Granulocyte Colony Stimulating Factor
Pronunciation: (gran-yoo-LOH-site kuh-LON-ee stim-yoo-LAY-ting FAK-tor).
- Generic name
- Granulocyte colony-stimulating factor
- Brand names
- Ratiograstim, Zarxio, Lapelga, Nivestym, Zarzio, Releuko
- Drug class
- Hematopoietic growth factor
Availability and supply rules vary by country
Trade names by country: India
Australia: · Full directory
What Granulocyte colony-stimulating factor is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how Granulocyte colony-stimulating factor works
G-CSF binds to specific cell surface receptors on hematopoietic cells in the bone marrow, stimulating the proliferation, differentiation, and activation of neutrophil precursors and mature neutrophils. This leads to increased production and release of neutrophils into the bloodstream, enhancing the body's ability to fight infection. (2)
What Granulocyte colony-stimulating factor is used for
Neutropenia associated with chemotherapy
Neutropenia associated with chemotherapy (2)
Neutropenia in patients with acute myeloid leukemia (AML) receiving induction or consolidation chemotherapy
Neutropenia in patients with acute myeloid leukemia (AML) receiving induction or consolidation chemotherapy (2)
Severe chronic neutropenia
Severe chronic neutropenia (2)
Mobilization of hematopoietic progenitor cells for autologous or allogeneic transplantation
Mobilization of hematopoietic progenitor cells for autologous or allogeneic transplantation (2)
Neutropenia associated with myelodysplastic syndromes (MDS)
Neutropenia associated with myelodysplastic syndromes (MDS) (2)
Before taking Granulocyte colony-stimulating factor
Do not take / not appropriate for
- Contraindicated in patients with hypersensitivity to G-CSF or its components. (Contraindication) (2)
Tell your clinician about
(2)How to take Granulocyte colony-stimulating factor
- General Instructions: G-CSF is usually given as a subcutaneous injection once daily, starting 24–72 hours after chemotherapy and continuing until your white blood cell count recovers.. Adult Dosing: Typical adult dose: 5 mcg/kg/day subcutaneously or intravenously, adjusted based on response and indication. For stem cell mobilization, dosing may vary.. Pediatric Dosing: Pediatric dosing is weight-based and should be determined by a pediatric oncologist or hematologist.. Administration: Administer as a subcutaneous injection (most common) or intravenous infusion. Rotate injection sites to reduce irritation.. When To Stop: Continue until your absolute neutrophil count (ANC) reaches the target level or as directed by your healthcare provider.. Storage: Store in the refrigerator (2–8°C). Do not freeze. Protect from light. Allow to reach room temperature before injection.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
If you miss a dose, contact your healthcare provider for instructions. Do not take an extra dose to make up for a missed one.
Overdose
Seek emergency medical attention. Overdose may cause excessive white blood cell counts, splenomegaly, or respiratory distress. Supportive care is recommended. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Bone pain
Incidence: Reported in the clinician-authored database; frequency not established
Nausea
Incidence: Reported in the clinician-authored database; frequency not established
Fatigue
Incidence: Reported in the clinician-authored database; frequency not established
Fever
Incidence: Reported in the clinician-authored database; frequency not established
Diarrhea
Incidence: Reported in the clinician-authored database; frequency not established
Splenic rupture
Incidence: Reported in the clinician-authored database; frequency not established
Acute respiratory distress syndrome (ARDS)
Incidence: Reported in the clinician-authored database; frequency not established
Rash
Incidence: Common in cancer patients receiving myelosuppressive chemotherapy
Cough
Incidence: Common in cancer patients receiving myelosuppressive chemotherapy
Difficulty breathing (dyspnea)
Incidence: Common in cancer patients receiving myelosuppressive chemotherapy
Headache
Incidence: Common, particularly during stem cell mobilization
Serious warnings
Risk of splenic rupture—report left upper abdominal or shoulder pain immediately — serious
Symptoms: Risk of splenic rupture—report left upper abdominal or shoulder pain immediately. Serious allergic reactions may occur. May cause acute respiratory distress syndrome (ARDS). Use with caution in patients with sickle cell disease. Monitor for signs of capillary leak syndrome.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindicated in patients with hypersensitivity to G-CSF or its components. Use caution in patients with sickle cell disease (risk of crisis), history of splenic rupture, or acute respiratory distress syndrome. Monitor for allergic reactions, splenomegaly, and capillary leak syndrome.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | G-CSF may interact with lithium (which can increase neutrophil production) and other hematopoietic growth factors. Use caution with concurrent chemotherapy or radiotherapy, as timing of administration is important to avoid increased toxicity. |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Available data from published studies have not established an association between G-CSF use during pregnancy and major birth defects, miscarriage, or adverse maternal or fetal outcomes; studies in women with severe chronic neutropenia found no significant difference in pregnancy outcomes between those exposed and unexposed to G-CSF. Discuss your individual situation with your healthcare provider. (2)
Breastfeeding
G-CSF is poorly secreted into breast milk and is not absorbed orally by an infant. A small number of case reports of use during breastfeeding found no adverse effects in the infants studied. Your clinician can weigh the benefits of breastfeeding against your individual clinical need for this medicine. (2)
Children
Frequency: Once daily.. Weight Based: 5 mcg/kg subcutaneously once daily, starting 24 hours after chemotherapy.. Max Daily Dose: Not established.. Max Single Dose: Not established.. Age Restrictions: Safety not established in children. (2)
Renal_impairment
The FDA label for filgrastim (Neupogen) reports specific renal and hepatic impairment studies. Renal: in a study of healthy volunteers, patients with moderate renal impairment, and patients with end-stage renal disease, higher serum concentrations were seen with end-stage renal disease, but dose adjustment in renal impairment is not necessary. Hepatic: pharmacokinetics and pharmacodynamics were similar between patients with hepatic impairment (including mild Child-Pugh Class A and moderate Child-Pugh Class B) and healthy subjects, so dose adjustment for hepatic impairment is not necessary. (2)
Hepatic_impairment
The FDA label for filgrastim (Neupogen) reports specific renal and hepatic impairment studies. Renal: in a study of healthy volunteers, patients with moderate renal impairment, and patients with end-stage renal disease, higher serum concentrations were seen with end-stage renal disease, but dose adjustment in renal impairment is not necessary. Hepatic: pharmacokinetics and pharmacodynamics were similar between patients with hepatic impairment (including mild Child-Pugh Class A and moderate Child-Pugh Class B) and healthy subjects, so dose adjustment for hepatic impairment is not necessary. (2)
Monitoring
(2)Storage
Store vials and prefilled syringes refrigerated at 2-8°C (36-46°F) in their original packaging, protected from light. Avoid freezing; if accidentally frozen once, thaw in the refrigerator before use, but discard if it has been frozen more than once. The product may be left at room temperature (20-25°C) for up to 24 hours before use if needed.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Neutropenia associated with chemotherapy
Dose summary: 5 mcg/kg subcutaneously once daily, starting 24 hours after chemotherapy.
Renal context: The FDA label for filgrastim (Neupogen) states that in a study of healthy volunteers, patients with moderate renal impairment, and patients with end-stage renal disease, higher serum concentrations were observed with end-stage renal disease, but dose adjustment in patients with renal impairment is not necessary. (2)
Hepatic guidance
The FDA label states that filgrastim pharmacokinetics and pharmacodynamics were similar between patients with hepatic impairment (mild Child-Pugh Class A and moderate Child-Pugh Class B studied) and healthy subjects; dose adjustment for hepatic impairment is not necessary.
Frequently asked questions
What is G-CSF used for?
G-CSF is used to prevent or treat neutropenia (low white blood cell count) in patients undergoing chemotherapy, bone marrow transplantation, or with certain chronic neutropenias.
How is G-CSF administered?
G-CSF is given as a subcutaneous injection (under the skin) or sometimes as an intravenous infusion, usually by a healthcare professional or after proper training.
What are the most common side effects?
The most common side effects are bone pain, muscle aches, headache, and redness or swelling at the injection site.
Can I use G-CSF if I am pregnant or breastfeeding?
Available data have not established an association between G-CSF use in pregnancy and major birth defects or adverse outcomes, and G-CSF is poorly secreted into breast milk. Even so, discuss your individual situation and risks/benefits with your healthcare provider before starting or continuing G-CSF.
How long do I need to take G-CSF?
The duration depends on your condition and response to treatment. It is usually continued until your white blood cell count recovers to a safe level.
What should I do if I experience severe pain or swelling?
Contact your healthcare provider immediately, as this could be a sign of a serious side effect such as splenic rupture or allergic reaction.
Can G-CSF interact with other medications?
Yes, G-CSF can interact with certain medications, especially lithium and other drugs affecting blood cell production. Always inform your doctor about all medicines you are taking.
What happens if I take too much Granulocyte colony-stimulating factor (G-CSF)?
Taking too much G-CSF can lead to an excessive increase in white blood cell counts, potentially causing issues like splenomegaly or acute respiratory distress syndrome. If you suspect an overdose, seek emergency medical attention immediately. Your healthcare provider will monitor your blood counts closely and manage any adverse effects.
Can I drink alcohol while taking Granulocyte colony-stimulating factor (G-CSF)?
While there are no direct contraindications for alcohol consumption with G-CSF, it's generally advisable to limit or avoid alcohol. Alcohol can potentially suppress bone marrow function, which might counteract the effects of G-CSF. Additionally, alcohol can exacerbate some side effects, such as fatigue. Always consult your healthcare provider for personalized advice.
Is Granulocyte colony-stimulating factor (G-CSF) safe during pregnancy?
Published data have not established an association between G-CSF use during pregnancy and major birth defects, miscarriage, or adverse maternal or fetal outcomes. Even so, it is crucial to discuss your pregnancy status and any potential risks with your healthcare provider before starting or continuing G-CSF treatment. They can provide the most appropriate guidance for your specific situation.
What is the mechanism of action of Granulocyte colony-stimulating factor?
G-CSF binds to specific cell surface receptors on hematopoietic cells in the bone marrow, stimulating the proliferation, differentiation, and activation of neutrophil precursors and mature neutrophils. This leads to increased production and release of neutrophils into the bloodstream, enhancing the body's ability to fight infection. (2)
What is the generic name of Granulocyte Colony Stimulating Factor?
The generic name is Granulocyte colony-stimulating factor. It is sold under brand names including Ratiograstim, Zarxio, Lapelga, Nivestym, Zarzio, Releuko.
What class of drug is Granulocyte colony-stimulating factor?
Granulocyte Colony Stimulating Factor is classed as: Hematopoietic growth factor.
References
- Granulocyte colony-stimulating factor (G-CSF) clinician-authored medicine recordMedGuideGlobal Clinician Team · Global (internal) · accessed 2026-08-06 · source 1
- NEUPOGEN (filgrastim) injection, prescribing and consumer labelingU.S. Food and Drug Administration (via DailyMed) · United States · accessed 2026-08-06 · source 2
Brand names by country
Single-ingredient Granulocyte colony-stimulating factor names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
India
- Peg Religrast6 mg/0.6 mL · Reliance Life Science
- Peg Grafeel6 mg/0.6 mL · Dr Reddy's Laboratories Ltd
- Pegasta6 mg/0.6 mL · Intas Pharmaceuticals Ltd