What Is Nivestym? Uses, Dosage, and What You Need to Know in 2026

If your oncologist or hematologist has prescribed Nivestym, you may have a lot of questions. What exactly is this medication? Why do you need it? How is it given? This guide answers those questions in plain language so you can feel prepared for your treatment.

What Is Nivestym?

Nivestym is the brand name for filgrastim-aafi, a biosimilar medication manufactured by Pfizer. It is biosimilar to Neupogen (filgrastim), the original brand-name version of the drug made by Amgen.

Nivestym belongs to a class of drugs called granulocyte colony-stimulating factors (G-CSFs). These medications stimulate the bone marrow to produce more neutrophils — a type of white blood cell that is critical for fighting bacterial and fungal infections. Nivestym received FDA approval on July 20, 2018.

A "biosimilar" means it has been rigorously tested and FDA-approved as highly similar to Neupogen with no clinically meaningful differences in safety, purity, or effectiveness.

What Is Nivestym Used For?

Nivestym is FDA-approved for five indications:

1. Chemotherapy-induced neutropenia: Prevents febrile neutropenia (low white blood cell count with fever) in patients with non-myeloid cancers receiving myelosuppressive chemotherapy. This is the most common use.
2. Acute myeloid leukemia (AML): Reduces time to neutrophil recovery and duration of fever following induction or consolidation chemotherapy for AML in adults.
3. Bone marrow transplantation (BMT): Reduces duration of neutropenia and related complications in patients with non-myeloid malignancies receiving myeloablative chemotherapy followed by BMT.
4. Stem cell mobilization: Mobilizes peripheral blood progenitor cells (PBPCs) into the bloodstream for collection via leukapheresis for autologous stem cell transplant.
5. Severe chronic neutropenia (SCN): Chronic administration for patients with congenital, cyclic, or idiopathic neutropenia to reduce infections and related complications.

What Forms Does Nivestym Come In?

Nivestym is available in the following dosage forms:

• Prefilled syringes: 300 mcg/0.5 mL and 480 mcg/0.8 mL (for subcutaneous injection)
• Single-dose vials: 300 mcg/mL and 480 mcg/1.6 mL (for subcutaneous use or IV infusion)

The prefilled syringe is the most common form for home use, with the passive needle guard for safety.

How Is Nivestym Given?

Nivestym can be given two ways:

• Subcutaneous (SC) injection: Given under the skin, most often in the abdomen, upper arm, or thigh. Can be self-administered at home after training.
• Intravenous (IV) infusion: Given through a vein as a short infusion (15–30 minutes) or continuous infusion. Typically done in a clinic or infusion center.

Remove Nivestym from the refrigerator and let it come to room temperature for at least 30 minutes before injecting — this reduces injection pain. Do not shake the syringe.

Nivestym Dosing by Indication

Doses are based on your body weight. Your oncologist will calculate and adjust your dose. Typical starting doses include:

• Chemotherapy patients: 5 mcg/kg/day SC or IV, starting at least 24 hours after the last chemo dose; continued until ANC reaches 10,000/mm³ or for up to 2 weeks
• BMT patients: 10 mcg/kg/day IV (starting ≥24 hours after chemo and ≥24 hours after bone marrow infusion)
• PBPC mobilization: 10 mcg/kg/day SC for at least 4 days before first leukapheresis
• Congenital neutropenia: 6 mcg/kg twice daily SC
• Cyclic or idiopathic neutropenia: 5 mcg/kg once daily SC

Important Things to Know Before Starting Nivestym

• Do not administer within 24 hours before or after chemotherapy — it can increase the toxicity of certain chemo drugs
• Bone pain is expected and usually manageable with acetaminophen — tell your provider if it's severe
• Store refrigerated at 2–8°C (36–46°F); do not freeze and do not leave at room temperature more than 24 hours
• Regular blood tests (CBC) are required — your ANC and platelet counts will be monitored to ensure safe dosing
• Tell your doctor if you are pregnant — Nivestym should only be used during pregnancy if clearly needed

Where to Get Nivestym

Nivestym is dispensed through specialty pharmacies and some hospital outpatient pharmacies. Finding a pharmacy that has it in stock can sometimes be a challenge. medfinder is a service that calls pharmacies near you to check stock availability so you don't have to. Learn more in our guide on how to find Nivestym near you.