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The following safety information is crucial for understanding the potential risks and necessary precautions associated with taking Neupogen (filgrastim). Please review these details carefully and discuss any concerns with your healthcare provider.

• Enlarged Spleen: In rare cases, Neupogen (filgrastim) can cause the spleen to enlarge and, in severe instances, rupture, which can be fatal. Seek immediate medical attention if you experience pain in the upper left abdomen or shoulder area.

• Breathing Difficulties: This medication may lead to acute respiratory distress syndrome (ARDS), a serious condition where fluid accumulates in the lungs, preventing oxygen from reaching the bloodstream and organs. Immediate medical help is required if you have symptoms such as shortness of breath, rapid breathing, or fever.

• Severe Allergic Reactions: Neupogen (filgrastim) can cause life-threatening allergic reactions. Do not use if you have had previous allergic reactions to Neupogen or similar drugs like Neulasta (pegfilgrastim). Ensure your healthcare team is aware of all your allergies. Seek urgent medical attention if you experience a rash, breathing difficulties, or swelling of lips, tongue, or throat.

• Sickle Cell Crisis: Individuals with sickle cell anemia may experience painful episodes, known as sickle cell crises, when taking Neupogen (filgrastim). If this occurs, your provider will discontinue the medication.

• Kidney Damage: There is a risk of kidney damage associated with Neupogen (filgrastim). If kidney issues are suspected, your provider may require blood tests to assess for damage and might adjust or pause your medication accordingly.

• Capillary Leak Syndrome: Neupogen (filgrastim) may cause capillary leak syndrome, characterized by fluid leakage from small blood vessels. Symptoms include low blood pressure, dizziness, fatigue, abdominal pain, extreme thirst, or sudden weight gain. Notify your healthcare provider immediately if you experience these symptoms.

• Blood Vessel Damage: Some individuals have reported skin lesions due to blood vessel inflammation and damage, known as cutaneous vasculitis. This condition is more common in long-term users. Report any itchy, red spots or bumps, feeling unwell, or muscle or joint pain to your provider, who may pause treatment until symptoms subside.

• Cancer Risk: As Neupogen (filgrastim) stimulates the production of neutrophils, there is a potential risk of promoting tumor growth. Some users have developed blood-related cancers. Your provider will monitor your labs closely and may discontinue the medication if cancer risk outweighs the benefits.

• Contraindications: Neupogen (filgrastim) should not be used if you have allergies to pegfilgrastim products such as Neulasta. Consult your healthcare provider for an alternative treatment plan if necessary.

When using this medication, some individuals may experience side effects. Common ones include fever, nausea, low platelet counts, and feelings of weakness or tiredness. Dizziness, cough, rash, shortness of breath, and chest pain are also reported. These effects are generally mild, but if they persist or worsen, it is advisable to consult a healthcare provider.

There are other side effects like bone or joint pain and general pain, which should be brought to your doctor's attention if they occur. While many people do not experience serious side effects, it is important to be aware of them. Serious side effects, although rare, demand immediate medical attention. These include difficulty breathing, a ruptured spleen indicated by pain in the left upper stomach or shoulder, and signs of kidney damage such as facial or ankle swelling, dark urine, or reduced urination.

In certain cases, patients with congenital neutropenia or those undergoing chemotherapy or radiation for breast or lung cancer may face an increased risk of developing bone marrow disorders or blood cancers. Additionally, a significant allergic reaction, though rare, requires urgent care. Symptoms include severe rash, swelling (particularly of the face, tongue, or throat), severe dizziness, or trouble breathing.

If you notice any side effects not listed here, contact your healthcare provider. It is crucial to monitor your health and seek medical advice whenever necessary to ensure your safety while using this medication.

When using Filgrastim, avoid taking pegfilgrastim products at the same time due to their similarity. Filgrastim can also affect certain laboratory tests, such as bone imaging tests, possibly leading to inaccurate results. It is important to inform lab technicians and all your healthcare providers that you are using this medication.

Additionally, Filgrastim (Neupogen) can interact with various medications and supplements. Always disclose all medications and supplements you are taking, including prescription drugs, over-the-counter medications, vitamins, and herbal supplements, to your doctor and pharmacist. Not all possible interactions are listed here, but using Filgrastim with medications like Vincristine or Vincristine Sulfate Liposome is generally not recommended unless necessary. If prescribed together, your doctor may adjust the dosage or frequency of one or both medications.