Granix is a man-made form of a protein that stimulates the growth of white blood cells in your body. White blood cells help your body fight against infection.

Granix is used to reduce the duration of severe neutropenia, a lack of certain white blood cells caused by receiving chemotherapy with certain cancer medications.

Granix is for use in adults and children who are least 1 month old.

Granix may also be used for purposes not listed in this medication guide.

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Granix is injected under the skin. A healthcare provider may teach you how to properly use the medication by yourself.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don't understand all instructions.

Prepare your injection only when you are ready to give it. Do not shake the prefilled syringe. Do not use if the medicine has particles in it. Call your pharmacist for new medicine.

The first dose of tbo-filgrastim is usually given within 24 hours after your chemotherapy dose. You will receive daily injections until your blood cell counts return to normal.

You should not inject Granix within 24 hours before your next chemotherapy dose.

Do not stop using Granix or change your medication schedule without your doctor's advice.

If this medicine accidentally gets on your skin, wash it thoroughly with soap and warm water.

Each prefilled syringe is for one use only. Throw it away after one use, even if there is still medicine left inside.

You will need frequent medical tests to help your doctor determine how long to treat you with Granix.

Store in the refrigerator, do not freeze. Protect from light.

Take the medicine out of the refrigerator and let it reach room temperature for 30 minutes before injecting your dose. Do not leave the medicine out for longer than 5 days.

Use a needle and syringe only once and then place them in a puncture-proof "sharps" container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.

Bone pain is a common side effect of tbo-filgrastim. Your doctor may recommend you take acetaminophen (Tylenol), ibuprofen (Advil, Motrin) other medications to relieve pain. Take only the dosage your doctor recommends.

You should not use Granix if you are allergic to filgrastim (Neupogen) or pegfilgrastim (Neulasta).

Tell your doctor if you have ever had:

• a hemoglobin blood cell disorder such as sickle cell anemia, thalassemia;

• kidney disease; or

• if you are scheduled to have radiation treatment, a bone scan, or other medical tests.

Using a G-CSF such as Granix can cause your spleen to rupture, which can be fatal. Talk with your doctor if you have concerns about this risk.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

Call your doctor for instructions if you miss a dose, or miss an appointment for your Granix.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Avoid injecting Granix into skin that is red, bruised, scarred, tender, or hard.

Avoid getting this medicine in your eyes. If contact does occur, rinse with water.

Get emergency medical help if you have signs of an allergic reaction: hives; wheezing, difficult breathing; fast heart rate, sweating, feeling light-headed; swelling in your face, lips, tongue, or throat.

Capillary leak syndrome is a rare but serious side effect of tbo-filgrastim. Call your doctor right away if you have signs of this condition: stuffy or runny nose followed by weakness or tired feeling, and sudden swelling in your arms, legs and other parts of the body.

Granix may cause serious side effects. Call your doctor at once if you have:

• stomach pain, back pain;

• a general ill feeling;

• signs of a kidney problem--blood in your urine, swelling in your face or ankles, little or no urination;

• signs of infection--fever, redness, or swelling;

• signs of acute respiratory distress syndrome--fever with shortness of breath or trouble breathing; or

• signs of a ruptured spleen--pain in your upper stomach spreading to your left shoulder.

Common side effects of Granix may include:

• bone pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other drugs may affect Granix, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.