In patients, children or adults with cyclic, or idiopathic neutropenia with an absolute neutrophil count (ANC) of ≤0.5 × 109/L, and a history of severe or recurrent infections, long term administration of filgrastim is indicated to increase neutrophil counts and to reduce the incidence and duration of infection-related events.
For this indication, competent medicine agencies globally authorize below treatments:
Subcutaneous
5 - 5 ug per kg of body weight
From 5 To 5 ug per kg of body weight once every day
The recommended starting dose is 0.5 MU (5 μg)/kg/day as a single dose or in divided doses.
Filgrastim should be administered daily by subcutaneous injection until the neutrophil count has reached and can be maintained at more than 1.5 × 109/L. When the response has been obtained, the minimal effective dose to maintain this level should be established. Long-term daily administration is required to maintain an adequate neutrophil count. After one to two weeks of therapy, the initial dose may be doubled or halved depending upon the patient’s response. Subsequently, the dose may be individually adjusted every 1-2 weeks to maintain the average neutrophil count between 1.5 × 109/L and 10 × 109/L. A faster schedule of dose escalation may be considered in patients presenting with severe infections. In clinical studies, 97% of patients who responded had a complete response at doses of ≤24 μg/kg/day. The long-term safety of administration of filgrastim at doses above 24 μg/kg/day) in patients with SCN has not been established.