Name of the Procedure:

Injection, filgrastim-sndz, biosimilar, (Zarxio), 1 microgram
Common name(s): Zarxio injection, Filgrastim biosimilar injection
Technical/medical terms: Filgrastim-sndz injection

Summary

Zarxio is an injectable medication designed to support the immune system by increasing the production of white blood cells. This helps reduce the risk of infection in patients who have weakened immune systems due to chemotherapy or other medical conditions.

Purpose

Medical Conditions or Problems Addressed:

• Neutropenia (a low count of neutrophils, a type of white blood cell)
• Patients undergoing chemotherapy
• Bone marrow transplantation patients
• Patients with chronic neutropenia

Goals or Expected Outcomes:

• Increase levels of white blood cells (WBCs) to reduce the risk of infections.
• Support the immune system’s ability to fight off infections.

Indications

Specific Symptoms or Conditions:

• Low neutrophil counts post-chemotherapy
• Chronic neutropenia
• Patients receiving a bone marrow transplant

Patient Criteria:

• Confirmed diagnosis of neutropenia
• Undergoing treatments that lead to a decreased WBC count, like chemotherapy

Preparation

Pre-procedure Instructions:

• There are no specific fasting requirements.
• Inform the healthcare provider of any current medications or allergies.

Diagnostic Tests or Assessments:

• Complete Blood Count (CBC) to establish current WBC levels.

Procedure Description

1. Preparation: The patient's skin is cleaned at the injection site to prevent infection.
2. Injection: The filgrastim-sndz (Zarxio) is drawn from its vial and injected subcutaneously (under the skin) using a sterile syringe.
3. Monitoring: The patient may be observed for a short period post-injection to monitor for any immediate adverse reactions.

Tools, Equipment, Technology Used:

• Sterile syringe and needle
• Antiseptic wipe
• Zarxio vial containing filgrastim-sndz

Anesthesia/Sedation:

• Typically, no anesthesia or sedation is required.

Duration

The actual injection process takes about 5-10 minutes. However, monitoring and preparation may extend the time to around 30 minutes.

Setting

Typically performed in a hospital, outpatient clinic, or specialized treatment center.

Personnel

• Healthcare Professionals Involved:
  
  • Nurses or specially trained medical assistants administer the injection.
  • Physicians may oversee the procedure and monitor patient outcomes.

Risks and Complications

Common Risks:

• Mild pain or redness at the injection site
• Headache
• Bone pain

Rare Risks:

• Allergic reactions
• Spleen rupture (very rare but serious)

Possible Complications:

• May require hospitalization if severe allergic reactions occur
• Management includes symptomatic treatment and monitoring

Benefits

Expected Benefits:

• Increased WBC count
• Reduced risk of infection Timeline for Realization:
• Benefits typically observed within days to a week following injection.

Recovery

Post-procedure Care and Instructions:

• Monitor the injection site for signs of infection (redness, swelling, pain).
• Report severe side effects to a healthcare provider immediately.

Expected Recovery Time:

• No extended recovery time needed; most patients can resume normal activities immediately.

Restrictions and Follow-up:

• Follow up with healthcare provider for additional CBC tests to monitor WBC levels.

Alternatives

Other Treatment Options:

• Other growth factor medications like pegfilgrastim
• Antibiotic prophylaxis in case of neutropenia

Pros and Cons of Alternatives:

• Other medications may have different dosing schedules or side effect profiles.
• Antibiotics do not increase WBC count but help prevent infections.

Patient Experience

During the Procedure:

• Minimal discomfort similar to a typical injection.

After the Procedure:

• Possible mild soreness at the injection site.
• Pain management may include over-the-counter pain relievers, per healthcare provider recommendations.