ter FEER on AL fa too
Biological Response Modulator
Patients >18 years of age: Hairy cell leukemia, AIDS-related Kaposi's
sarcoma, chronic myelogenous leukemia (CML), chronic hepatitis C, adjuvant
treatment to surgery for primary or recurrent malignant melanoma; multiple
unlabeled uses; indications and dosage regimens are specific for a particular
brand of interferon
Hypersensitivity to alfa-2a interferon or any component of the
Use with caution in patients with seizure disorders, brain metastases,
compromised CNS, multiple sclerosis, and patients with pre-existing cardiac
disease, severe renal or hepatic impairment, or myelosuppression; safety and
efficacy in children <18 years of age have not been established. Higher doses
in the elderly or in malignancies other than hairy cell leukemia may result in
Central nervous system: Dizziness, fatigue, malaise, fever (usually within
4-6 hours), chills
Gastrointestinal: Xerostomia, nausea, vomiting, diarrhea, abdominal cramps,
weight loss, metallic taste
Hematologic: Mildly myelosuppressive and well tolerated if used without
adjunct antineoplastic agents; thrombocytosis has been reported, leukopenia
(mainly neutropenia), anemia, thrombocytopenia, decreased hemoglobin,
Onset (days): 7-10
Nadir (days): 14
Recovery (days): 21
Neuromuscular & skeletal: Rigors, arthralgia
Miscellaneous: Flu-like syndrome, diaphoresis
1% to 10%:
Central nervous system: Headache, delirium, somnolence, neurotoxicity
Dermatologic: Alopecia, dry skin
Gastrointestinal: Anorexia, stomatitis
Neuromuscular & skeletal: Peripheral neuropathy, leg cramps
Ocular: Blurred vision
<1%: Tachycardia, arrhythmias, chest pain, hypotension, SVT, edema,
confusion, sensory neuropathy, psychiatric effects, EEG abnormalities,
depression, hypothyroidism, increased uric acid level, change in taste,
increased hepatic transaminase, myalgia, visual disturbances, proteinuria,
increased BUN/creatinine, coughing, dyspnea, nasal congestion, neutralizing
antibodies, local sensitivity to injection; usually patient can build up a
tolerance to side effects
Symptoms of overdose include CNS depression, obtundation, flu-like symptoms,
Treatment is supportive
Cimetidine: May augment the antitumor effects of interferon in melanoma
Theophylline: Clearance has been reported to be decreased in hepatitis
patients receiving interferon
Increased toxicity: Vinblastine: Enhances interferon toxicity in several
patients; increased incidence of paresthesia has also been noted
Refrigerate (2°C to
46°F); do not freeze; do not shake; after reconstitution,
the solution is stable for 24 hours at room temperature and for 1 month when
Alpha interferons are a family of proteins, produced by nucleated cells, that
have antiviral, antiproliferative, and immune-regulating activity. There are 16
known subtypes of alpha interferons. Interferons interact with cells through
high affinity cell surface receptors. Following activation, multiple effects can
be detected including induction of gene transcription. Inhibits cellular growth,
alters the state of cellular differentiation, interferes with oncogene
expression, alters cell surface antigen expression, increases phagocytic
activity of macrophages, and augments cytotoxicity of lymphocytes for target
Absorption: Filtered and absorbed at the renal tubule
Distribution: The Vd of interferon is 31 L; but has been noted to
be much greater (370-720 L) in leukemia patients receiving continuous infusion
IFN; IFN does not penetrate the CSF
Metabolism: Majority of dose thought to be metabolized in the kidney
Bioavailability: I.M.: 83%; S.C.: 90%
Half-life: Elimination: I.M., I.V.: 2 hours after administration; S.C.: 3
Time to peak serum concentration: I.M., S.C.: ~6-8 hours
Refer to individual protocols
Adults >18 years: I.M., S.C.:
Hairy cell leukemia:
Induction: 3 million units/day for 16-24 weeks.
Maintenance: 3 million units 3 times/week (may be treated for up to 20
AIDS-related Kaposi's sarcoma:
Induction: 36 million units/day for 10-12 weeks
Maintenance: 36 million units 3 times/week (may begin with dose escalation
from 3-9-18 million units each day over 3 consecutive days followed by 36
million units/day for the remainder of the 10-12 weeks of induction)
If severe adverse reactions occur, modify dosage (50% reduction) or
temporarily discontinue therapy until adverse reactions abate
Baseline chest x-ray, EKG, CBC with differential, liver function tests,
electrolytes, platelets, weight; patients with pre-existing cardiac
abnormalities, or in advanced stages of cancer should have EKGs taken before and
|Mental Health: Effects
on Mental Status|
Dizziness and drowsiness are common; may rarely cause delirium or
Effects on Psychiatric
May cause leukopenia; use caution with clozapine and carbamazepine;
concurrent use with psychotropics may produce additive sedation and dry
|Dental Health: Local
No information available to require special precautions
Effects on Dental Treatment|
>10% of patients experience significant dry mouth and metallic
Use as directed; do not change dosage or schedule of administration without
consulting prescriber. Maintain adequate hydration (2-3 L/day of fluids unless
instructed to restrict fluid intake). You may experience flu-like syndrome
(acetaminophen may help); nausea, vomiting, dry mouth, or metallic taste
(frequent small meals, frequent mouth care, sucking lozenges, or chewing gum may
help); drowsiness, dizziness, agitation, abnormal thinking (use caution when
driving or engaging in tasks requiring alertness until response to drug is
known). Report unusual bruising or bleeding; persistent abdominal disturbances;
unusual fatigue; muscle pain or tremors; chest pain or palpitation; swelling of
extremities or unusual weight gain; difficulty breathing; pain, swelling, or
redness at injection site; or other unusual symptoms.
Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend
to be pregnant. Do not breast-feed.
Do not freeze or shake solution; a flu-like syndrome (fever, chills) occurs
in the majority of patients 2-6 hours after a dose; pretreatment with
nonsteroidal anti-inflammatory drug (NSAID) or acetaminophen can decrease fever
and its severity and alleviate headache
Injection: 3 million units/mL (1 mL); 6 million units/mL (3 mL); 9 million
units/mL (0.9 mL, 3 mL); 36 million units/mL (1 mL)
Powder for injection: 6 million units/mL when reconstituted
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