Fil: L03AA02. ; Pegfil: L03AA13

Filgrastim is a non-glycosylated stimulating factor of granulocyte colonies (G-CSF) which is obtained by recombinant technology. The naturally occurring product is found in breast milk. Pegfilgrastim and Lipegfilgrastim are Filgrastim conjugated with monomethoxy polyethylene glycol (PEG). They are used to induce the production of granulocytes and lower infection risk after myelosuppressive therapy. Intravenous or subcutaneous administration.

A very high molecular weight explains the insignificant or no excretion into milk that has been observed both with Lenograstim and Filgrastim. ^{(Nelson 2018, Kaida 2007, Shibata 2003)}

Its low oral bioavailability hampers absorption into infant plasma from the breast milk ingested, as for their proteic nature it is degraded in the gastrointestinal tract, not being absorbed. Filgrastim is not absorbed by the infant's gut even during the neonatal period or prematurity. ^{(Calhoun 2003)}

The granulocyte colony-stimulating factor has been used in premature newborns, both on prevention and treatment of neonatal sepsis and/or necrotizing enterocolitis without adverse effects being observed among treated infants. ^{(Canpolat 2006, Carr 2003, Bedford 2001, Gillan 1994))}

Granulocyte colony-stimulating factor (G-CSF) is a normal component of breastmilk. The bovine G-CSF is found in the usual diet of meat eaters. ^{(Pessach 2013)}

Expert authors consider the use of this medication to be safe or very probably safe during breastfeeding. ^{(LactMed, Briggs 2015, Pistilli 2013)}