Impact of High-Pillow Sleeping Posture on Intraocular Pressure in Glaucoma
January 28, 2026
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Brand Name :
Leukine
Synonyms :
sargramostim
Class :
Hematopoietic growth factors
Brand Name :
Leukine
Synonyms :
sargramostim
Class :
Hematopoietic growth factors
Dosage Forms & Strengths
Injectable solution
500mcg/ml
Indicated for Acute myeloid leukemia following induction therapy:
• This is a treatment regimen for administering medication (likely a form of chemotherapy) intravenously at a dose of 250 mcg/m2/day over 4 hours
• The treatment is to begin on or around day 11 of the treatment cycle, or four days after the completion of induction chemotherapy provided that the patient's bone marrow is hypoplastic (meaning that it has a reduced number of cells) and that the number of blasts (immature blood cells) is less than 5%. Suppose a second cycle of induction chemotherapy is needed
• In that case, the treatment is to be administered approximately four days after the completion of the chemotherapy, again provided that the bone marrow is hypoplastic with less than 5% blasts
• The treatment is to continue until the patient's absolute neutrophil count (ANC) is more significant than 1500 cells/mm3 for three consecutive days or a maximum of 42 days
It should be administered via IV infusions, the dose range is 15-500 mcg/m² per day. The infusion can be administered over 1-12 hours per day (every day) or 30-500 mcg/m² in a continuous infusion over 24 hours
Dosage Forms & Strengths
Lyophilized powder for reconstitution, injection
250mcg/vial
It should be noted that clinical studies did not include a sufficient number of subjects aged 65 or older to determine whether they respond differently from younger subjects.
may increase the toxic effect of granulocyte colony stimulating factors
may increase the toxic effect of granulocyte colony stimulating factors
may increase the toxic effect of granulocyte colony stimulating factors
relugolix/estradiol/norethindrone
may increase the hypertensive effects of hypertension associated agents
relugolix/estradiol/norethindrone
may increase the hypertensive effects of hypertension associated agents
may increase the hypertensive effects of hypertension associated agents
may increase the hypertensive effects of hypertension associated agents
may increase the hypertensive effects of hypertension associated agents
may increase the toxic effect of granulocyte colony stimulating factors
may increase the hypertensive effect
may increase the therapeutic effect
may increase the therapeutic effect
may increase the therapeutic effect
may increase the therapeutic effect
may increase the therapeutic effect
Mechanism of action
The primary mechanism of action of sargramostim is to stimulate the production and maturation of white blood cells, particularly granulocytes and macrophages. These cells play a vital role in the body’s immune system by fighting off infections and foreign substances. It also promotes the recovery of white blood cells after chemotherapy or radiation therapy
Spectrum
It has a broad spectrum of activity, including the promotion of white blood cell recovery after chemotherapy or radiation therapy, the treatment of neutropenia (low levels of white blood cells), the treatment of certain types of cancer, and reducing the incidence of serious infections in patients with HIV/AIDS. It has been used in the treatment of various types of cancer such as leukaemia, non-Hodgkin’s lymphoma, and breast cancer
Frequency defined:
>10%
Autologous bone marrow transplantation
Diarrhea
Malaise
Chest pain
Abdominal pain
Asthenia
Rash
Peripheral edema
Acute myelogenous leukemia
Skin reactions
Nausea
Weight loss
Nausea
Abdominal pain
Rigor
Pericardial effusion
Bone pain
Hypercholesterolemia
Chest pain
Fever
Metabolic disease
Vomiting
Pruritis
Pharyngitis
Myalgia
Arthralgia
Intraocular hemorrhage
Hematemesis
1-10%
Pericardial effusion
Cardiac dysrhythmia
<1%
Capillary leak syndrome
Frequency undefined:
Fever
Cerebral hemorrhage
Sepsis
Anorexia
Malaise
Stomatitis
Renal failure
Contraindications
It should not be administered to patients with a history of severe allergic reactions (e.g., anaphylaxis) to human GCSFs (such as sargramostim), yeast-derived products, or any product component. It should not be administered to patients with greater than 10% leukemic myeloid blasts in their bone marrow or peripheral blood. It should not be administered within 24 hours preceding or following chemotherapy or radiotherapy.
Caution
caution in fluid retention, pulmonary infiltrates, CHF, lung disease, cardiac disease, hypoxia, hepatic/renal impairment; conditions may worsen.
Pregnancy consideration: Insufficient data available
Lactation: Excretion of the drug in human breast milk is unknown
Pregnancy category:
Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: There is no data available for the drug under this category
Pharmacology
It is also a recombinant granulocyte-macrophage colony-stimulating factor (rGM-CSF) and is a synthetic form of the naturally occurring GM-CSF protein. It acts on hematopoietic cells by binding to specific receptors on their surface, stimulating their proliferation and differentiation, particularly into neutrophils, monocytes/macrophages, and myeloid-derived dendritic cells. Additionally, it also has some end-cell function activity. This increases the number of white blood cells in the body, which can help boost the immune system and fight off infections. It is used to treat neutropenia and certain types of cancer and reduce the incidence of severe infections in patients with HIV/AIDS
Pharmacodynamics
The effects of sargramostim include an increase in circulating neutrophils and other white blood cells, which can help boost the immune system and fight off infections. It also has some end-cell function activity, which can enhance the activity of white blood cells and increase the production of other cytokines.
The pharmacodynamic effects are dose-dependent, with higher doses resulting in a more significant increase in white blood cells.
Pharmacokinetics
Absorption:
The peak plasma concentration of sargramostim is 16.7 ng/mL when administered intravenously and 3.03 ng/mL subcutaneously. The area under the curve (AUC) is 32.9 ng·hr/mL when administered intravenously and 21.3 ng·hr/mL when administered subcutaneously. The bioavailability of sargramostim is 75% when administered subcutaneously.
Distribution:
When administered intravenously, the volume of distribution (Vd) of sargramostim is 96.8 L.
Metabolism:
Proteolytic degradation is metabolized in the body, breaking down proteins into smaller peptides and amino acids. The metabolic breakdown of sargramostim occurs primarily in the liver and the kidneys.
Elimination/Excretion:
The half-life elimination of sargramostim is 3.84 h when administered intravenously and 1.4 h when administered subcutaneously. The clearance of sargramostim is 17.2L/h
Administration
Subcutaneous administration
The injection should not be administered simultaneously with or within 24 hours preceding cytotoxic chemotherapy or radiotherapy or within 24 hours following chemotherapy.
Also, sargramostim injection is formulated as a sterile solution preserved with 1.1% benzyl alcohol and should appear as a clear, colorless single-dose solution.
It is important to use only sargramostim for injection (lyophilized powder) reconstituted with sterile water for injection without preservatives when administering to neonates or infants to avoid benzyl alcohol exposure as it can cause toxicity in neonates and infants.
Intravenous administration
When administering sargramostim, it is essential not to use an inline membrane filter for IV infusions. Other medications should only be added to infusion solutions containing Sargramostim with compatibility and stability information.
Using only 0.9%, NaCl is recommended to prepare IV infusion solutions. It’s important to visually inspect the solution for particulate matter and discoloration before administration. The vial should not be used if particulate matter is present or the solution is discolored.
sargramostim is usually infused over 2-4 hours, although longer, shorter, or continuous infusions have been done. It’s essential to follow the instructions provided by the healthcare provider or the package insert for the appropriate administration method and duration.
Storage
Unused vials of sargramostim should be refrigerated at 2-8°C (36-46°F) in the original carton to protect them from light. They should not be frozen or shaken, or used beyond the expiration date printed on the vial.
Diluted solutions or reconstituted vials of sargramostim should also be refrigerated at 2-8°C (36-46°F) for up to 20 days once the vial has been entered. It’s essential to discard any remaining solution after 20 days and not to freeze the solution
Patient information leaflet
Generic Name: sargramostim
Pronounced: [ sar-GRA-moe-stim ]
Why do we use sargramostim?
A modified version of human granulocyte-macrophage colony-stimulating factor called sargramostim is used to boost the generation of immune cells after myelosuppressive therapy or bone marrow transplant.
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