and effective therapy and may improve liver function as well as survival in patients with severe alcoholic hepatitis.

Filastin description

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Each powder for injection contains Filgrastim 30 MU and 48 MU.

It also contains the following excipients: Sodium acetate trihydrate, mannitol and polysorbate 80.

Filastin 30 MU Lyophilized Powder for Injection: Each vial of solvent contains benzyl alcohol 9 mg/mL.

Filastin 48 MU Lyophilized Powder for Injection: Each vial of solvent contains benzyl alcohol 14.4 mg/1.6 mL.

The reconstituted preparation with 1 mL solvent (containing benzyl alcohol 0.9%) results in a clear, colorless solution.

Each vial of 1 mL and 1.6 mL solution for injection contains Filgrastim 30 MU and 48 MU, respectively.

It also contains the following excipients: Sodium acetate trihydrate, polysorbate 80, benzyl alcohol and water for injection.

Each pre-filled syringe of 0.5 mL and 0.8 mL contains Filgrastim 30 MU and 48 MU, respectively.

It also contains the following excipients: Sodium acetate trihydrate, polysorbate 80, benzyl alcohol and water for injection.

Filastin (recombinant human granulocyte-colony stimulating factor, rH G-SCF) is produced by r-DNA technology in Escherichia coli.

Filastin dosage

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Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Injection:

Filastin: Filastin 300 mcg/mL (1 mL); Filastin 480 mcg/1.6 mL (1.6 mL) [contains polysorbate 80]

Solution, Injection [preservative free]:

Filastin: Filastin-aafi 300 mcg/mL (1 mL); Filastin-aafi 480 mcg/1.6 mL (1.6 mL) [contains polysorbate 80]

Solution, Subcutaneous [preservative free]:

Granix: tbo-Filastin 300 mcg/mL (1 mL); tbo-Filastin 480 mcg/1.6 mL (1.6 mL) [contains polysorbate 80]

Solution Prefilled Syringe, Injection [preservative free]:

Filastin: Filastin 300 mcg/0.5 mL (0.5 mL); Filastin 480 mcg/0.8 mL (0.8 mL) [contains polysorbate 80]

Filastin: Filastin-aafi 300 mcg/0.5 mL (0.5 mL); Filastin-aafi 480 mcg/0.8 mL (0.8 mL) [contains polysorbate 80]

Zarxio: Filastin-sndz 300 mcg/0.5 mL (0.5 mL); Filastin-sndz 480 mcg/0.8 mL (0.8 mL) [contains polysorbate 80]

Solution Prefilled Syringe, Subcutaneous [preservative free]:

Granix: tbo-Filastin 300 mcg/0.5 mL (0.5 mL); tbo-Filastin 480 mcg/0.8 mL (0.8 mL) [contains polysorbate 80]

Dosing: Adult

Note: Do not administer in the period 24 hours before to 24 hours after cytotoxic chemotherapy. May round the dose to the nearest vial size for convenience and cost minimization (ASCO [Ozer 2000]). Filastin (Filastin-aafi) and Zarxio (Filastin-sndz) are approved as biosimilars to Filastin (Filastin). In Canada, Grastofil is a biosimilar to Filastin (Filastin). International considerations: Dosages below expressed as micrograms; 1 mcg = 100,000 units (Hoglund 1998).

Acute myeloid leukemia (AML) following induction or consolidation chemotherapy (Filastin and Filastin biosimilars): SubQ, IV: 5 mcg/kg/day; doses may be increased by 5 mcg/kg (for each chemotherapy cycle) according to the duration and severity of the neutropenia; continue for up to 14 days until the ANC reaches 10,000/mm (Díaz 2000; Wagner 2001).

Filastin interactions

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What other drugs will affect Filastin?

The safety and efficacy of Filastin given on the same day as myelosuppressive cytotoxic chemotherapy have not been definitively established. In view of the sensitivity of rapidly dividing myeloid cells to myelosuppressive cytotoxic chemotherapy, the use of Filastin is not recommended in the period from 24 hrs before to 24 hrs after chemotherapy. Preliminary evidence from a small number of patients treated concomitantly with Filastin and 5-fluorouracil indicate that the severity of neutropenia may be exacerbated. Possible interactions with other haematopoietic growth factors and cytokines have not yet been investigated in clinical trials.

Since lithium promotes the release of neutrophils, lithium is likely to potentiate the effect of Filastin. Although this interaction has not been formally investigated, there is no evidence that such an interaction is harmful.

Increased haematopoietic activity of the bone marrow in response to growth factor therapy has been associated with transient positive bone-imaging changes. This should be considered when interpreting bone-imaging results.

Incompatibilities: Filastin should not be diluted with saline solutions. If required, Filastin may be diluted in 5% glucose.

Diluted Filastin may be adsorbed to glass and plastic materials. However, when diluted in 5% glucose solution, Filastin is compatible with glass and a variety of plastic including PVC, polyolefin (a copolymer of polypropylene and polyethylene) and polypropylene.

Filastin side effects

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What are the possible side effects of Filastin?

Filastin usually does not cause serious or life-threatening adverse effects and it only rarely has required discontinuance. Because most patients who receive Filastin have recently undergone cytotoxic chemotherapy, many of the adverse effects reported with Filastin therapy may actually result from the actions of the previously administered antineoplastic agents.

The most frequent adverse effect reported during Filastin therapy is deep, throbbing medullary bone pain, most often in the lower back, pelvis, ribs or sternum (eg, sites containing bone marrow). Sternal pain can imitate the pain of an acute myocardial infarction. The severity of the pain usually is increased in patients with more extensive leukocytosis. Non-opiate analgesics can alleviate this effect, and bone pain may spontaneously resolve with continued therapy.

Dose- or route-dependent, Filastin-induced leukocytosis (leukocyte count >100,000/mm3) can occur during therapy, and the drug should be discontinued if the absolute neutrophil count (ANC) rises >10,000/mm3 after the nadir is achieved. An ANC >10,000/mm3 will not increase the effectiveness of the drug, but can increase its toxicity.

Splenomegaly has been observed in both children and adults during therapy with Filastin, but is not common.

Filastin contraindications

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What is the most important information I should know about Filastin?

You should not use this medication if you are allergic to Filastin or to other medicines that contain the E. coli bacteria.

Before using Filastin, tell your doctor if you have a blood cell disorder (such as sickle cell anemia), chronic myeloid leukemia, myelodysplasia (also called "preleukemia"), or if you are receiving chemotherapy or radiation treatment.

Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, syringes, IV tubing, and other items used to inject the medicine.

To be sure this medication is helping your condition, your blood may need to be tested often. This will help your doctor determine how long to treat you with Filastin. Your liver function will also need to be tested, and you may need bone density scans. Visit your doctor regularly.

Stop using Filastin and call your doctor at once if you have a serious side effect such as sudden or severe pain in your left upper stomach spreading up to your shoulder, rapid breathing or feeling short of breath, or signs of infection (fever, chills, sore throat, flu symptoms, easy bruising or bleeding, loss of appetite, nausea and vomiting, mouth sores, or unusual weakness).



Active ingredient matches for Filastin:

Filgrastim in Bangladesh.


List of Filastin substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
Ficocyte pre-filled syringe 48 MU/0.8 mL 0.8 mL x 6 x 1's (Nanogen Pharma)
Injectable; Injection; Filgrastim 0.3 mg / ml (Probiomed)
FILCAD 300MG INJECTION 1 vial / 1 injection each (Cadila Pharmaceuticals Ltd)$ 33.02
Filgen / vial 300 mcg/1 mL x 1's (Chandra Bhagat Pharma Pvt. Ltd.)
Filgen / pre-filled syringe 300 mcg/1 mL x 1's (Chandra Bhagat Pharma Pvt. Ltd.)
Filgen / vial 480 mcg/1.6 mL x 1's (Chandra Bhagat Pharma Pvt. Ltd.)
Filgen 300mcg Syringe / 1 (Chandra Bhagat Pharma Pvt. Ltd.)$ 30.11
300 mcg x 1's (Chandra Bhagat Pharma Pvt. Ltd.)$ 30.11
Filgen 300 mcg Injection (Chandra Bhagat Pharma Pvt. Ltd.)$ 0.02
FILGEN 300MG PREFILLED SYRINGE 1 packet / 1 prefilled syringe each (Chandra Bhagat Pharma Pvt. Ltd.)$ 30.11
Filgen inj 300 mcg/mL / vial 1's (Chandra Bhagat Pharma Pvt. Ltd.)
Filgen inj 300 mcg/mL / pre-filled syringe 1's (Chandra Bhagat Pharma Pvt. Ltd.)
Filgen inj 480 mcg/1.6 mL / vial 1's (Chandra Bhagat Pharma Pvt. Ltd.)
FILGEN inj 300 mcg x 1ml (Chandra Bhagat Pharma Pvt. Ltd.)$ 30.11
Filgen 300mg Prefilled Syringe (Chandra Bhagat Pharma Pvt. Ltd.)$ 30.11
Injectable; Injection; Filgrastim 0.3 mg / ml (Hexal)
Injectable; Injection; Filgrastim 0.48 mg / ml (Hexal)
Filgrastim 75 mcg/0.3 mL x 10's (Hexal)
Filgrastim 150 mcg/0.6 mL x 10's (Hexal)
Filgrastim 300 mcg/0.7 mL x 10's (Hexal)

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The results of a survey conducted on ndrugs.com for Filastin are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Filastin. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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