Tbo-filgrastim increases white blood cell levels in patients receiving chemotherapy that affects the bone marrow and decreases your white blood cells. It is injected at least 24 hours after chemo.

Tbo-filgrastim Overview

Reviewed: November 9, 2012

Tbo-filgrastim is a prescription medication used to in adults with certain types of cancer who are taking chemotherapy medicines that cause a severe decrease in the production of neutrophils in the bone marrow. Neutrophils are a type of white blood cell. Tbo-filgrastim belongs to a group of drugs called colony stimulating factors, which work by  stimulating the cells to grow and divide into white blood cells to decrease the duration of severe neutropenia (low level of neutrophils in the blood).

This medication comes in an injectable form to be given just under the skin (subcutaneous), usually once every day until your white blood cell count returns to normal. 
The most common side effects of Tbo-filgrastim is bone pain. 

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Tbo-filgrastim Cautionary Labels


Uses of Tbo-filgrastim

Tbo-filgrastim is a prescription medicine:

  • used in people with certain types of cancer (non-myeloid malignancies), who are receiving chemotherapy that affects the bone marrow
  • given to help decrease the length of time that the number of certain white blood cells (neutrophils) are very low (severe neutropenia). Neutrophils are white blood cells that are important in fighting bacterial infections.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Tbo-filgrastim Brand Names

Tbo-filgrastim may be found in some form under the following brand names:

Tbo-filgrastim Drug Class

Tbo-filgrastim is part of the drug class:

Side Effects of Tbo-filgrastim

Tbo-filgrastim can cause serious side effects, including:

  • Spleen rupture, which can cause death. Call your doctor right away if you have pain in your left upper stomach area or left shoulder area while taking tbo-filgrastim. This pain could mean your spleen is enlarged or ruptured.
  • A serious lung problem called Acute Respiratory Distress Syndrome (ARDS). Get medical help right away if you have any of these symptoms of Acute Respiratory Distress Syndrome (ARDS):
    • fever
    • shortness of breath
    • trouble breathing
  • Serious Allergic Reactions. If you have a serious allergic reaction during a tbo-filgrastim injection, your doctor will treat your allergic reaction and stop giving you the injections. Tell your doctor right away if you have any of these symptoms during or after your injection:
    • a rash over the whole body
    • shortness of breath
    • trouble breathing (wheezing)
    • dizziness
    • swelling around the mouth or eyes
    • fast heart rate
    • sweating
  • Severe Sickle Cell Crisis in people with a sickle cell disease. If you have sickle cell disease, talk to your doctor about the risks of taking tbo-filgrastim.

The most common side effect of tbo-filgrastim is bone pain. Pain medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may be necessary. Discuss the use of pain medications with your doctor.

Tell your doctor about any side effect that bother you or that do not go away.

These are not all the possible side effects of tbo-filgrastim. For a complete list, ask your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1988.

Tbo-filgrastim Interactions

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take lithium (Eskalith CR, Eskalith, Lithobid).


Tbo-filgrastim Precautions

Serious, potentially life-threatening side effects can occur with tbo-filgrastim use. See "Side Effects" section.

Tell your doctor if you are allergic to tbo-filgrastim, filgrastim (Neupogen), pegfilgrastim (Neulasta) or any other medications.

Tbo-filgrastim may affect the results of bone imaging studies. Tell your doctor you are using tbo-filgrastim before having this type of study.

Tbo-filgrastim Food Interactions

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of tbo-filgrastim there are no specific foods that you must exclude from your diet when receiving tbo-filgrastim.


Inform MD

Before you take tbo-filgrastim, tell your doctor if you:

  • have sickle cell anemia or other blood problem
  • plan to have bone scans or tests
  • are allergic to filgrastim (Neupogen) or pegfilgrastim (Neulasta)
  • have any other medical conditions
  • are pregnant or plan to become pregnant
  • are breastfeeding or plan to breastfeed

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Know the medicines you take. Keep a list of them to show your doctor and pharmacist when you get a new medicine.

Tbo-filgrastim and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant. It is not known if tbo-filgrastim will harm your unborn baby. If you become pregnant while using tbo-filgrastim, tell your doctor right away.

Tbo-filgrastim and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed. 

It is not known whether Tbo-filgrastim crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication.Your doctor and you will decide if the benefits outweigh the risk of using Tbo-filgrastim.


Tbo-filgrastim Usage

  • Tbo-filgrastim is given by an injection under your skin (subcutaneous).
  • Administer your first dose of tbo-filgrastim at least 24 hours after you receive your chemotherapy.
  • Tbo-filgrastim injections are usually given 1 time each day until your white blood cell count returns to normal.
  • Your doctor will test your blood before your chemotherapy and during your tbo-filgrastim treatment until your white blood cell count returns to normal.
  • Keep all of your appointments for blood tests.

Tbo-filgrastim Dosage

The recommended once-daily dose of tbo-filgrastim is 5 mcg/kg given by injection under the skin (subcutaneously) at least 24 hours after chemotherapy. Daily dosing continues until blood count returns to normal.


Tbo-filgrastim Overdose

If you inject too much tbo-filgrastim, call your local Poison Control Center or seek emergency medical attention right away.

Other Requirements

  • If you will be injecting tbo-filgrastim at home, store this medication in the refrigerator at 36° to 46° F, out of the reach of children.
  • Tbo-filgrastim syringes can be stored at room temperature (73° to 81° F) for a period of up to 5 days. If not used within 5 days, it may be returned to the refrigerator and stored up to the expiration date.
  • Avoid shaking the medication-filled syringe.
  • Inspect the solution before use. Only clear solutions with no visible particles should be used.

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