ter FEER on AL fa too
INF-alpha 2; a-2-interferon;
Biological Response Modulator
Hairy-cell leukemia in patients >18 years, condylomata acuminata,
AIDS-related Kaposi's sarcoma in patients >18 years, chronic non-A/non-B/C
hepatitis in patients >18 years, chronic hepatitis B in patients >18 years
(indications and dosage are specific for a particular brand of
Known hypersensitivity to interferon alfa-2b or any components, patients with
pre-existing thyroid disease uncontrolled by medication, coagulation disorders,
diabetics prone to DKA, pulmonary disease
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 has not been established. Higher doses in the
elderly or in malignancies other than hairy cell leukemia may result in severe
obtundation. A baseline ocular exam is recommended in patients with diabetes or
Central nervous system: Dizziness, fatigue, malaise, fever (usually within
4-6 hours), chills
Dermatologic: Skin rash
Gastrointestinal: Xerostomia, nausea, vomiting, diarrhea, dizziness,
abdominal cramps, weight loss, metallic taste, anorexia
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: Neurotoxicity
Dermatologic: Dry skin, alopecia
Neuromuscular & skeletal: Peripheral neuropathy, leg cramps
Ocular: Blurred vision
<1%: Cardiotoxicity, tachycardia, arrhythmias, hypotension, SVT,
arrhythmias, chest pain, edema, EEG abnormalities, confusion, sensory
neuropathy, headache, psychiatric effects, delirium, somnolence, partial
alopecia, increased uric acid level, hypothyroidism, change in taste, increased
hepatic transaminase, increased ALT/AST, sensitivity to injection, myalgia,
rigors, visual disturbances, proteinuria, increased creatinine, increased BUN,
coughing, dyspnea, nasal congestion, neutralizing antibodies; usually patient
can build up a tolerance to side effects
Symptoms of overdose include CNS depression, obtundation, flu-like symptoms,
Treatment is supportive
Increased effect: Cimetidine: May augment the antitumor effects of interferon
Theophylline: Clearance has been reported to be decreased in hepatitis
patients receiving interferon
Vinblastine: Enhances interferon toxicity in several patients; increased
incidence of paresthesia has also been noted
Zidovudine: Increased myelosuppression
Store intact vials at refrigeration (2°C to
8°C); powder and premixed solutions are stable at
95°F to 113°F for 7 days
Reconstitute vials with diluent; solution is stable for 30 days under
refrigeration (2°C to 8°C)
Standard I.M./S.C. dilution: Dose/syringe or dispense vial to floor
Solution is stable for 7 days at room temperature and 30 days under
refrigeration (2°C to 8°C)
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; S.C.: 3 hours
Time to peak serum concentration: I.M., S.C.: ~6-8 hours
Adults (refer to individual protocols):
AIDS-related Kaposi's sarcoma: I.M., S.C. (use 50 million international unit
vial): 30 million units/m2 3 times/week
Condylomata acuminata: Intralesionally (use 10 million international
unit vial): 1 million units/lesion 3 times/week for 4-8 weeks; not to exceed 5
million units per treatment (maximum: 5 lesions at one time)
Chronic hepatitis C (non-A/non-B): I.M., S.C.: 3 million units 3 times/week
for approximately a 6-month course
Chronic hepatitis B: I.M., S.C.: 5 million international units/day or 10
million international units 3 times/week for 16 weeks; if severe adverse
reactions occur, reduce dosage 50% or temporarily discontinue therapy until
adverse reactions abate; when platelet/granulocyte count returns to normal,
Hemodialysis: Supplemental dose is not necessary
Peritoneal dialysis: Supplemental dose is not necessary
Baseline chest x-ray, EKG, CBC with differential, liver function tests,
electrolytes, thyroid function tests, platelets, weight; patients with
pre-existing cardiac abnormalities, or in advanced stages of cancer should have
EKGs taken before and during treatment
|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 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.
Use acetaminophen to prevent or partially alleviate headache and fever; do
not use 3, 5, 18, and 25 million unit strengths intralesionally, solutions are
hypertonic; 50 million unit strength is not for use in condylomata, hairy cell
leukemia, or chronic hepatitis.
Injection, albumin free: 3 million units (0.5 mL); 5 million units (0.5 mL);
10 million units (1 mL); 25 million units
Powder for injection, lyophilized: 18 million units, 50 million units
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