Nivestim (Filgrastim)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Nivestim Used For?
Nivestim contains filgrastim, which is a copy of a natural substance in your body called Granulocyte Colony Stimulating Factor (G-CSF). It helps your bone marrow produce more neutrophils, a type of white blood cell that fights infections.
Primary Uses
Nivestim is used to increase white blood cells after chemotherapy treatment, after bone marrow or stem cell transplants, before high-dose chemotherapy to collect stem cells, for severe chronic neutropenia (long-term low white blood cell count), and in patients with advanced HIV infection to reduce infection risk.
How It Works
G-CSF is naturally produced in bone marrow and helps create neutrophils, which are white blood cells that fight infections by surrounding and destroying harmful bacteria. Nivestim encourages your bone marrow to produce more of these infection-fighting cells and helps them work more effectively.
How to Take Nivestim
Nivestim is given by injection, usually just under the skin (subcutaneous injection). Your doctor, nurse, or pharmacist may teach you or your caregiver how to give these injections at home so you can receive treatment conveniently.
Dosage Instructions
Your doctor will determine the right strength and amount based on your treatment reason, body weight, and neutrophil count in your blood. Inject at the same time each day for best results. Treatment duration varies: 1-3 weeks for chemotherapy patients, 4-5 days for stem cell donors, long-term for chronic neutropenia, and daily until normal levels for HIV patients (then often reduced to 3 times weekly).
What If You Miss a Dose?
If you miss your scheduled dose, inject it as soon as you remember – but only if it’s still the same day. If you miss a whole day, don’t take a double dose or increase your next dose. Contact your doctor, nurse, or pharmacist as soon as possible about the missed dose.
Important: Do not use Nivestim 24 hours before or after chemotherapy, radiotherapy, bone marrow transplant, or stem cell transplant as these treatments may prevent Nivestim from working properly.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- bone, back, muscle, joint pain
- mouth or throat pain
- swelling or stiffness of joints
- muscle spasms
- abdominal discomfort
- diarrhea or constipation
- nausea and vomiting
- severe nose bleeds
- reddish or purplish bumps or blotches
- mouth ulcers
- numbness, tingling in hands and feet
- injection site reactions
- cough
- hair loss
- headache
- looking pale
- loss of appetite
- unusual weakness
- difficulty sleeping
Seek immediate medical attention if you experience:
- rash, itching or hives
- swelling of face, lips, mouth or throat
- difficulty swallowing or breathing
- shortness of breath, wheezing
- light-headedness, dizziness or fainting
- rapid pulse or breathing, sweating
- painful skin lesions
- chest, abdominal or back pain
- fever
- easy bruising or bleeding
- left shoulder pain
- frequent infections
- coughing up blood or mucus
- pain in upper left side of stomach
- swelling of stomach area
- reduced urination
- blood in urine
Important Warnings
There are important safety considerations before using Nivestim. Make sure to discuss your complete medical history with your doctor.
Who Should Not Take Nivestim
Do not use if you’re allergic to filgrastim, any ingredients in Nivestim, or products made using E. coli bacteria. Do not use within 24 hours before or after chemotherapy, radiotherapy, bone marrow transplant, or stem cell transplant.
Medical Conditions to Discuss
Tell your doctor if you have allergies to medicines/foods/preservatives, bone marrow or blood conditions, family history of genetic disorders, sickle cell disease, kidney/liver/heart problems, spleen problems, previous cancer treatment, infections/cancers/tumors, recent pneumonia, osteoporosis, hereditary fructose intolerance (HFI), or take other medications.
Pregnancy and Breastfeeding
Check with your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Call your doctor immediately if you become pregnant during treatment. Your doctor will discuss the risks and benefits with you.
Drug Interactions
Some medicines may interfere with Nivestim and affect how it works. Always inform your healthcare providers about all medications you’re taking.
- medicines that may affect the blood
- prescription medications
- over-the-counter medicines
- vitamins
- supplements from pharmacy, supermarket, or health food shops
Alcohol & Driving
Be careful when driving or using machinery until you know how Nivestim affects you, as it may cause dizziness that could impair your ability to drive safely.
Alcohol
No specific alcohol interactions mentioned in the source material. Consult your doctor about alcohol consumption during treatment.
Driving and Operating Machinery
You may experience dizziness after receiving Nivestim, which might affect your ability to drive or use machines safely. Be cautious until you know how the medication affects you.
Storage
Keep Nivestim in the refrigerator at 2°C to 8°C in its original carton to protect from light. Brief freezing (up to 24 hours) won’t harm it, and it can stay at room temperature for up to 15 days in a single period. Don’t use if left out of refrigerator for more than 15 days, frozen for more than 24 hours, or frozen more than once. Store away from moisture, heat, and sunlight. Keep out of reach of children.
Overdose Information
If you think you’ve injected more than the recommended dose, seek urgent medical attention immediately. Too much Nivestim may lead to dangerously high neutrophil levels. Call the Poisons Information Centre (13 11 26), contact your doctor, or go to the nearest hospital emergency department, even if you feel fine.
Frequently Asked Questions
Treatment duration varies by condition: 1-3 weeks for chemotherapy patients until neutrophil levels are restored, 4-5 days for stem cell donors, long-term regular use for chronic neutropenia, and daily use for HIV patients until neutrophil numbers normalize (then often reduced to 3 times weekly).
Yes, your doctor, nurse, or pharmacist may teach you or your caregiver how to give subcutaneous injections at home. This allows you to receive treatment conveniently without frequent hospital visits.
Go straight to the hospital if you notice any signs of infection, including fever (38.2°C or higher), chills, rash, sore throat, diarrhea, earache, or difficulty breathing. Even though Nivestim helps fight infections, you can still get sick and need immediate medical attention.
The best injection sites are your abdomen (except around the navel) or the front or side of your thighs. Change the injection site each time to avoid soreness at one location.
If you miss your scheduled dose, inject it as soon as you remember – but only if it’s still the same day. If you miss a whole day, don’t take a double dose. Contact your doctor, nurse, or pharmacist about the missed dose.
Keep Nivestim in the refrigerator at 2°C to 8°C in its original carton to protect from light. It can be left at room temperature for up to 15 days in a single period, and brief freezing up to 24 hours won’t harm it.
No, never reuse syringes. After injection, don’t put the needle cover back on. Dispose of used syringes in an approved puncture-resistant sharps container, never in regular household trash.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.