Before attempting self-administration of filgrastim, it is essential to receive training from a healthcare professional, such as a nurse or doctor. This ensures you fully understand the process, including dose measurement and safety precautions. Always use this medication exactly as directed by your doctor.
Before you begin
Gather your supplies
Gather all necessary items and place them on a clean, flat, and well-lit surface. The materials you will need include:
- Your filgrastim prefilled syringe or vial
- One or two alcohol wipes
- A cotton ball or gauze pad
- An adhesive bandage
- A puncture-resistant sharps disposal container
- If using a vial, you will also need a separate sterile disposable syringe and needle.
Prepare the syringe or vial
Proper preparation is key to a smooth and safe injection. Follow these steps carefully:
- Allow to warm: Remove the filgrastim from the refrigerator approximately 30 minutes before the planned injection to allow it to reach room temperature. This can help reduce injection site discomfort. Do not use external heat sources like hot water or a microwave to warm it.
- Inspect the medication: Before use, inspect the liquid in the syringe or vial. It should be clear and colorless. Do not use it if it appears cloudy, discolored, or contains particles or flakes.
- Check date and dose: Verify that the name and dose on the package match your prescription. Also, check the expiration date and do not use the medication if it has expired.
- Do not shake: Never shake the syringe or vial. Shaking can damage the medication, causing it to look foamy.
- Expel air (if needed): For prefilled syringes, hold the syringe with the needle pointing up and gently tap the side to encourage any air bubbles to rise. Push the plunger slowly to remove the air without pushing out any medication. If using a vial, your healthcare provider will instruct you on the proper technique for drawing the dose and removing air bubbles.
Performing the injection
Choose and prepare the injection site
Selecting a new site for each injection helps prevent soreness and the formation of scar tissue, which can interfere with medication absorption. Suitable areas for subcutaneous injection include:
- The front of your upper arms (if someone else is giving the injection)
- Your abdomen (stomach), at least 2 inches away from the navel
- The middle front or middle outside of your thighs
- The upper areas of your buttocks (if someone else is giving the injection)
After selecting a clean area, use a fresh alcohol wipe to clean the skin in a circular motion, moving outward from the center. Allow the area to air dry completely before injecting. Do not touch the cleaned site again.
Inject the medication
- Wash your hands: Wash your hands thoroughly with soap and water.
- Remove the cap: Carefully pull the needle cap straight off the syringe. Do not replace the cap once removed.
- Pinch the skin: With your non-dominant hand, gently pinch a 1-to-2-inch fold of skin at the prepared injection site.
- Insert the needle: In one smooth, quick motion, insert the entire needle straight down into the pinched skin fold at a 45- to 90-degree angle.
- Inject the medication: Release the pinched skin and use your thumb to slowly push the plunger all the way down until all the medication is injected.
- Withdraw the needle: Pull the syringe straight out of your skin.
Post-injection steps
- Apply pressure: Place a cotton ball or gauze pad over the injection site and press gently for a few seconds. Do not rub the area.
- Engage safety guard: If your syringe has a safety guard, follow the manufacturer's instructions to properly activate it until you hear a click. This covers the needle and prevents accidental needle-sticks.
- Dispose safely: Immediately place the used syringe and any other sharp materials into your sharps disposal container. Never recap the needle or throw it in the regular trash.
Important safety considerations
- Timing with chemotherapy: Filgrastim should be administered at least 24 hours after chemotherapy. Do not use it within 24 hours before your next chemotherapy dose.
- Latex allergy: Some syringe needle caps contain natural rubber latex. Inform your doctor if you have a latex allergy so they can ensure you receive a safe alternative.
- Side effects: The most common side effect is bone pain, which can often be managed with over-the-counter pain relievers as advised by your doctor. Serious side effects, though rare, include splenic rupture, allergic reactions, or trouble breathing. Report any severe or unusual symptoms to your healthcare provider immediately.
- Hydration: Drink plenty of fluids during your treatment with filgrastim.
Filgrastim vs. Pegfilgrastim: A comparison
While filgrastim (e.g., Neupogen, Zarxio, Nivestym) is a daily injection, a modified version, pegfilgrastim (Neulasta), offers a longer-acting effect with different administration frequency. It is crucial to use the medication prescribed for your specific needs.
| Feature | Filgrastim (e.g., Neupogen) | Pegfilgrastim (Neulasta) |
|---|---|---|
| Mechanism | Short-acting G-CSF | Long-acting (pegylated) G-CSF |
| Administration frequency | Once daily for several days | Single dose per chemotherapy cycle |
| Injection timing | At least 24 hours after chemo | At least 24 hours after chemo and 14 days before next chemo |
| Patient convenience | Requires multiple daily injections | One-time injection per cycle is more convenient |
Conclusion
Administering a filgrastim injection safely at home involves careful preparation, correct technique, and proper disposal of materials. By following these detailed steps, and adhering to the personalized instructions from your healthcare team, you can effectively manage your treatment. Regular monitoring with your doctor is essential to ensure the medication works as intended and to address any concerns. Always consult your healthcare provider with any questions, and never hesitate to seek help for serious side effects.
