Interferon Alfa-2b
Indications
Interferon Alfa-2b is used for:
Chronic active hepatitis B, Chronic hepatitis C, AIDS-related Kaposi's sarcoma, Hairy cell leukaemia, Melanoma, Condyloma acuminata, Chronic myeloid leukaemia, Follicular lymphoma, Carcinoid tumours, Multiple myeloma
Adult Dose
Parenteral
Chronic active hepatitis B
Adult: 5-10 million units IM/SC 3 times wkly for 4-6 mth, or 5 million units daily for 16 wk.
Chronic hepatitis C
Adult: 3 million units IM/SC 3 times wkly for 6-12 mth (depending on genotype) when used with ribavirin, or for 6-18 mth (up to 24 mth) when used as monotherapy.
AIDS-related Kaposi's sarcoma
Adult: 30 million units/m2 IM/SC 3 times wkly.
Hairy cell leukaemia
Adult: 2 million units/m2 IM/SC 3 times wkly for up to 6 mth or more.
Melanoma
Adult: Initially, 20 million units/m2 daily for 5 days each wk for 4 wk by IV infusion over 20 minutes. Maintenance: 10 million units/m2 via SC inj 3 times wkly for 48 wk.
Condyloma acuminata
Adult: Inject 1 million units into each lesion 3 times wkly for 3 wk; repeat after 12-16 wk as needed. Max: 5 lesions per treatment course.
Subcutaneous
Chronic myeloid leukaemia
Adult: 4-5 million units/m2 daily; continue at the max tolerated dose to maintain remission.
Max Dosage: 4-10 million units/m2 daily.
Follicular lymphoma
Adult: As an adjunct to chemotherapy: 5 million units 3 times wkly for 18 mth.
Carcinoid tumours
Adult: 3-9 million units (usually 5 million units) 3 times wkly. Advanced disease: 5 million units daily.
Multiple myeloma
Adult: Maintenance dose following chemotherapy induction: 3 million units/m2 3 times wkly.
Child Dose
Chronic Hepatitis B
3 million Units/m² IM/SC 3 times/wk for 1 wk; increase to 6 million U/m² 3 times/wk SC for 16-24 wk; not to exceed 10 million Units/dose 3 times/wk
Renal Dose
Administration
IV Preparation
General
Reconstitute vials with provided diluent
Preparation should be clear & colorless to light yellow
IM, SC, or Intralesional Preparation
Inject 1 mL diluent (SWI, supplied) into drug vial
Swirl gently to dissolve powder
Withdraw appropriate dose to be injected
Refer to Medication Guide for detailed instructions
IV Administration
Prepare immediately prior to use
Reconstitute w/ diluent provided
Inject 1 mL diluent (SWI, supplied) into drug vial
Swirl gently to dissolve powder
Withdraw appropriate dose & inject into a 100 mL bag of NS
Make sure final conc of Intron A is NOT <10 MIU/100 mL
Refer to Medication Guide for detailed instructions
Intron A Solution for Injection not recommended for IV
SC Administration
SC administration is suggested for those who are at risk for bleeding or thrombocytopenic
Rotate SC injection site
Contra Indications
Hypersensitivity
Autoimmune hepatitis
Decompensated liver disease (Child-Pugh >6 [class B and C])
Contraindications for combination therapy with ribavirin:
Pregnant women and men whose female partners are pregnant.
Hemoglobinopathies (e.g., thalassemia major, sickle-cell anemia)
Creatinine clearance less than 50 mL/min
Precautions
Hypersensitivity
Autoimmune hepatitis
Decompensated liver disease (Child-Pugh >6 [class B and C])
Contraindications for combination therapy with ribavirin:
Pregnant women and men whose female partners are pregnant.
Hemoglobinopathies (e.g., thalassemia major, sickle-cell anemia)
Creatinine clearance less than 50 mL/min
Pregnancy-Lactation
Pregnancy Category: C
Lactation: unknown
Interactions
Reduces clearance of theophylline. Enhanced myelosuppression with other myelosuppressive drugs (e.g. zidovudine).
Adverse Effects
Side effects of Interferon Alfa-2b :
>10%
Fatigue (8-96%)
Fever (34-94%)
Neutropenia (92%)
Flu-like syndrome (79%)
Myalgia (28-75%)
Anorexia (1-69%)
Leukopenia (68%)
Nausea (17-66%)
Transaminases increased (13-63%)
Weakness (63%)
Headache (21-62%)
Chills (54%)
Diarrhea (2-45%)
Rigors (42%)
Depression (up to 40% of pts), suicidal ideation/ attempts, suicide
Alopecia (38%)
Dyspnea (34%)
Somnolence (33%)
Vomiting (2-32%)
Anemia (32%)
Cough (31%)
Pharyngitis (31%)
Chest pain (28%)
Xerostomia (28%)
Rash (25%)
Dizziness (24%)
Taste alteration (24%)
Abdominal pain (1-23%)
Irritability (22%)
Sinusitis (21%)
Skeletal pain (21%)
Diaphoresisi (1-21%)
Paresthesias (1-21%)
Arthralgia/back pain (19%)
Pain (18%)
Moniliasis (17%)
Thrombocytopenia (15%)
Amnesia (14%)
Constipation (14%)
Gingivitis (14%)
Impaired concentration (14%)
Malaise (14%)
Weight loss (1-13%)
Amenorrhea (12%)
BUN increased (12%)
Confusion (12%)
Insomnia (12%)
Iruritus (11%)
Mechanism of Action
Interferon alfa-2b binds to a specific cell surface protein. Once bound, it initiates a series of intracellular activities including induction of certain enzymes, suppression of cell proliferation, enhancement of phagocytic activity of macrophages, augmentation of cytotoxicity of lymphocytes for target cells, and inhibition of viral replication.