Pediatric Medication

Brand Names: US

Granix; Neupogen; Zarxio

Brand Names: Canada

Grastofil; Neupogen

What is this drug used for?

  • It is used to lower the chance of getting an infection in people with bone marrow problems caused by chemo.
  • It is used to raise the number of white blood cells in certain patients.
  • It is used to raise the chance of staying alive in certain patients who have had radiation.
  • It may be given to your child for other reasons. Talk with the doctor.

What do I need to tell the doctor BEFORE my child takes this drug?

  • If your child has an allergy to this drug or any part of this drug.
  • If your child is allergic to any drugs like this one or any other drugs, foods, or other substances. Tell the doctor about the allergy and what signs your child had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
This drug may interact with other drugs or health problems.
Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for your child to take this drug with all of his/her drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.

What are some things I need to know or do while my child takes this drug?

All products:

  • Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
  • Do not give this drug to your child on the same day that he/she gets chemo or radiation.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • This drug may affect certain lab tests. Tell all of your child’s health care providers and lab workers that your child takes this drug.
  • This drug may cause a very bad and sometimes deadly problem called capillary leak syndrome (CLS). CLS may lead to low blood pressure and harm to the body. It may also lead to a heartbeat that is not normal, chest pain or pressure, heart attack, lung or breathing problems, bleeding or lower blood flow in the stomach or bowel, kidney problems, swelling, or feeling confused. Talk with the doctor.
  • Some people with sickle cell disease have had times where the sickle cell disease has gotten worse when taking this drug. Sometimes, this has been deadly. Talk with the doctor.

If your child is pregnant or breast-feeding a baby:

  • Talk with the doctor if your child is pregnant, becomes pregnant, or is breast-feeding a baby. You will need to talk about the benefits and risks of using this drug.

Neupogen, Zarxio, and Grastofil:

  • If your child has a latex allergy, talk with the doctor. Some products have latex.

What are some side effects that I need to call my child’s doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:
  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
  • Dark urine.
  • Dizziness or passing out.
  • A fast heartbeat.
  • Sweating a lot.
  • Shortness of breath.
  • Fast breathing.
  • Fever.
  • Coughing up blood.
  • Feeling very tired or weak.
  • Any unexplained bruising or bleeding.
  • Purple spots or redness of the skin.
  • Very bad headache.
  • Swelling.
  • Enlarged and ruptured spleens have happened with this drug. Sometimes, ruptured spleens have been deadly. Call the doctor right away if your child has left upper stomach pain or left shoulder pain.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:
  • Back pain.
  • Bone pain.
  • Joint pain.
  • Cough.
  • Headache.
  • Upset stomach.
  • Feeling tired or weak.
These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.
You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.

All products:

  • It is given as a shot into the fatty part of the skin.
  • To gain the most benefit, do not miss giving your child doses.
  • Keep giving this drug to your child as you have been told by your child’s doctor or other health care provider, even if your child feels well.
  • If you will be giving your child the shot, your child’s doctor or nurse will teach you how to give the shot.
  • Follow how to give this drug as you have been told by your child’s doctor or read the package insert.
  • Before using this drug, take it out of the refrigerator and leave it at room temperature for 30 minutes.
  • Do not use if the solution is cloudy, leaking, or has particles.
  • Do not use if solution changes color.
  • Do not shake the solution.
  • Wash your hands before and after you give the shot.
  • Do not give into skin that is irritated, bruised, red, infected, or scarred.
  • Move the site where you give the shot with each shot.
  • Throw away any part left over after the dose is given.
  • Throw syringe away after use. Do not use the same syringe more than one time.
  • Throw away needles in a needle/sharp disposal box. Do not reuse needles or other items. When the box is full, follow all local rules for getting rid of it. Talk with a doctor or pharmacist if you have any questions.
  • Do not switch between different brands of this drug without first talking with the doctor.


  • Do not switch between different forms of this drug without first talking with the doctor.

Neupogen, Zarxio, and Grastofil:

  • It may be given as a shot into a vein.


  • If you get this drug on the skin, wash it off right away with soap and water.
  • If you get this drug in the eyes, flush right away with cool water and get medical help.

What do I do if my child misses a dose?

  • Call your child’s doctor to find out what to do.

How do I store and/or throw out this drug?

All products:

  • Store in a refrigerator. Do not freeze.
  • Store in original container.
  • Protect from light.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Check with your pharmacist about how to throw out unused drugs.

Neupogen, Zarxio, and Grastofil:

  • If this drug freezes, let it thaw in the refrigerator before use.
  • Do not use if this drug has been frozen more than once.
  • If needed, this drug can be left out at room temperature for some time. Be sure you know how long you can leave this drug at room temperature before you need to throw it away.
  • Do not put this drug back in the refrigerator after it has been stored at room temperature.


  • If needed, this drug can be left out at room temperature for up to 5 days. If not used within 5 days of being left out at room temperature, you can return this drug to the refrigerator. Do not do this more than 1 time.
  • Throw away unopened drug if left at room temperature for more than 5 days.

General drug facts

  • If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Keep a list of all your child’s drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child’s doctor.
  • Talk with your child’s doctor before giving your child any new drug, including prescription or OTC, natural products, or vitamins.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Last Reviewed Date



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