{"entity":{"id":"filgrastim","kind":"drug","name":"Filgrastim (G-CSF)","aka":["Zarxio (filgrastim-sndz)","Nivestym (filgrastim-aafi)","Releuko (filgrastim-ayow)","Granix (tbo-filgrastim)","Nypozi","Zarzio","Tevagrastim","Ratiograstim","Accofil","Grastofil"],"tldr":"Filgrastim (Neupogen and its biosimilars) is a daily injection that speeds the recovery of infection-fighting white cells after chemotherapy, lets doctors give chemotherapy on schedule and mobilises stem cells for transplant.","summary":"Filgrastim was approved by the FDA in February 1991 to reduce the incidence of infection from febrile neutropenia in non-myeloid malignancies receiving myelosuppressive chemotherapy, and later for AML induction, bone marrow transplantation, peripheral blood progenitor cell mobilisation, severe chronic neutropenia and acute radiation syndrome. It was the first Amgen blockbuster and the model for supportive-care biologics; the first US biosimilar of any kind was filgrastim-sndz (Zarxio, 2015), and the EU authorised the first filgrastim biosimilars in 2008. Guidelines recommend primary prophylaxis when the febrile neutropenia risk of a regimen exceeds about 20%. Bone pain is the main adverse effect; splenic rupture, acute respiratory distress syndrome and sickle cell crises are rare but serious. Pegfilgrastim gives a once-per-cycle alternative.","status":"approved","asOf":"2026-09-10","wikipedia":"https://en.wikipedia.org/wiki/Filgrastim","links":[{"label":"US label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=filgrastim"},{"label":"NCI drug page","url":"https://www.cancer.gov/about-cancer/treatment/drugs/filgrastim"},{"label":"EPAR (Zarzio)","url":"https://www.ema.europa.eu/en/medicines/human/EPAR/zarzio"}],"tags":["nci-list","supportive"],"related":["pegfilgrastim","plerixafor"],"cancers":[],"sections":[],"technologies":["g-csf-growth-factors"],"targets":[],"drugs":[],"companies":["amgen","sandoz","teva","eurofarma"],"institutions":[],"pathways":[],"terms":[],"trials":["nct06212752","nct06514508","nct03246529","nct05722015"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Neupogen","modality":"Recombinant granulocyte colony-stimulating factor","supportive":true,"mechanism":"Recombinant methionyl human G-CSF that binds the G-CSF receptor on myeloid progenitors, driving neutrophil proliferation, differentiation and release from marrow.","approvals":[{"region":"US","year":1991,"indication":"Reduction of febrile neutropenia in non-myeloid malignancies on myelosuppressive chemotherapy; later AML induction, transplantation, stem cell mobilisation, severe chronic neutropenia"},{"region":"US","year":2015,"indication":"First US biosimilar (Zarxio, filgrastim-sndz); further biosimilars 2018 onwards"},{"region":"EU","year":2008,"indication":"First biosimilar filgrastims (Tevagrastim, Ratiograstim, Biograstim); Zarzio 2009"}],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/filgrastim/","neighbours":{"drug":[{"id":"efbemalenograstim-alfa","kind":"drug","name":"Efbemalenograstim alfa","route":"/drugs/efbemalenograstim-alfa/"},{"id":"lenograstim","kind":"drug","name":"Lenograstim","route":"/drugs/lenograstim/"},{"id":"motixafortide","kind":"drug","name":"Motixafortide","route":"/drugs/motixafortide/"},{"id":"pegfilgrastim","kind":"drug","name":"Pegfilgrastim","route":"/drugs/pegfilgrastim/"},{"id":"plerixafor","kind":"drug","name":"Plerixafor","route":"/drugs/plerixafor/"},{"id":"sargramostim","kind":"drug","name":"Sargramostim","route":"/drugs/sargramostim/"}],"technology":[{"id":"biosimilar-manufacturing","kind":"technology","name":"Biosimilar manufacturing and comparability","route":"/technologies/biosimilar-manufacturing/"},{"id":"g-csf-growth-factors","kind":"technology","name":"Growth factors: G-CSF and febrile neutropenia prevention","route":"/technologies/g-csf-growth-factors/"}],"company":[{"id":"amgen","kind":"company","name":"Amgen","route":"/companies/amgen/"},{"id":"biolinerx","kind":"company","name":"BioLineRx","route":"/companies/biolinerx/"},{"id":"eurofarma","kind":"company","name":"Eurofarma","route":"/companies/eurofarma/"},{"id":"sandoz","kind":"company","name":"Sandoz","route":"/companies/sandoz/"},{"id":"teva","kind":"company","name":"Teva Pharmaceuticals","route":"/companies/teva/"}],"trial":[{"id":"nct03246529","kind":"trial","name":"A Phase III, Safety, Tolerability and Efficacy of Combination Treatment of BL-8040 and Granulocyte Colony Stimulating Factor (G-CSF) as Compared to Pl","route":"/trials/nct03246529/"},{"id":"nct05722015","kind":"trial","name":"A Study of Subcutaneous (SC) Pembrolizumab Coformulated With Berahyaluronidase Alfa (MK-3475A) vs Intravenous Pembrolizumab in Adult Participants With Metastatic Non-small Cell Lung Cancer (NSCLC) (MK-3475A-D77)","route":"/trials/nct05722015/"},{"id":"nct06212752","kind":"trial","name":"A Study of Subcutaneous (SC) Pembrolizumab Coformulated With Berahyaluronidase Alfa (MK-3475A) vs Intravenous Pembrolizumab in Adult Participants With Metastatic Non-small Cell Lung Cancer (NSCLC) (MK-3475A-D77)-Japan Extension","route":"/trials/nct06212752/"},{"id":"aews0031","kind":"trial","name":"AEWS0031","route":"/trials/aews0031/"},{"id":"nct00002719","kind":"trial","name":"Combination Chemotherapy With or Without G-CSF in Treating Older Patients With Acute Myeloid Leukemia","route":"/trials/nct00002719/"},{"id":"nct00557193","kind":"trial","name":"Combination Chemotherapy With or Without Lestaurtinib in Treating Younger Patients With Newly Diagnosed Acute Lymphoblastic Leukemia","route":"/trials/nct00557193/"},{"id":"nct00002658","kind":"trial","name":"Combination Chemotherapy, Biological Therapy, and Bone Marrow Transplantation in Treating Patients With Acute Myeloid Leukemia","route":"/trials/nct00002658/"},{"id":"nct01767714","kind":"trial","name":"Evaluation of Plerixafor Plus G-CSF to Mobilize and Collect 5×10^6CD34+ Cells/kg in Non-Hodgkin's Lymphoma (NHL) Patients for Autologous Transplantation","route":"/trials/nct01767714/"},{"id":"nct01301963","kind":"trial","name":"Filgrastim With or Without Plerixafor in Treating Patients With Multiple Myeloma Previously Treated With Lenalidomide","route":"/trials/nct01301963/"},{"id":"nct00541125","kind":"trial","name":"G-CSF in Preventing Neutropenia During First-Line Treatment With Chemotherapy and Bevacizumab in Patients With Metastatic Colorectal Cancer","route":"/trials/nct00541125/"},{"id":"nct00004157","kind":"trial","name":"Interleukin-11 Plus Filgrastim Prior to Peripheral Stem Cell Transplantation in Patients With Non-Hodgkin's Lymphoma, Hodgkin's Disease, Breast Cancer, or Other Solid Tumors","route":"/trials/nct00004157/"},{"id":"nct06514508","kind":"trial","name":"Mobilization of Stem Cells With Motixafortide (BL-8040) in Combination With G-CSF in Multiple Myeloma Patients","route":"/trials/nct06514508/"},{"id":"nct00186628","kind":"trial","name":"Phase 2 Trial of Prophylactic Rituximab Therapy for Prevention of CGVHD","route":"/trials/nct00186628/"},{"id":"ptld-1","kind":"trial","name":"PTLD-1","route":"/trials/ptld-1/"},{"id":"nct00057811","kind":"trial","name":"Rituximab, Rasburicase, and Combination Chemotherapy in Treating Young Patients With Newly Diagnosed Advanced B-Cell Leukemia or Lymphoma","route":"/trials/nct00057811/"},{"id":"nct04174599","kind":"trial","name":"Study to Compare the Efficacy and Safety of F-627 and GRAN®","route":"/trials/nct04174599/"},{"id":"nct07064018","kind":"trial","name":"Trial of Single Protein Encapsulated Doxorubicin, SPEDOX-6 in Advanced Malignancies","route":"/trials/nct07064018/"}],"term":[{"id":"lymphoma-tx-pjp-and-infection-prophylaxis","kind":"term","name":"Infection prophylaxis in lymphoma: PJP, herpes, fungal risk and vaccination","route":"/terms/lymphoma-tx-pjp-and-infection-prophylaxis/"}],"target":[{"id":"csf3r","kind":"target","name":"G-CSF receptor (CSF3R)","route":"/targets/csf3r/"}]}}