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Pegylated G-CSF

Pegfilgrastim

Brand names: Neulasta, Pelmeg, Ziextenzo, Pelgraz

Pegfilgrastim is a long-acting pegylated granulocyte colony-stimulating factor (G-CSF) used to reduce the duration of neutropenia and incidence of febrile neutropenia after myelosuppressive chemotherapy.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It stimulates proliferation, differentiation and release of neutrophils from the bone marrow by acting on the G-CSF receptor; pegylation prolongs its half-life through reduced renal clearance.

Prescribing in practice

  • It must not be given in the period immediately before or after cytotoxic chemotherapy as this may worsen myelosuppression; observe the recommended interval around chemotherapy dosing.
  • Splenic rupture and capillary leak syndrome are rare but serious; left upper abdominal or shoulder-tip pain should prompt assessment.
  • A single dose is given per chemotherapy cycle by subcutaneous injection in line with the SPC.

Monitoring

Monitor full blood count and watch for splenomegaly, signs of capillary leak syndrome and pulmonary or allergic reactions.

Counselling the patient

  • Explain that bone pain is a common side effect and can usually be managed with simple analgesia.
  • Advise reporting left upper abdominal or shoulder pain, breathlessness or signs of infection promptly.

Evidence & guidelines

Randomised trials support pegfilgrastim given once per cycle as comparable to daily filgrastim for chemotherapy-induced neutropenia.

Reference: ESMO febrile neutropenia guidelines; NICE/SACT protocols; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Pathways