Limited coverage criteria – filgrastim
Last updated on March 19, 2025
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Generic name |
filgrastim | |
Brand name |
Strength |
Form |
| Grastofil® | 300 mcg/0.5 mL 480 mcg/0.8 mL |
pre-filled syringe |
| Nivestym® | 300 mcg/0.5 mL 480 mcg/0.8 mL |
pre-filled syringe |
| 300 mcg/1 mL 480 mcg/1.6 mL |
single-use vial | |
| Nypozi® | 300 mcg/0.5 mL 480 mcg/0.8 mL |
pre-filled syringe |
Special Authority criteria |
Approval period |
|---|---|
|
For primary prophylaxis of febrile neutropenia in cancer patients receiving potentially curative myelosuppressive chemotherapy regimens where the risk of febrile neutropenia is ≥ 20% |
6 months |
| For secondary prophylaxis of febrile neutropenia in cancer patients receiving potentially curative myelosuppressive chemotherapy | 6 months |
| For the rescue of prolonged febrile neutropenia following chemotherapy | 6 months |
| For cancer patients undergoing peripheral blood progenitor cell collection and therapy | 6 months |
| For post–bone marrow transplant patients to stimulate bone marrow engraftment (start greater than or equal to d+1) | 6 months |
| For post–bone marrow transplant patients requiring rescue of failure to engraft (start greater than or equal to d+14) | 6 months |
|
For patients with the following benign disorders:
|
6 months |
Practitioner exemptions
- None
Special notes
- For coverage for HIV-infected patients, please contact BC Centre for Excellence in HIV/AIDS