Filgrastim is also sometimes used to stimulate the bone marrow to make more young white blood cells (stem cells) and release them into the bloodstream, where they can be collected for a peripheral blood stem cell transplant (PBSCT).

• If you are allergic to any medicines, dyes, additives, or foods, especially if you are allergic medicines made from E. coli bacteria. Also, if you or the person who will help you inject the filgrastim is allergic to latex.

• If you have sickle cell disease. This drug may raise your risk of having a serious sickle cell crisis.

• If you have ever had seizures. This drug may raise your risk of seizures.

• If you have any other medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, lung disease, congestive heart failure, diabetes, gout, or infections. This drug may make some of these conditions worse. You may need closer monitoring of these conditions while being treated, or the drug dose, regimen, or timing may need to be changed.

• If you have ever had an enlarged spleen, myelodysplastic disease, or chronic myeloid leukemia. This drug may worsen these conditions or cause other problems.

• If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. It is not known if this drug might cause problems if either the male or female is taking it at the time of conception or during pregnancy. Check with your doctor about what kinds of birth control can be used with this medicine. This drug should be used during pregnancy only if the expected benefit is thought to outweigh the potential risk to the fetus.

• If you are breast-feeding. This drug may pass into breast milk, but would not be expected to harm the baby. Talk with your doctor about the possible risks of breast-feeding while taking this drug.

• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

No serious interactions with other drugs are known at this time. But this does not necessarily mean that none exist. Check with your doctor, nurse, or pharmacist about all of your medicines, herbs, and supplements, and whether alcohol can cause problems with this medicine.

The dose and treatment schedule will depend on your weight, general health, and the reason you are being treated. The dose and/or schedule may need to be changed based on how your body responds to treatment.

If you are taking filgrastim at home, make sure to keep it in its original container in the refrigerator. Take this drug exactly as directed by your doctor. If you are not sure of the instructions, ask your doctor or nurse to explain them to you. Keep the needles and other equipment in a safe place out of reach of children and pets. Store used needles in a closed needle bucket and bring them back to your doctor or nurse for disposal.

This drug is generally not given within 24 hours of chemotherapy treatments.

Your doctor will obtain blood tests to find out how you respond to the drug. Your doctor will adjust your dose based on your test results. Keep all your appointments for doctor visits and blood tests.

Even though this drug is given to help you fight infections, it cannot prevent all infections. Call your doctor if you notice signs of infection such as fever (100.5° or higher), chills, pain when passing urine, a new cough, or bringing up sputum.

In a few people, this drug has caused severe lung problems, trouble breathing, or coughing up blood. Let your doctor know of any shortness of breath you notice.

In rare cases, this drug can cause allergic reactions, especially with the first few treatments. Mild reactions may consist of fever, chills, skin itching, or feeling flushed. More serious reactions happen rarely, but can be dangerous. Symptoms can include feeling lightheaded or dizzy (due to low blood pressure), chest tightness, shortness of breath, back pain, or swelling of the face, eyes, tongue, or throat. Tell your doctor or nurse right away if you notice any of these symptoms during or after being given the drug.

In rare cases, people getting this drug have had their spleen grow very large or even rupture, which can cause death. Let your doctor know right away if you begin to have pain or swelling on your left side under your rib cage or if you notice pain in your left shoulder area.

If you are having surgery, including dental surgery, tell your surgeon or dentist that you are using filgrastim.

If you plan to have a bone imaging study, be sure the doctor and technician know you are using this drug. Filgrastim may affect the imaging results.

• none

• bone and muscle pain
• abnormal blood tests which suggest that the drug is affecting the liver (Your doctor will discuss the importance of this finding, if any.)

• injection site reaction (redness, pain, or swelling)
• allergic reaction*
• spleen enlargement or rupture*
• trouble breathing or coughing up blood*

*See "Precautions" section for more detailed information.