Intravenous, SubcutaneousNeutropenia following bone marrow transplantationAdult: 150 mcg/m2 (19.2 million IU/m2) daily given via IV infusion over 30 minutes or via SC inj, to be started the day (not less than 24 hours) after transplantation and continued until the expected nadir has passed and the neutrophil count has stabilised. Max duration: 28 days.
Child: >2 years Same as adult dose.
SubcutaneousMobilisation of peripheral blood progenitor cells for autologous peripheral blood stem cell transplantationAdult: As monotherapy: 10 mcg/kg (1.28 million IU/kg) daily for 4-6 days (5-6 days in healthy donors). After myelosuppressive chemotherapy: 150 mcg/m2 (19.2 million IU/m2) daily, to be started 1-5 days after completion of chemotherapy and continued until the neutrophil count has stabilised.
SubcutaneousChemotherapy-induced neutropeniaAdult: 150 mcg/m2 (19.2 million IU/m2) daily, to be started on the day (not less than 24 hours) after the last dose of antineoplastic and continued until the expected nadir has passed and the neutrophil count has stabilised. Max duration: 28 days.
Child: >2 years Same as adult dose.
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Dilute the contents of the vial with the contents of 1 ampoule of the solvent provided (water for inj). Shake gently for approx 5 seconds until it is completely dissolved. Do not shake vigorously. For IV infusion, dilute further with an appropriate amount of Na chloride 0.9% solution or in dextrose 5% solution as instructed in product labelling.
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Myeloid malignancy other than de novo acute myeloid leukaemia, de novo acute myeloid leukaemia aged <55 years, de novo acute myeloid leukaemia with good cytogenetics. Do not use 24 hours before to 24 hours after administration of cytotoxic chemotherapy.
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Patient with pre-malignant myeloid condition, recent history of pulmonary infiltrates or pneumonia, sickle cell trait or sickle cell disease; known risk factors for thrombosis (including donors). Children. Pregnancy and lactation.
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Significant: Leucocytosis, apheresis-related thrombocytopenia, venous thromboembolism (e.g. DVT, pulmonary embolism), arterial thromboembolism (e.g. MI, cerebrovascular event), splenomegaly, glomerulonephritis. Rarely, aortitis, splenic rupture. Very rarely, allergic reactions including anaphylaxis, cutaneous vasculitis.
Gastrointestinal disorders: Stomatitis, diarrhoea, nausea, vomiting, abdominal pain.
General disorders and administration site conditions: Fever, asthenia, pain.
Infections and infestations: Sepsis.
Investigations: Increased AST, ALT, alkaline phosphatase, lactate dehydrogenase.
Musculoskeletal and connective tissue disorders: Bone pain, back pain.
Nervous system disorders: Headache.
Skin and subcutaneous tissue disorders: Rash, alopecia. Very rarely, Sweet's syndrome, erythema nodosum, pyoderma gangrenosum, Lyell's syndrome.
Potentially Fatal: Pulmonary infiltrates leading to respiratory failure or acute respiratory distress syndrome (ARDS), capillary leak syndrome.
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IV/Parenteral/SC: Z (Animal studies showed embryo-foetal lethality. Not recommended unless clinically required.)
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Monitor WBC with differential and platelets frequently during therapy and as clinically necessary; urinalysis, spleen size. Monitor for signs or symptoms of allergic reactions, aortitis, capillary leak syndrome, cutaneous vasculitis, respiratory distress syndrome, and splenic rupture.
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May enhance the toxicity of antineoplastic agents (e.g. nitrosoureas, mitomycin); do not use lenograstim 24 hours before to 24 hours after chemotherapy ends.
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Description:
Mechanism of Action: Lenograstim is a recombinant human granulocyte-colony stimulating factor (rhG-CSF) that belongs to the cytokine group of biologically active proteins. It stimulates the production, maturation and activation of neutrophils thereby increasing peripheral neutrophil counts.
Onset: Within 24 hours.
Pharmacokinetics:
Absorption: Bioavailability: 30%.
Distribution: Volume of distribution: Approx 1 L/kg.
Metabolism: Metabolised to peptides.
Excretion: Via urine (<1%, as unchanged drug). Elimination half-life: 1-1.5 hours (IV); 3-4 hours (SC).
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Store below 30°C. Do not freeze.
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L03AA10 - lenograstim ; Belongs to the class of colony stimulating factors. Used as immunostimulants.
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Anon. Lenograstim. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 19/08/2022. Buckingham R (ed). Lenograstim. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 19/08/2022. Granocyte 33.6 MIU = 263 µg Lyophilised Powder for Injection SC/IV Infusion (Sanofi Winthrop Industrie). MIMS Philippines. http://www.mims.com/philippines. Accessed 19/08/2022. Joint Formulary Committee. Lenograstim. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 19/08/2022.
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