This drug should not be given within 24 hours of radiation or chemotherapy treatments. Your doctor will obtain blood tests as often as twice a week at first, to find out how you respond to the drug. Your doctor will adjust your dose or your medicines based on your test results. Keep all your appointments for doctor visits and blood tests. Some people have a reaction to the first dose of sargramostim that may include low blood pressure, fast heart rate, trouble breathing, flushing, or feeling dizzy or faint. Tell your doctor or nurse right away if you notice these symptoms so that they can be treated. Most often, a reaction to the first dose in a cycle is not a true allergic reaction and tends not to happen with future doses. This drug may affect the function of your liver and kidneys. These organs normally help filter the blood and help the body get rid of certain chemicals. Changes in these organs can change the blood levels of any other drugs you are taking. Your doctor will likely check the function of these organs with blood tests on a regular basis. The drug may need to be stopped or the dose reduced if the changes are severe. If you have kidney disease, liver metastasis, or other liver problems before starting treatment, the doctor may need to watch you more closely. In rare cases, some people who were given sargramostim reported shortness of breath, which is thought to be due to white blood cells building up in the blood vessels of the lungs. Tell your doctor or nurse right away if you begin to notice shortness of breath, cough, or fever. A rare but serious side effect is capillary leak syndrome, in which the small blood vessels in the body become leaky. This can allow fluid to leave the bloodstream and collect in other parts of the body. This could result in low blood pressure, fluid buildup, and poor blood flow to the internal organs. Tell your doctor right away if you feel dizzy or notice sudden swelling or rapid weight gain, trouble breathing, abnormal heart beats, chest pain, or little or no urine output. In rare cases, this drug can cause allergic reactions when the drug is given. Mild reactions may consist of fever, chills, skin itching, or feeling flushed. More serious reactions happen rarely, but can be dangerous. Symptoms can include feeling lightheaded or dizzy (due to low blood pressure), chest tightness, shortness of breath, back pain, or swelling of the face, tongue, or throat. Tell your doctor or nurse right away if you notice any of these symptoms during or after being given the drug. How is this drug taken or given?
Sargramostim may be given either as an infusion into a vein (intravenously, or IV) or as a shot under the skin (subcutaneously, or SubQ). It may be given in a hospital or doctor's office, or you or a family member can learn how to give the shot under the skin at home. The dose and treatment schedule will depend on your weight, general health, and the reason you are being treated. The dose and/or schedule may need to be adjusted based on how your body responds to treatment. If you are taking it at home, make sure to keep the medicine in its original container in the refrigerator. Take this drug exactly as directed by your doctor. If you are not sure of the instructions, ask your doctor or nurse to explain them to you. Keep the needles and other equipment in a safe place out of reach of children and pets. Keep used needles in a closed needle bucket and bring them back to your doctor or nurse.