Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Pegfilgrastim
Drug ID BADD_D01693
Description Pegfilgrastim is a PEGylated form of the recombinant human granulocyte colony-stimulating factor (G-CSF) analogue, [filgrastim].[A187601] It is used to decrease the incidence of infection, as manifested by febrile neutropenia, in patients with with non-myeloid cancer receiving myelosuppressive anti-cancer treatment. Some patients with greater risk factors may develop febrile neutropenia from myelosuppressive therapy and are susceptible to an increased risk of developing infections. Although the risk of developing febrile neutropenia is less than 20% in many readily used chemotherapy regimens,[L9782] infections pose risks of hospitalization and mortalities.[A187631] Due to the relatively short circulating half-life of filgrastim, a 20 kDa PEG moiety was covalently conjugated to the N-terminus of filgrastim (at the methionine residue) to develop a longer acting version of the drug.[A29, A187607] Due to a longer half-life and slower elimination rate than filgrastim, pegfilgrastim requires less frequent dosing than filgrastim. However, pegfilgrastim retains the same biological activity as filgrastim and binds to the same G-CSF receptor to stimulate the proliferation, differentiation, and activation of neutrophils.[A187607] First developed by Amgen, pegfilgrastim was initially approved by the FDA in 2002 and marketed as Neulasta®. It is typically administered via a subcutaneous injection. There are several pegfilgrastim biosimilars (Fulphila®, Pelgraz® or Lapelga®, Pelmeg®, Udenyca®, Ziextenzo®, and Grasustek®) that are approved for the same therapeutic indication by Health Canada, European Union (EU), and FDA.[L9779,L9785] These biosimilars are highly similar to the reference product, Neulasta®, in terms of pharmacological and pharmacokinetic profile and condition(s) of use, such as the therapeutic indication(s), dosing regimen(s), strength(s), dosage form(s), and route(s) of administration.[L9974]
Indications and Usage Pegfilgrastim is indicated to decrease the incidence of infection, as manifested by febrile neutropenia, in patients with non­ myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a clinically significant incidence of febrile neutropenia.[L9746] It is also indicated to increase survival in patients acutely exposed to myelosuppressive doses of radiation (Hematopoietic Subsyndrome of Acute Radiation Syndrome).[L9746]
Marketing Status approved
ATC Code L03AA13
DrugBank ID DB00019
KEGG ID D06889
MeSH ID C455861
PubChem ID 70683024
TTD Drug ID D0AT8C
NDC Product Code 55513-192; 67457-833; 55513-190; 70121-1627
UNII 3A58010674
Synonyms pegfilgrastim | SD-01, polyethylene glycol-conjugated filgrastim | PEG-rmetHuG-CSF | SD-01-filgrastim | N-(3-hydroxypropyl)methionylcolony-stimulating factor (human), 1-ether with alpha-methyl-omega-hydroxypoly(oxyethylene) | PEG SD-01 | LA-EP2006 | XM22 | XM-22 | lipegfilgrastim | Neulasta
Chemical Information
Molecular Formula C27H46N4O19
CAS Registry Number 208265-92-3
SMILES CC(C(C(=O)O)N)OC1C(C(C(C(O1)COC2(CC(C(C(O2)C(C(CO)O)O)NC(=O)CNC(=O)OCCOC)O)C(=O) O)O)O)NC(=O)C
Chemical Structure
ADRs Induced by Drug
*The priority for ADR severity classification is based on FAERS assessment, followed by the most severe level in CTCAE rating. If neither is available, it will be displayed as 'Not available'.
**The 'Not Available' level is hidden by default and can be restored by clicking on the legend twice.
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Acute febrile neutrophilic dermatosis01.02.01.006; 23.03.03.033---
Acute respiratory distress syndrome10.02.01.067; 22.01.03.001; 24.03.02.034--
Anaphylactic reaction10.01.07.001; 24.06.03.006--
Angioedema10.01.05.009; 22.04.02.008; 23.04.01.001---
Blood lactate dehydrogenase increased13.04.02.002--
Bone pain15.02.01.001--
Chest pain02.02.02.011; 08.01.08.002; 22.12.02.003---
Cutaneous vasculitis10.02.02.003; 23.06.02.001; 24.12.04.008---
Dermatitis23.03.04.002---
Erythema23.03.06.001---
Flushing08.01.03.025; 23.06.05.003; 24.03.01.002--
Headache17.14.01.001--
Hypersensitivity10.01.03.003--
Hypokalaemia14.05.03.002--
Immune system disorder10.02.01.001---
Injection site induration08.02.03.007; 12.07.03.007---
Injection site pain08.02.03.010; 12.07.03.011---
Injection site reaction08.02.03.014; 12.07.03.015--
Interstitial lung disease10.02.01.033; 22.01.02.003---
Leukocytosis01.02.01.002--
Lung infiltration22.01.02.004---
Musculoskeletal pain15.03.04.007--
Myalgia15.05.02.001--
Nervous system disorder17.02.10.001---
Pain in extremity15.03.04.010--
Pulmonary fibrosis22.01.02.006--
Pulmonary oedema02.05.02.003; 22.01.03.003--
Rash23.03.13.001---
Respiratory failure14.01.04.003; 22.02.06.002--
Sickle cell anaemia with crisis01.04.02.001---
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