Formulary
Lenograstim: Indications, Dosing, Side Effects and Interactions
For all granulocyte-colony stimulating factors Recombinant human granulocyte-colony stimulating factor (rhG-CSF) stimulates the production of neutrophils.
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Lenograstim: Indications, Dosing, Side Effects and Interactions
For all granulocyte-colony stimulating factors Recombinant human granulocyte-colony stimulating factor (rhG-CSF) stimulates the production of neutrophils.
Drug action
For all granulocyte-colony stimulating factors Recombinant human granulocyte-colony stimulating factor (rhG-CSF) stimulates the production of neutrophils.
Indications and dose
**Reduction in the duration of neutropenia and associated complications following bone-marrow transplantation**
- **Adult** (By Intravenous Infusion, Or By Subcutaneous Injection): for non-myeloid malignancy (specialist use only), Reduction in the duration of neutropenia and associated complications following peripheral stem cells transplantation for non-myeloid malignancy (specialist use only) 150 micrograms/m 2 daily until neutrophil count stable in acceptable range (max. 28 days), to be started the day after transplantation. Intravenous infusion to be given over 30 minutes.
**Reduction in the duration of neutropenia and associated complications following treatment with cytotoxic chemotherapy associated with a significant incidence of febrile neutropenia (specialist use only)**
- **Adult** (By Subcutaneous Injection): 150 micrograms/m 2 daily until neutrophil count stable in acceptable range (max. 28 days), to be started on the day after completion of chemotherapy.
**Mobilisation of peripheral blood progenitor cells**
- **Adult** (By Subcutaneous Injection): for harvesting and subsequent infusion, used alone (specialist use only) 10 micrograms/kg daily for 4-6 days (5-6 days in healthy donors).
**Mobilisation of peripheral blood progenitor cells, used following adjunctive myelosuppressive chemotherapy (to improve yield) (specialist use only)**
- **Adult** (By Subcutaneous Injection): 150 micrograms/m 2 daily until neutrophil count stable in acceptable range, to be started 1-5 days after completion of chemotherapy, for timing of leucopheresis, consult product literature.
**Reduction in the duration of neutropenia and associated complications following bone-marrow transplantation for non-myeloid malignancy (specialist use only), Reduction in the duration of neutropenia and associated complications following peripheral stem cells transplantation for non-myeloid malignancy (specialist use only) for lenograstim**
- **Child 2-17 years** (By intravenous infusion, or by subcutaneous injection): 150 micrograms/m2 daily until neutrophil count stable in acceptable range (max. 28 days), to be started the day after transplantation. Intravenous infusion to be given over 30 minutes.
**Reduction in the duration of neutropenia and associated complications following treatment with cytotoxic chemotherapy associated with a significant incidence of febrile neutropenia (specialist use only) for lenograstim**
- **Child 2-17 years** (By subcutaneous injection): 150 micrograms/m2 daily until neutrophil count stable in acceptable range (max. 28 days), to be started on the day after completion of chemotherapy.
**Mobilisation of peripheral blood progenitor cells for harvesting and subsequent infusion, used alone (specialist use only) for lenograstim**
- **Child 2-17 years** (By subcutaneous injection): 10 micrograms/kg daily for 4-6 days (5-6 days in healthy donors).
**Mobilisation of peripheral blood progenitor cells, used following adjunctive myelosuppressive chemotherapy (to improve yield) (specialist use only) for lenograstim**
- **Child 2-17 years** (By subcutaneous injection): 150 micrograms/m2 daily until neutrophil count stable in acceptable range, to be started 1-5 days after completion of chemotherapy, for timing of leucopheresis, consult product literature.
Cautions
For all granulocyte-colony stimulating factors Malignant myeloid conditions; pre-malignant myeloid conditions; risk of splenomegaly and rupture-spleen size should be monitored; sickle-cell disease Cautions, further information Acute respiratory distress syndrome There have been reports of pulmonary infiltrates leading to acute respiratory distress syndrome-patients with a recent history of pulmonary infiltrates or pneumonia may be at higher risk.
Side effects
For all granulocyte-colony stimulating factors Common or very common Arthralgia; cutaneous vasculitis; dyspnoea; haemoptysis; headache; hypersensitivity; leucocytosis; pain; spleen abnormalities; thrombocytopenia Uncommon Acute febrile neutrophilic dermatosis; capillary leak syndrome; hypoxia; interstitial pneumonia; pulmonary fibrosis; pulmonary oedema; respiratory disorders; sickle cell anaemia with crisis Side-effects, further information Treatment should be withdrawn in patients who develop signs of pulmonary infiltration. Side-effects For lenograstim Common or very common Abdominal pain; asthenia Rare or very rare Erythema nodosum; pyoderma gangrenosum; toxic epidermal necrolysis
Pregnancy
For all granulocyte-colony stimulating factors Manufacturers advise avoid-toxicity in animal studies.
Breast feeding
For all granulocyte-colony stimulating factors There is no evidence for the use of granulocyte-colony stimulating factors during breast-feeding and manufacturers advise avoiding their use.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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