| Hematopoietic subsyndrome of acute radiation syndrome

Neupogen vs Leukine

Side-by-side clinical, coverage, and cost comparison for hematopoietic subsyndrome of acute radiation syndrome.

Deep comparison between: Neupogen vs Leukine with Prescriber.AI

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Safety signalsLeukine has a higher rate of injection site reactions vs Neupogen based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Leukine but not Neupogen, including UnitedHealthcare

Category

Neupogen

Leukine

At A Glance

RouteSC injection

FrequencyDaily

ClassG-CSF

RouteIV infusion or SC injection

FrequencyOnce daily

ClassGM-CSF

Indications

Febrile Neutropenia
Leukemia, Myelocytic, Acute
Neutropenia
Severe congenital neutropenia
Cyclic neutropenia
Idiopathic neutropenia
Hematopoietic subsyndrome of acute radiation syndrome

Leukemia, Myelocytic, Acute
Lymphoma, Non-Hodgkin
Acute lymphocytic leukemia
Hodgkin Disease
Hematopoietic subsyndrome of acute radiation syndrome

Dosing

Febrile Neutropenia, Leukemia, Myelocytic, Acute 5 mcg/kg/day SC injection, short IV infusion (15-30 min), or continuous IV infusion; administer at least 24 hours after cytotoxic chemotherapy.

Neutropenia (bone marrow transplantation) 10 mcg/kg/day IV infusion no longer than 24 hours; administer at least 24 hours after cytotoxic chemotherapy and bone marrow infusion.

Autologous PBPC collection 10 mcg/kg/day SC injection; administer for at least 4 days before first leukapheresis and continue until last leukapheresis.

Severe congenital neutropenia 6 mcg/kg SC injection twice daily.

Cyclic neutropenia, Idiopathic neutropenia 5 mcg/kg SC injection daily.

Hematopoietic subsyndrome of acute radiation syndrome 10 mcg/kg/day SC injection; administer as soon as possible after suspected or confirmed exposure to radiation doses >2 Gy.

Leukemia, Myelocytic, Acute 250 mcg/m2/day IV over a 4-hour period starting day 11 or four days after induction chemotherapy completion; continue until ANC >1500 cells/mm3 for 3 consecutive days or up to 42 days.

Lymphoma, Non-Hodgkin, Acute lymphocytic leukemia, Hodgkin Disease 250 mcg/m2/day IV over 24 hours or SC once daily beginning immediately following progenitor cell infusion; continue until ANC >1500 cells/mm3 for three consecutive days.

Autologous or allogeneic bone marrow transplantation 250 mcg/m2/day IV over a 2-hour period beginning 2-4 hours after bone marrow infusion; continue until ANC >1500 cells/mm3 for three consecutive days.

Delayed neutrophil recovery or graft failure 250 mcg/m2/day for 14 days as a 2-hour IV infusion; may repeat after 7 days off therapy if neutrophil recovery has not occurred, up to three courses.

Hematopoietic subsyndrome of acute radiation syndrome SC injection once daily: 7 mcg/kg for adults and pediatric patients >40 kg, 10 mcg/kg for pediatric patients 15-40 kg, 12 mcg/kg for pediatric patients <15 kg; continue until ANC >1000/mm3 for three consecutive CBCs.

Contraindications

History of serious allergic reactions to human granulocyte colony-stimulating factors such as filgrastim or pegfilgrastim

History of serious allergic reactions, including anaphylaxis, to sargramostim, yeast-derived products, or any component of the product

Drug Interactions

824View drug interactions

5View drug interactions

Adverse Reactions

Most common (>=5%) Pyrexia, nausea, fatigue, thrombocytopenia, bone pain, back pain, rash, dizziness, cough, dyspnea, chest pain, arthralgia

Serious Splenic rupture, acute respiratory distress syndrome, serious allergic reactions, sickle cell disorders, glomerulonephritis, alveolar hemorrhage and hemoptysis, capillary leak syndrome, myelodysplastic syndrome, acute myeloid leukemia, thrombocytopenia, leukocytosis, cutaneous vasculitis, aortitis

Postmarketing Splenic rupture, splenomegaly, anaphylaxis, sickle cell disorders, glomerulonephritis, alveolar hemorrhage and hemoptysis, capillary leak syndrome, leukocytosis, cutaneous vasculitis, Sweet's syndrome, decreased bone density and osteoporosis, myelodysplastic syndrome, acute myeloid leukemia, aortitis, extramedullary hematopoiesis

Most common (>=10%) Fever, nausea, diarrhea, vomiting, rash, alopecia, stomatitis, asthenia, malaise, anorexia, edema, headache, chills, peripheral edema, dyspnea

Serious Hypersensitivity and anaphylaxis, infusion-related reactions, severe myelosuppression, effusions, capillary leak syndrome, supraventricular arrhythmias, leukocytosis

Postmarketing Infusion-related reactions, serious allergic reactions including anaphylaxis, effusions, capillary leak syndrome, supraventricular arrhythmias, leukocytosis including eosinophilia, thromboembolic events, injection site reactions

Pharmacology

Filgrastim is a recombinant human G-CSF that binds to specific cell surface receptors on hematopoietic cells, stimulating neutrophil progenitor proliferation and differentiation and enhancing end-cell functional activities including phagocytic ability, respiratory burst priming, and antibody-dependent killing.

Sargramostim (GM-CSF) is a colony-stimulating factor that supports survival, clonal expansion, and differentiation of hematopoietic progenitor cells, inducing partially committed progenitors to divide and differentiate into granulocyte-macrophage pathways including neutrophils, monocytes/macrophages, and myeloid-derived dendritic cells; it can also activate mature granulocytes and macrophages and promote proliferation of megakaryocytic and erythroid progenitors.

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Most Common Insurance

Anthem BCBS

Neupogen