Interferon Alfa-2b (Injection)

Overview

Interferon alfa-2b (human leukocyte clone hif-sn 206 moiety reduced) is an antineoplastic or antiviral drug that was originally discovered in the Charles Wiessmann laboratory. It is marketed by Schering-Plough under the brand name Intron-A. It is indicated for a myriad of conditions including cancers and viral infections.

Interferon alfa-2b is a synthetic version of interferons, a group of proteins called cytokines that are secreted by fibroblasts, white blood cells, or T-cells as part of the body's immune response to infection-causing pathogens. Interferon alfa-2b works by boosting the immune system's fight against viral infections and cancer cells. It treats cancer by interrupting the multiplication of the cancerous cells.

Available only with the doctor's prescription, this medication is administered by injection under the skin, into the vein, into a muscle, or into a lesion. The product is available via the following dosage:

  • Powder for solution
  • Solution
  • Kit

Conditions Treated

Type Of Medicine

  • Immunomodulator

Side Effects

Along with the intended effects, this medication may come with some undesired outcomes. These are the side effects of interferon alfa-2b. Some of the medication's side effects are mild and tend to go away as the body adjusts to treatment. However, some side effects are severe and may require medical attention.

Talk to your healthcare provider if any of these side effects are severe or do not go away after several weeks of interferon alfa-2b therapy.

  • Bleeding, bruising, redness, swelling, pain, or irritation on the spot of injection
  • Loss of appetite and ability to taste
  • Muscle pain
  • Dizziness
  • Hair loss
  • Dry mouth
  • Loss of concentration
  • Feeling hot or cold
  • Skin changes
  • Weight changes

As already indicated, some interferon alfa-2b symptoms can be severe. Contact your healthcare provider, or visit the emergency room, immediately if you experience any of these symptoms.

  • Rashes all over your body
  • Hives
  • Itching
  • Peeling of the skin
  • Breathing and swallowing troubles
  • Blurred vision
  • Swelling of the face, eyes, mouth, tongue, and throat
  • Swelling, tenderness, or pain in the abdomen
  • Yellowing of the eyes and skin
  • Extreme fatigue and tiredness
  • Loss of appetite
  • Nausea and frequent vomiting
  • Back and side pain
  • Burning, numbness, or tingling in the hands and feet
  • Loss of consciousness
  • Abnormal ejaculation
  • Bleeding, inflammation, burning, pain, or itching at the injection spot
  • Irregular, missed, or absent menstrual periods
  • Bone deformity
  • Pain, burning, or itchy feeling in the hairy areas, with occasional pus at the root of the hair
  • Pain, burning, or numb feeling in the fingers
  • Cold, clammy skin
  • Reduced interest in sexual intercourse
  • Decreased height
  • Degenerative disease of the joint
  • Moving and walking difficulty
  • Inability to have and sustain an erection
  • Skin discoloration
  • Increased white or clear vaginal discharge
  • Itching or pain in the genital area
  • Increased sensitivity of the skin to sunlight and UV radiation
  • Leg cramps
  • Loss of sexual drive or performance
  • Longer and irregular menstrual period
  • Multiple swellings and inflammation of the skin
  • Ankle or knee pains
  • Painful, red lumps under the skin, especially on the legs
  • Pain in the ribs
  • Pelvic pain
  • Painful inflammation and swelling in the shoulders, calves, or hands
  • Rashes with flat or small raised lesions on the skin
  • Redness or swelling in the legs and arms
  • Red, irritating eyes
  • Itching, redness, burning, tenderness, or peeling of the skin
  • Shivering
  • Severe com/health/burns/">sunburns
  • Small lumps under the skin
  • Skin rashes, scaly, encrusted and oozing small lumps
  • Soreness of the muscles
  • Stopping of menstrual bleeding
  • Swelling or redness in the joints
  • Tearing of the eyes
  • Tanning or blue discoloration of the skin
  • Under-active reflexes
  • Unexpected menstrual bleeding
  • Flue like symptoms such as chills, fever and muscle aches
  • Tooth and gum problems
  • Temporary hair loss
  • Chest pain, seizures and general body weakness
  • Slurred speech
  • Mental or mood changes
  • Allergic reactions characterized by breathing difficulty, dizziness, rashes, swelling, and itching

If you experience a serious side effect or one that does not go away, be sure to seek medical attention as report the side effect to the FDA at 1-800-FDA-1088. Your healthcare provider should be able to advise you on how to prevent or manage these side effects.

Dosage

Interferon alfa-2b is produced in powder form and sold in a vial with liquid as a solution to inject under the skin, into the vein, into a muscle, or into a lesion. To get the best results, it is advisable to administer the medication at around the same time, usually late evening or during bedtime.

Proper use

Your nurse or healthcare provider will give you this injection. You may also learn to self-medicate at home. If you are self-injecting, be sure to use the medication exactly as directed by your healthcare provider. Do not use more or less of it, and do not use it more often than prescribed by your healthcare provider. The right amount of medicine you need has been carefully set. Overdosing may increase the severity of side effects, while under-dosing may not improve your condition.

Your healthcare provider should show the body areas where this injection can be given. It is advisable that you use a different body area every time you give yourself an injection. Keep track of where you give each injection to avoid injecting the same spot over and over.

Use only interferon alfa-2b brand prescribed by your healthcare provider. Different brands may not work the same way or treat the same condition.

Interferon alfa-2b comes in a prefilled syringe or vial (glass container). You might not use all of the medicine in each syringe or vial. Use any open vial only once and dispose of any unused medicine. Do not use medicines that has changed color or has particles.

Allow the solution in the prefilled syringe or vial to warm to room temperature before injecting. A new needle and syringe should be used each time you are treating yourself. For safety purposes, do not share syringes and needles with another patient.

Drink a lot of fluid, possibly water, in order to pass more urine while on interferon alfa-2b treatment. This will keep your kidneys working well and help prevent any kidney complications that may be associated with this medicine.

Interferon alfa-2b comes with a medication guide. Carefully read the information contained therein and be sure to understand:

  • How to prepare your injections
  • How to properly use and dispose of syringes and needles
  • How to inject yourself
  • How long the injection remains stable

Be sure to ask your doctor or pharmacist about any information you do not understand.

Dosing information

Up to three subcutaneous per week on alternate days.
Duration of treatment:

Up to 6 months

    • Dosage for malignant melanoma

- Induction phase:

Intravenous injection via 20-minute infusion for five consecutive days.
Duration of treatment:

up to 4 weeks
- Maintenance phase:

Three subcutaneous injections per week on alternate days.
Duration of treatment:

48 weeks
Note:

differential WBC and liver function tests should be conducted weekly during the induction and maintenance treatment periods.

    • Dosage for follicular lymphoma

Three subcutaneous injections per week on alternate days.
Treatment period:

18 months
Note:
Interferon alfa-2b should be used in combination with anthracycline-containing chemotherapy regimen after the completion of the chemotherapy treatment.

    • Dosage for Condylomata acuminate

One injection into each lesion (up to five lesions per single course) three times per week on alternate days.
Duration of treatment:

3 weeks

Note:
An additional course may be given at 12 to 16 weeks

    • Dosage for Kaposi's sarcoma

Three subcutaneous injections per week on alternate days.
Treatment duration:

until disease progression or maximal response is achieved, usually after about 16 weeks of treatment.

Note:
Dose reduction is recommended as the patient's condition improves

    • Dosage for chronic hepatitis C

Three subcutaneous injections per week on alternate days.
Treatment period:
- 72 to 96 weeks for monotherapy, or
- 24 to 28 weeks when combined with ribavirin for interferon alfa-naïve patients, or
- 24 weeks when treating patients with a relapse after non-pegylated interferon monotherapy

    • Dosage for chronic hepatitis B

Three subcutaneous injections per week on alternate days.
Treatment duration:

16 weeks

    • Dosage for conjunctival mucosa-associated lymphoid tissue lymphoma

Three subcutaneous injections per week on alternate days for 12 doses.

    • Pediatric dosage for hepatitis C

3 years and older
25kg to 61 kg:

Three subcutaneous injections per week on alternate days.
Greater than 61 kg:

Three subcutaneous injections per week on alternate days.

Treatment duration:
Genotype 1:

up to 48 weeks
Genotypes 2 and 3:

up to 24 weeks

Note:

This therapy is used on combination with ribavirin capsules or oral solution
This medication should never be administered to infants under three years old without doctor's approval

    • Pediatric dosage for chronic hepatitis B

1 year or older
Week 1:

Three subcutaneous injections per week on alternate days.
Subsequent weeks:

dosage amount can be adjusted based on the patient's response to medication
Treatment duration:

16 to 24 weeks
This medication should not be given to infants under one-year-old for purposes of treating chronic hepatitis without the doctor's approval.

    • Pediatric dosage for angioblastoma

Infants older than four months:

Daily subcutaneous injection for up to four weeks.

    • Pediatric dosage for idiopathic (immune) thrombocytopenic purpura

Infants older than four years:

Three subcutaneous injections per week on alternate days.
Treatment period: f

our weeks

Interferon alfa-2b overdose

If a patient has overdosed this medication and has serious overdose symptoms like breathing difficulty and passing, call 911 immediately. You may also report an overdose to the poison control center at 1-800-222-1222. Common symptoms of interferon alfa-2b overdose include chest pain, dark urine, persistent vomiting and nausea, and stomach or abdominal pain.

Missed dose

For optimal benefit, you need to receive each scheduled dosage as prescribed. However, should you miss your dosage for any reason, contact your healthcare provider immediately to establish a new dosing schedule. Do not double dose to make up for the missed injection.

Interferon alfa-2b interactions

Although certain medications should never be combined for fear of interactions, there are cases where two different medicines may be prescribed even if an interaction might occur. In such cases, your healthcare provider may recommend a change in dosage for one or both medications or recommend other precautions. When you are on interferon alfa-2b therapy, it is especially vital that your healthcare provider know if you are on any other treatment.

Using interferon alfa-2b with pirfenidone is not recommended. However, this may be required in some cases. If both medications are prescribed together, your doctor may recommend a change in dosage or how often you take one or both medications.

Interactions with food, alcohol, and tobacco
Some foods should never be taken while on some medications. Also, alcohol and tobacco products tend to affect the efficiency of some medications. Discuss with your healthcare provider the kinds of foods you need to avoid while on interferon alfa-2b treatment. Also, discuss with your healthcare provider whether it is safe to use alcohol and tobacco products while on this medication.

Other medical conditions that may affect interferon alfa-2b efficiency
Certain pre-existing medical conditions may affect the use and efficiency of interferon alfa-2b. Be sure to tell your doctor if you suffer from, or have a history of, any of the following conditions.

Interferon alfa-2b warnings

Before using this medication, tell your healthcare provider if you are allergic to it, its ingredients, or if you have any other allergy including drug, food, and animal allergies. Interferon alfa-2b may contain inactive ingredients like albumin that can trigger fatal allergic reactions like anaphylaxis and other problems.

Before using interferon alfa-2b, tell your healthcare provider or pharmacist your medical history, especially of blood cell disorders, cancer, diabetes, heart and eye problems, high blood pressure, immune system disease, HIV infection, intestinal diseases, kidney disease, liver disease, pancreatitis, thyroid diseases, seizures and abuse of alcohol and hard drugs.

Interferon alfa-2b may make you dizzy. Do not operate machinery, drive, or perform an activity that requires you to be alert until you are sure you can perform such activities safely while on medication. Limit alcohol intake while on this medication.

Do not get vaccinations and immunizations while on this medication without the consent of your healthcare provider. Additionally, avoid contact with people who have recently received flu vaccine or oral polio vaccine. Thoroughly wash your hands to prevent the spread of infections.

Exercise caution when using sharp objects like razors and blades to reduce the risk of getting cut or bruises. Also, avoid activities like contact sports that may pre-dispose you to bruising and other injuries.

Before having surgery, tell your surgeon or dentist about all the products you are currently using including prescription and non-prescription medications as well as herbal products.

Children and teenagers may be more sensitive to the side effects of this medication, especially mood swings associated with severe depression and suicidal thoughts. Continued use of interferon and ribavirin may also slow down the child's growth rate. The normal growth rate, as well as weight gain, usually returns when treatment is through. It is important that you monitor your child's growth rate while they are on this medication.

Caution is advised when administering this medication to elderly patients because they may be more sensitive to the drug's effects, especially mental/mood changes, dizziness as well as its effects to the heart and blood.

Interferon alfa-2b is not recommended for use during pregnancy as it may harm the unborn baby. Use an effective birth control method while on this medication. Stop the medication immediately if you get pregnant while under treatment.

Interferon alfa-2b when combined with ribavirin, should never be used during pregnancy by either the expectant woman or her male partner as this combination may cause harm to the unborn baby. There should be no conception for at least six months after stopping this medication. Tell your doctor right away should you conceive before the end of the six months' period.

It is not clear whether this drug can be passed to the nursing baby via breastmilk. Consult your healthcare provider before taking this medication when breastfeeding.

This medication can trigger serious allergic reactions including anaphylaxis, a life-threatening condition that requires immediate medical attention. Call your healthcare provider immediately if you have hives, itching, hoarseness, breathing and swallowing difficulty, or swellings on the face, mouth, throat, and hands.

Interferon alfa-2b can temporarily lower the number of white blood cells in your blood, reducing your body's immune system. It can also affect blood clotting by lowering the number of platelets. Should this occur, possibly after long-term therapy, you need to take certain precautions to reduce the risk of excessive bleeding or infection.

These include:

  • Avoiding crowded places where the risk of catching an infection is high. Talk to your healthcare provider immediately if you get an infection or if you get chills, fever, lower back or side pain, painful urination or a cough and hoarseness.
  • Check with your healthcare immediately if you pass black, tarry stool, experience unusual bruising or bleeding, pass urine or stool with blood, or notice red spots on your skin.
  • Exercise caution when using regular dental floss, toothbrush, or toothpick. Your dentist or doctor may other ways to clean your teeth and gums while on interferon alfa therapy. Do not have any dental work before checking with your doctor.
  • Avoiding touching your eyes or inside of your nose without thoroughly washed hands
  • Avoid contact sports that can increase your risk of cuts and bruises

Interferon alfa-2b can prompt suicidal thoughts in patients with or without a history of mental illness. The medication may also cause a relapse in patients with a history of substance abuse. Contact your doctor as soon as possible if you develop signs of depression or aggressive behaviors. Also, tell your healthcare provider if you have thoughts of hurting yourself or others. Report all unusual behaviors or thoughts that are troubling, especially if they are new or worsen quickly.

Interferon alfa-2b injection, when combined with ribavirin, may cause dryness of mouth. For temporary relief from dry mouth, use sugarless gum or candy, melt bits of ice in your mouth, or get saliva substitute. However, if this condition continues beyond two weeks, consult your healthcare provider or oral health specialist. Prolonged mouth dryness may increase your chance of dental illness, including gum disease, tooth decay, as well as fungus infection.

Some patients may vomit while taking this medication. If you vomit during or immediately after injection, rinse your mouth out with water to prevent damage to your gums and teeth. Additionally, take plenty of fluid to prevent dehydration.

Do not take other medications before discussing with your healthcare provider. This includes both prescription and non-prescription medication, vitamin supplements as well as herbal medications.

Wear sunscreen protection and avoid exposing to UV radiation while on this medication.

Interferon alfa-2b

storage

This medicine should be stored in the refrigerator between two to eight degrees Centigrade. Store the medication away from moisture and light. Do not freeze. All medication should be kept away from children and pets.

Interferon alfa-2b multi-dose pen may be used for up to 4 weeks after opening. Dispose of the pen after four weeks of use even if it contains unused medicine. Do not leave this medicine outside the refrigerator for more than 48 hours. Properly dispose of any expired or unused medication. Do not flush down your toilet or kitchen sink.

Summary

Interferon alfa-2b is synthesized from human proteins. Interferons help the body's immune system respond to viruses, bacteria, cancer, and other invasive pathogens. Interferon alfa-2b is used alone or in combination with other medication to treat malignant melanoma, hairy cell leukemia, follicular lymphoma, genital warts, and Kaposi's sarcoma caused by HIV/AIDS. It is also used for treating chronic hepatitis B and C in adults and chronic hepatitis B in children older than one year.

Like with other medications, Interferon alfa-2b comes with its share of side effects. Some of the drugs side effects are mild and will go away as your body adjusts to the medication. However, some side effects are severe and may require immediate medical attention. Specifically, call your healthcare provider of the emergency room if you experience serious allergic reactions while using this medication. Additionally, be sure to inform your healthcare provider of any underlying medical conditions such as HIV/AIDS, hepatic conditions, and a history of organ transplant before using this medication.

Interferon alfa-2b should not be administered to pregnant women as it can cause a com/health/miscarriage/">miscarriage or cause birth defects. It is important that you use an effective birth control method while on interferon alfa-2b treatment and up to six months from the last dose. Be sure to talk to your healthcare provider right away should pregnancy occur while either partner is on interferon alfa-2b and ribavirin medication.

Interferon alfa-2b dosage is based on the medical condition for which it is administered as well as the patient's response to treatment. Do not change your dosage of the frequency of using this medication without your healthcare provider's approval.

Interferon alfa-2b can affect growth in children when combined with ribavirin. Talk to your healthcare provider if you think your child is not growing as they should while on this medication.

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