The drug atlas
Haematology/Haematopoietic growth factorslow yield
EPO & G-CSF
also: erythropoietin · epoetin · darbepoetin · filgrastim · G-CSF
Overview
Recombinant growth factors that stimulate red-cell or neutrophil production — renal anaemia and chemotherapy-related cytopenias.
Mechanism
Erythropoietin (epoetin/darbepoetin) stimulates erythroid precursors → ↑red cells (ensure iron-replete first). G-CSF (filgrastim) stimulates neutrophil production/release.
Indications
- Anaemia of CKD (EPO)
- Chemotherapy-induced / febrile neutropenia (G-CSF)
- Stem-cell mobilisation (G-CSF)
The agents
Epoetin / darbepoetin (EPO)erythropoiesis
SC/IV
CKD anaemia; ensure iron replete; target Hb not too high.
Filgrastim (G-CSF)neutrophils
SC
Chemo neutropenia.
Adverse effects
EPO: hypertension, thrombosis, pure red cell aplasia (rare)serious
Don't overshoot Hb (stroke/VTE risk).
G-CSF: bone pain, splenomegalycommon
Cautions & contraindications
EPO with uncontrolled hypertensionall
EPO without iron repletionall
Won't respond.
Interactions
- —
Monitoring & kinetics
EPO: Hb, BP, iron studies; G-CSF: FBC
SC/IV. (Anticoagulants/antiplatelets/heparin/DOACs/warfarin/TXA are in the Cardiovascular section — cross-reference.)
Source: NICE NG8 — CKD anaemia · BNF — Drugs affecting blood