Leucostim

Leukostim stimulates leukopoiesis.

[1], [2]

Indications Leucostim

It is used for the following violations:

• neutropenia  in people who have undergone chemotherapy;
• potentiation of stem cells excretion inside the blood of persons undergoing chemotherapy;
• severe neutropenia (periodic, congenital or malignant);
• neutropenia in patients with HIV;
• potentiation of stem cell excretion into the blood (carried out for healthy people-donors).

Release form

The release of drugs is made in the form of liquid for s / c and in / in injections, in syringes equipped with soldered needles, having a volume of 150, 300 or 600 μg / ml.

Pharmacodynamics

The drug is a bioactive non-glycolized protein of a highly purified nature that regulates the proliferation and differentiation of neutrophils, and with it their removal into the blood from the bone marrow. It leads to an increase in the number of neutrophils, affecting their progenitor cells.

The therapeutic effect develops within 24 hours, but with lower stem cell counts in a patient (due to intensive radiation or chemotherapy), the degree of increase in the number of neutrophils may be less pronounced. It also demonstrates immunomodulating activity.

Pharmacokinetics

With subcutaneous administration, blood values of Cmax are recorded after 8-16 hours. These values are proportional to the dosage used; blood levels of neutrophils depend on the level of drugs.

The half-life is 3.5-4 hours. Metabolic processes lead to the formation of peptides; only 1% of the applied portion is excreted with the urine in an unchanged state.

Prolonged drug administration (up to 28 days) does not cause accumulation of the substance.

[3]

Dosing and administration

The substance may be administered in / in or s / c method. The doctor selects the method of application and the size of the dosage, which is determined by the clinical picture. Subcutaneous use is considered preferable. In the case of IV injection, the substance from the syringe must be added to the vial with 5% dextrose, after which it should be injected for half an hour.

It is necessary to use Leukostim at least 24 hours after the completion of chemotherapy. Apply in portions of 5-12 mg / kg daily, 1 time per day. Therapy is carried out until the achievement of normal neutrophils. Often it lasts 2 weeks.

During therapy, you must constantly monitor the number of leukocytes. If you exceed 50,000 / µl, you must cancel the medication.

Treatment may cause thrombocytopenia. With a stable preservation of platelet counts below 100,000 / μl during repeated analyzes, it is necessary to consider the option of temporary discontinuation of the drug or a decrease in its portion.

Use Leucostim during pregnancy

Appropriate adequate testing for the use of Leucostim in pregnancy has not been performed; in the medical literature there are reports that filgrastim is able to penetrate the placenta. It is necessary to use the medicine only in situations when the benefits are more expected than the negative effects on the fetus.

There is no comprehensive information as to whether filgrastim is excreted from mother’s milk. Such a possibility cannot be ruled out, because of which the prescription of the drug during breastfeeding should be carried out with extreme caution.

[4], [5], [6], [7], [8]

Contraindications

Among the contraindications:

• the presence of intolerance associated with the active element of the drug;
• neutropenia, which is congenital;
• Appointment of people with problems in the liver or kidneys, with a pronounced degree.

Caution is required when used in people who receive chemotherapy in large quantities.

[9], [10]

Side effects Leucostim

Main adverse events:

• pain developing in the area of the bones with muscles;
• hepato-or splenomegaly;
• dysuria symptoms;
• temporary decrease in blood pressure;
• feeling tired or weak, as well as headaches;
• an increase in uric acid and alkaline phosphatase;
• alopecia;
• signs of allergy (usually due to intravenous injections at the initial stage of therapy).

[11], [12]

Interactions with other drugs

Because myeloid cells, which are at the stage of active growth, are extremely sensitive to cytostatics, it is required to use filgrastim 24 hours before or after the administration of these medicines.

The element 5-fluorouracil potentiates neutropenia.

If the drug is used to mobilize the activity of progenitor cells at the end of chemotherapy, it is necessary to take into account that the severity of this action is weakened in the case of prolonged use of carmustine, melphalan or carboplatin.

It does not have pharmaceutical compatibility with NaCl.

[13], [14], [15]

Storage conditions

Leucostim is required to be maintained at a temperature range of 2-8 ° C.

[16]

Shelf life

Leukostim can be used within a 2-year period from the time the therapeutic drug is manufactured.

[17]

Application for children

Do not assign to infants up to 1 month of age.

[18]

Analogs

Analogues of the substance are the means Neupogen, Neurostim and Granogen with Mielastra, and also Grasalva, Neipomax, Leucite and Filergim.

[19], [20], [21], [22]