{"id":9108,"date":"2021-03-25T09:54:42","date_gmt":"2021-03-25T09:54:42","guid":{"rendered":"https:\/\/zeepedia.com\/?p=9108"},"modified":"2021-04-12T14:18:25","modified_gmt":"2021-04-12T14:18:25","slug":"fulphila","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/fulphila\/","title":{"rendered":"Fulphila &#8211; Pegfilgrastim uses, dose and side effects"},"content":{"rendered":"\n<p> 6 mg\u00a0solution for injection\u00a0in a pre-filled\u00a0syringe of<br>pegfilgrastim<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">1. What Fulphila is and what it is used for<\/h2>\n\n\n\n<p>Fulphila contains the active substance pegfilgrastim.&nbsp;Pegfilgrastim is a&nbsp;protein&nbsp;that is produced using biotechnology in a&nbsp;bacterium&nbsp;called&nbsp;<em>E. coli<\/em>.&nbsp;It belongs to a group of&nbsp;proteins&nbsp;called&nbsp;cytokines&nbsp;and it is very similar to a natural&nbsp;protein&nbsp;(granulocyte colony-stimulating factor) that is produced in the body.<br><\/p>\n\n\n\n<p>Fulphila is used to reduce the duration of&nbsp;neutropenia&nbsp;(low&nbsp;white blood cell count&nbsp;) and the occurrence of febrile&nbsp;neutropenia&nbsp;(low&nbsp;white blood cell count&nbsp;with concomitant fever) which may be due to the use of&nbsp;cytotoxic&nbsp;chemotherapy&nbsp;(drugs that destroy fast-growing cells).&nbsp;The white&nbsp;blood cells&nbsp;are important because they help your body fight&nbsp;infection.&nbsp;These&nbsp;blood cells&nbsp;are very sensitive to&nbsp;chemotherapy&nbsp;and this treatment can lead to a decrease in their number in the body.&nbsp;About the number of&nbsp;white blood cells drops to a low level, there may not be enough left in the body to fight bacteria, and then you may become more susceptible to&nbsp;infection.<\/p>\n\n\n\n<p>Your doctor has given you Fulphila to help your&nbsp;bone marrow&nbsp;(the part of the skeleton where&nbsp;blood cells&nbsp;are formed) to form more&nbsp;white blood cells&nbsp;that help your body fight&nbsp;infection.<br><\/p>\n\n\n\n<p>Fulphila is intended for adults who are 18 years or older.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">2. What you need to know before using Fulphila<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Do not use Fulphila<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>if you are allergic to pegfilgrastim, filgrastim, or any of the other ingredients of this medicine (listed in section 6).<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Warnings and cautions<\/h2>\n\n\n\n<p>Talk to your doctor, pharmacist, or nurse before using Fulphila:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you suffer from an&nbsp;allergic reaction, which may manifest as a feeling of weakness, drop in blood pressure, difficulty breathing, swelling of the face (&nbsp;anaphylaxis&nbsp;),&nbsp;redness&nbsp;and swelling, rash, and areas of skin with&nbsp;itching.<\/li><li>if you have a cough, fever, and difficulty breathing.&nbsp;This may be a sign of&nbsp;acute&nbsp;respiratory distress syndrome.<\/li><li>if you experience any of the following side effects: swelling or fluid retention, which may occur while urinating less frequently than usual, difficulty breathing;&nbsp;swollen abdomen and a feeling of satiety;&nbsp;general feeling of tiredness. This can be a symptom of a condition called capillary leakage syndrome, which causes blood to leak from the small blood vessels.&nbsp;See section 4.<\/li><li>if you experience pain in the upper abdomen on the left side of the tip of the left shoulder blade.&nbsp;This may be a sign of&nbsp;splenomegaly.<\/li><li>if you have recently had a serious lung infection (&nbsp;pneumonia&nbsp;), fluid in the lungs (&nbsp;pulmonary edema&nbsp;),&nbsp;inflammation&nbsp;of the lungs (interstitial lung disease), or abnormal chest X-ray results (lung infiltration).<\/li><li>if you know you have altered&nbsp;blood cell count&nbsp;(eg increased&nbsp;white blood cell count&nbsp;or&nbsp;anemia&nbsp;) or decreased&nbsp;platelet count, which reduces the blood&#8217;s ability to clot (&nbsp;thrombocytopenia&nbsp;).&nbsp;Your doctor may want to check this more often than usual.<\/li><li>if you have&nbsp;sickle cell anemia.&nbsp;Your doctor may want to check this more often than usual.<\/li><li>if you experience sudden signs of&nbsp;allergy, such as a rash,&nbsp;itching&nbsp;or&nbsp;hives, swelling of the face, lips, tongue, or other parts of the body, shortness of breath, wheezing, or difficulty breathing.&nbsp;These may be signs of a severe&nbsp;allergic reaction.<\/li><li>Inflammation&nbsp;of the carotid artery (the large blood vessel that carries blood from the heart to the body) has been reported with the frequency &#8220;rare&#8221; in cancer patients and healthy donors.&nbsp;Symptoms may include fever, abdominal pain, malaise, back pain, and increased inflammatory markers.&nbsp;Tell your doctor if you experience these symptoms.<\/li><\/ul>\n\n\n\n<p>You will be given regular blood and urine samples as Fulphila can damage the small filters in your kidneys (&nbsp;glomerulonephritis&nbsp;).<br><\/p>\n\n\n\n<p>Severe skin reactions (&nbsp;Stevens-Johnson syndrome&nbsp;) have been reported with pegfilgrastim.&nbsp;Stop using Fulphila and seek medical attention immediately if you notice any of the symptoms described in section 4.<br><\/p>\n\n\n\n<p>Talk to your doctor about the risk of developing blood cancer.&nbsp;If you develop or are at high risk of developing blood cancer, do not use Fulphila unless your doctor tells you to.<br><\/p>\n\n\n\n<p><strong>Impaired treatment response to Fulphila<\/strong><\/p>\n\n\n\n<p>If you stop responding to treatment with pegfilgrastim or if the response to treatment decreases, your doctor will investigate the reasons for this.&nbsp;Your doctor will, among other things, check if you have developed&nbsp;antibodies&nbsp;that neutralize the activity of pegfilgrastim.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Children and young people<\/h2>\n\n\n\n<p>Fulphila is not recommended for use in children and adolescents due to insufficient data on safety and efficacy.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other drugs and Fulphila<\/h2>\n\n\n\n<p>Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy, breastfeeding, and fertility<\/h2>\n\n\n\n<p>If you are pregnant or breast-feeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.<br><\/p>\n\n\n\n<p>Fulphila has not been tested in pregnant women.&nbsp;Your doctor may therefore decide not to use this medicine.<br><\/p>\n\n\n\n<p>If you become pregnant during treatment with Fulphila, talk to your doctor.<br><\/p>\n\n\n\n<p>If you do not receive any other instructions from your doctor, you must stop breast-feeding if you are taking Fulphila<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Fulphila contains sorbitol and sodium acetate<\/h2>\n\n\n\n<p>Fulphila has no or negligible effect on the ability to drive and use machines.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Fulphila contains excipients<\/h2>\n\n\n\n<p>This medicine contains 30 mg sorbitol in each prefilled&nbsp;syringe&nbsp;equivalent to 50 mg\/ml.<br><\/p>\n\n\n\n<p>This medicine contains less than 1 mmol (23 mg)&nbsp;sodium&nbsp;per&nbsp;dose, ie essentially &#8216;sodium-free&#8217;.<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">3. How to use Fulphila<\/h2>\n\n\n\n<p>Always use this medicine exactly as your doctor has told you.&nbsp;Ask your doctor or pharmacist if you are unsure.<br><\/p>\n\n\n\n<p>The recommended&nbsp;dose&nbsp;is a 6 mg&nbsp;subcutaneous&nbsp;injection&nbsp;(&nbsp;injection&nbsp;under the skin) with a pre-filled&nbsp;syringe.&nbsp;Dose&nbsp;one should be given at least 24 hours after your last&nbsp;dose&nbsp;of&nbsp;chemotherapy&nbsp;at the end of each chemotherapy cycle.<br><\/p>\n\n\n\n<p>Do not shake Fulphila vigorously as this may affect its effect.<br><\/p>\n\n\n\n<p><strong>How to give yourself&nbsp;the injection&nbsp;with Fulphila<\/strong><\/p>\n\n\n\n<p>Your doctor may decide that you should inject Fulphila yourself.&nbsp;Your doctor or nurse will show you how to&nbsp;inject&nbsp;yourself.&nbsp;Do not try to inject yourself if your doctor or nurse has not shown you how to do it.<\/p>\n\n\n\n<p>For more information on how to give yourself&nbsp;the injection&nbsp;you with Fulphila at the end of this leaflet.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you use more Fulphila then you should&nbsp;<\/h2>\n\n\n\n<p>If you take more Fulphila then you should contact a doctor, pharmacist, or nurse.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you forget to use Fulphila<\/h2>\n\n\n\n<p>If you have missed your&nbsp;dose&nbsp;of Fulphila, you should contact your doctor to discuss when you should inject the next&nbsp;dose.<br><\/p>\n\n\n\n<p>If you have any further questions on the use of this product, ask your doctor, pharmacist, or nurse.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">4. Possible side effects<\/h2>\n\n\n\n<p>Like all medicines, this medicine can cause&nbsp;side effects, although not everybody gets them.<br><\/p>\n\n\n\n<p>If you get any of these&nbsp;side effects,&nbsp;talk to your doctor straight away:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>swelling or fluid retention, which may occur while urinating less frequently than usual, difficulty breathing, a swollen abdomen and a feeling of satiety, and a general feeling of tiredness.&nbsp;These symptoms often develop rapidly.<\/li><\/ul>\n\n\n\n<p>These symptoms may be signs of a less common condition (may affect up to 1 in 100 people) called capillary leakage syndrome, which causes blood to leak from small blood vessels into the body.&nbsp;This condition must be treated immediately.<br><\/p>\n\n\n\n<p><strong>A very common&nbsp;side effect&nbsp;is<\/strong>&nbsp;(can occur in more than 1 in 10)<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>skeletal pain.&nbsp;Your doctor may recommend what you can take to relieve skeletal pain.<\/li><li>headache and nausea.<\/li><\/ul>\n\n\n\n<p><strong>Common&nbsp;side effects&nbsp;are<\/strong>&nbsp;(may affect up to 1 in 10)<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>injection site pain.<\/li><li>general joint and muscle pain.<\/li><li>some changes in blood values \u200b\u200bmay occur, but these are detected during routine blood tests.&nbsp;Your&nbsp;white blood cells&nbsp;may increase for a limited period of time.&nbsp;The number of&nbsp;platelets&nbsp;can decrease which can lead to bruising.<\/li><li>chest pain.<\/li><\/ul>\n\n\n\n<p><strong>Less common&nbsp;side effects&nbsp;are<\/strong>&nbsp;(may affect up to 1 in 100)<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>allergy-like reactions, including&nbsp;redness&nbsp;and swelling, rash, and raised itchy skin areas.<\/li><li>severe allergic reactions, including&nbsp;anaphylaxis&nbsp;(weakness, drop in blood pressure, difficulty breathing, swelling of the face).<\/li><li>sickle cell crisis in patients with&nbsp;sickle cell anemia.<\/li><li>increased spleen size.<\/li><li>anthrax.&nbsp;Some cases of anthrax were fatal.&nbsp;You must contact your doctor immediately if you experience pain in the upper left side of the abdomen or up against the left shoulder, as this may indicate problems with the spleen.<\/li><li>breathing problems.&nbsp;If you have a cough, fever, and difficulty breathing, consult a doctor.<\/li><li>Sweet&#8217;s syndrome (plum-colored, raised, painful skin changes on the arms and legs and sometimes on the face and neck with fever) have occurred, but other factors may be important.<\/li><li>cutaneous&nbsp;vasculitis&nbsp;(&nbsp;inflammation&nbsp;of the blood vessels of the skin).<\/li><li>damage to the small filters in the kidneys (&nbsp;glomerulonephritis&nbsp;).<\/li><li>redness&nbsp;at the injection site.<\/li><li>hemorrhages (hemoptysis).<\/li><\/ul>\n\n\n\n<p><strong>Rare&nbsp;side effects&nbsp;are<\/strong>&nbsp;(may affect up to 1 in 1000 users)<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>inflammation&nbsp;of the carotid artery (the large blood vessel that carries blood from the heart to the body), see section 2.<\/li><li>bleeding from the lungs (&nbsp;pulmonary&nbsp;hemorrhage).<\/li><li>Stevens-Johnson syndrome&nbsp;can begin as reddish target-like or round spots on the torso, often with blisters in the middle.&nbsp;Skin peeling and sores in the mouth, throat, nose, genitals, and eyes may also occur.&nbsp;These reactions are often preceded by fever and&nbsp;flu-like symptoms.&nbsp;If you develop any of these symptoms, stop using Fulphila and contact your doctor immediately or seek medical attention.&nbsp;See also section 2.<br><\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">5. How to store Fulphila<\/h2>\n\n\n\n<p>Keep this medicine out of the sight and reach of children.<br><\/p>\n\n\n\n<p>Do not use this medicine after the expiry date which is stated on the carton, blister, and syringe label after EXP.&nbsp;The expiration date is the last day of the specified month.<br><\/p>\n\n\n\n<p>Store in a refrigerator (2 \u00b0 C &#8211; 8 \u00b0 C).<br><\/p>\n\n\n\n<p>Do not freeze.&nbsp;Fulphila can be used if the solution has been inadvertently frozen for less than 24 hours at a time.<br><\/p>\n\n\n\n<p>Store the packaging in the outer carton.&nbsp;Sensitive to light.<br><\/p>\n\n\n\n<p>You can remove Fulphila from the refrigerator and store it at room temperature (maximum 30 \u00b0 C) for a maximum of 3 days.&nbsp;Once a&nbsp;syringe&nbsp;has been removed from the refrigerator and reached room temperature (maximum 30 \u00b0 C), it must be used within 3 days or discarded.<br><\/p>\n\n\n\n<p>Do not use this medicine if it is cloudy or contains particles.<br><\/p>\n\n\n\n<p>Medicines should not be disposed of via wastewater or household waste.&nbsp;Ask your pharmacist how to dispose of medicines no longer required.&nbsp;These measures will help to protect the environment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">6. Contents of the packaging and other information<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Content declaration<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>The active substance is pegfilgrastim.&nbsp;Each pre-filled&nbsp;syringe&nbsp;contains 6 mg of pegfilgrastim in 0.6 ml solution.<\/li><li>The other ingredients are sodium acetate, sorbitol (E420), polysorbate 20, and water for injections.&nbsp;See section 2 &#8220;Fulphila contains sorbitol and sodium acetate&#8221;.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">What the medicine looks like and the contents of the pack<\/h2>\n\n\n\n<p>Fulphila is a clear, colorless&nbsp;solution for injection&nbsp;in a pre-filled&nbsp;glass&nbsp;syringe&nbsp;with a stainless steel needle and needle sleeve.&nbsp;The syringe is delivered in a blister pack.&nbsp;The syringe comes with an automatic needle guard.<\/p>\n\n\n\n<p>Each pack contains 1 pre-filled&nbsp;glass&nbsp;syringe.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorisation Holder<\/h2>\n\n\n\n<p>Mylan SAS<\/p>\n\n\n\n<p>117 All\u00e9e des Parcs<\/p>\n\n\n\n<p>69800 Saint \u2011 Priest<\/p>\n\n\n\n<p>France<br><\/p>\n\n\n\n<p><strong>Manufacturer<\/strong><\/p>\n\n\n\n<p>McDermott Laboratories to Mylan Dublin Biologics<\/p>\n\n\n\n<p>Newenham Court, Northern Cross, Malahide Road<\/p>\n\n\n\n<p>17 Dublin<\/p>\n\n\n\n<p>Ireland<br><\/p>\n\n\n\n<p>Contact the representative of the marketing authorization holder to find out more about this medicine:<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>Belgium \/ Belgique \/ Belgien<\/strong>Mylan EPD bvba \/ sprlTel: + 32 (0) 2 658 61 00<\/td><td><strong>Lithuania<\/strong>BGP Products UABTel: +370 5 205 1288<\/td><\/tr><tr><td><strong>Bulgaria<\/strong>\u041c\u0430\u0439\u043b\u0430\u043d \u0415\u041e\u041e\u0414Tel: +359 2 44 55 400<\/td><td><strong>Luxembourg \/ Luxemburg<\/strong>Mylan EPD bvba \/ sprlTel: + 32 (0) 2 658 61 00(Belgium \/ Belgium)<\/td><\/tr><tr><td><strong>Czech Republic<\/strong>Mylan Pharmaceuticals.sroTel: + 420 222 004 400<\/td><td><strong>Hungary<\/strong>Mylan EPD KftTel: + 36 1 465 2100<\/td><\/tr><tr><td><strong>Denmark<\/strong>Mylan Denmark ApSTel: + 45 28116932<\/td><td><strong>Malta<\/strong>VJ Salomone Pharma LtdTel: + 356 21 22 01 74<\/td><\/tr><tr><td><strong>Germany<\/strong>Mylan Healthcare GmbHTel: + 49\u2011 (0) 511 475 43 400<\/td><td><strong>The Netherlands<\/strong>Mylan Healthcare BVTel: +31 (0) 20 426 3300<\/td><\/tr><tr><td><strong>Eesti<\/strong>BGP Products Switzerland GmbH Eesti subsidiaryTel: + 372 6363 052<\/td><td><strong>Norway<\/strong>Mylan Healthcare Norge ASTel: + 47 66 75 33 00<\/td><\/tr><tr><td><strong>Greece<\/strong>BGP \u03a0\u03a1\u039f\u03aa\u039f\u039d\u03a4\u0391 \u039c.\u0395.\u03a0.\u0395.:\u0397\u03bb: +30 210 9891 777<\/td><td><strong>Austria<\/strong>Mylan \u00d6sterreich GmbHTel: +43 1 86390<\/td><\/tr><tr><td><strong>Spain<\/strong>Mylan Pharmaceuticals, SLTel: + 34 900 102 712<\/td><td><strong>Poland<\/strong>Mylan Healthcare Sp.&nbsp;ZooTel: + 48 22 546 64 00<\/td><\/tr><tr><td><strong>France<\/strong>Mylan Medical SASTel: +33 1 56 64 10 70<\/td><td><strong>Portugal<\/strong>Mylan, Lda.Tel: + 351 21 412 72 56<\/td><\/tr><tr><td><strong>Croatia<\/strong>Mylan Hrvatska dooTel: +385 1 23 50 599<\/td><td><strong>Romania<\/strong>BGP Products SRLTel: + 40 372 579 000<\/td><\/tr><tr><td><strong>Ireland<\/strong>Mylan IrelandTel: +353 (0) 87 1694982<\/td><td><strong>Slovenia<\/strong>GSP Proizvodi dooTel: + 386 1 236 31 85<\/td><\/tr><tr><td><strong>Iceland<\/strong>BGP Products ApSTel: +45 28116932(Denmark)<\/td><td><strong>Slovak Republic<\/strong>Mylan sroTel: +421 2 32 199 100<\/td><\/tr><tr><td><strong>Italy<\/strong>Mylan SpATel: + 39 02 612 46921<\/td><td><strong>Finland \/ Finland<\/strong>Mylan Finland OYPuh \/ Tel: +358 20 720 9555<\/td><\/tr><tr><td><strong>Latvia<\/strong>BGP Products SIATel: +371 676 055 80<\/td><td><strong>United Kingdom<\/strong>Generics [UK] LtdTel: +44 1707 853000<\/td><\/tr><\/tbody><\/table><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>6 mg solution for injection in a pre-filled syringe of<br \/>\npegfilgrastim<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2206,2200],"tags":[2270,2271,2215,2216,2212,2213,2393,2395,2396,2394,2272],"class_list":["post-9108","post","type-post","status-publish","format-standard","hentry","category-f","category-medicines","tag-fulphila","tag-how-to-use-fulphila","tag-injection","tag-injections","tag-medicine","tag-medicines","tag-pegfilgrastim","tag-pegfilgrastim-doses","tag-pegfilgrastim-side-effects","tag-pegfilgrastim-uses","tag-side-effects-of-fulphila"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/9108","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=9108"}],"version-history":[{"count":8,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/9108\/revisions"}],"predecessor-version":[{"id":9954,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/9108\/revisions\/9954"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=9108"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=9108"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=9108"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}