Interferon Beta-1b (Subcutaneous)

Overview

Interferon beta-1b is a prescription medication that treats relapsing-remitting multiple sclerosis. While there is no cure for MS, this medication has been reported to slow some of the debilitating effects of MS in a number of patients.

This medication is often self-administered via injection. The injection process can be quite complex and some patients may have difficulty injecting themselves with interferon beta-1b. If you do not feel capable of self-administering this medication, speak with your doctor and other members of your medical team about your concerns. In some instances, it may be possible to have a home healthcare aid administer this medication for you.

If you do proceed with self-administration, be sure that you are completely comfortable with the process and are aware of how to combine the interferon beta-1b with the diluent solution. Rotate the site of your injection each time to avoid infection and irritation to the skin. Many patients find it helpful to keep a written record of the date of their injection and its exact location. Notify your doctor right away if you experience any redness, scabbing, or other irritation at the site of the injection.

All needles and syringes must be disposed of in a safe and appropriate manner.

Patients who are not comfortable with the mixing and injection process should discuss their concerns with their doctor in order to evaluate possible alternative options.

Interferon beta-1b is delivered via this dosage method:

  • Powder solution

Condition(s) Treated:

  • Relapsing-remitting multiple sclerosis (MS)

Type Of Medicine

  • Interferon, Beta
  • Immunological Agent

Side Effects

Similar to many other medications, there can be some unwanted side effects with the use of interferon beta-1b. Patients are advised to recognize the difference between side effects that require immediate medical advice and attention and those that will likely dissipate on their own. If you are unsure if your symptoms are significant or could be the sign of a more serious problem, it is always best practice to confer with your prescribing doctor for further guidance.

In the event that you experience one or more of the symptoms listed below, let your doctor know right away as they may be a sign of a more serious problem that may require immediate medical attention:

More likely:

  • Abdominal or stomach pain
  • Irregular or pounding heartbeat
  • Flu-like symptoms including chills
  • Stuffy nose
  • Hives, itchiness, or swelling at the injection site
  • Headaches, including migraines
  • Redness, pain, or feeling of heat at the injection site
  • Break in the skin at the injection site
  • Black-blud discoloration at the site of injection
  • Swelling, or drainage of fluid at the injection location

Less likely:

  • Bloody or cloudy urine
  • Swollen glands
  • Changes in vision
  • Pain
  • Unexplained weight gain
  • Frequent urge to urinate
  • Pelvic pain
  • Cold hands and feet
  • Troubled breathing
  • Breast pain
  • Fast or racing heartbeat
  • Difficult or painful urination

Rare likelihood:

  • Abnormal growth in the breast
  • Red, itching, or swollen eyes
  • Bleeding problems
  • Mental depression with thoughts of suicide
  • Changes in menstrual periods
  • Increased urge to urinate
  • Convulsions
  • Hyperactivity
  • Decreased sexual ability in males
  • Unexplained weight loss
  • Feeling cold
  • Increased muscle tone
  • Cysts
  • Loss of memory
  • Confusion
  • Problems with speaking
  • Bloating or swelling
  • Swelling of the front part of the neck
  • Dry, puffy skin
  • Benign lumps in the breast

As your body adjusts to the introduction of interferon beta-1b you may experience some temporary side effects that will likely dissipate on their own. If you experience any of the symptoms that are listed below and they last for more than a few days or become worse, it is advised that you check with your doctor for further medical advice:

More likely:

  • Constipation
  • Loss of voice
  • Dizziness
  • Unexplained tiredness or weakness
  • Menstrual pain or other changes
  • Diarrhea

Less likely:

  • Anxiety
  • Vomiting
  • Hair loss
  • Drowsiness

This list of possible side effects aims to be comprehensive, however, it is possible that you may experience certain symptoms that are not listed here. If you have a reaction to interferon beta-1b that you find concerning, they last more than a couple of days, or the symptoms are growing worse, contact your doctor as these may be a sign of a more serious problem.

Dosage

This medication can be administered by a medical professional, such as a nurse, or you may be trained to administer the drug yourself via injection. It is important that the drug is administered following the directions provided by the prescribing physician in order to be as effective as possible. If you do not feel as though the drug is effective, or providing the expected results, discuss your concerns with your doctor and do not make any changes to the way that you take this medication without their supervision.

This medication has been known to cause symptoms similar to those associated with the flu. Many patients have found that administering the injection close to bedtime can help to reduce the occurrence of these symptoms. The medical team may also provide tips and other medications to help to alleviate these types of symptoms when they occur.

Patients will be trained on how to safely inject themselves with interferon beta-1b and will also need to be aware of how to properly prepare the injection site, measure the dosage accurately, and utilize the syringe and needles safely.

  • Be sure to have all of the necessary items collected and in place before you start the injection process.
  • Patients are advised to use soap and warm water to wash their hands. Avoid touching anything after the hand washing.
  • Confirm that all needle guards are tightly secured.
  • When opening the interferon beta-1b vial, use a wipe containing alcohol to ensure that the top of the vial is free of any germs, dust, or debris.
  • Keep the vials covered with the alcohol wipe until you are ready to inject the interferon beta-1b.

The importance of cleanliness and keeping all injection items sterile cannot be overstated. Make sure that the tops of the vials and the needles themselves are never touched. If you inadvertently touch the stopper, wipe and clean it thoroughly with an alcohol pad. Anytime a needle is accidentally touched, no matter how slightly, the syringe must be discarded. The same applies if the needle touches the countertop or any other non-sterile surface. Sodium chloride (0.54% strength) is the diluent that must be used for this injection and should be included with your medication. If you do not receive this solution contact your pharmacist at once as it is necessary to dilute the medication prior to injection.

Instructions for mixing the contents of the interferon beta-1b vial:

  • Remove the cover from the needle of the 3mL syringe and also ensure that you never directly touch the needle.
  • The plunger should be pulled back to the 1.2mL line as measured by the syringe.
  • Insert the needle into the vial of diluent that you have been given with your interferon beta-1b solution.
  • Depress the plunger and inject 1.2mL of air back into the vial of diluent, leaving the needle in the vial.
  • Next, turn the vial over and ensure that the entire needle tip is submerged in the solution. Bring back the plunger and bring 1.2mL of diluent into the syringe.
  • Do not ever shake the syringe, if a movement is necessary, gently tap the side of the syringe.
  • Keep the vial turned upside down and tap the vial in order to dispel any air bubbles that may have formed; depress the plunger to dispel any formed air bubbles out through the needle tip. Next, remove the needle from the vial.
  • Now take the syringe that contains the diluent and insert the needle into the vial of interferon beta-1b. Slowly depress the plunger and place the needle on the interior side of the vial in order to force the diluent onto the side; do not inject the diluent directly into the medicine (white cake) as that may cause excessive foaming.
  • Remove the needle.
  • In order to dissolve the cake of interferon beta-1b, simply roll the closed vial gently between your hands.
  • Ensure that the solution is clear and free from any floating particles. If the solution is cloudy or discolored or contains particles, it must be disposed and the process begun again.

Instructions for preparing the syringe used to inject interferon beta-1b:

  • First, take off the guard from the needle of your 1mL syringe and pull the plunger back to the 1mL line.
  • Next, insert the needle into the solution of interferon beta-1b vial.
  • Firmly, but gently, depress the plunger to the bottom of the syringe in order to inject the vial with air.
  • Swing the vial upside down but keep the needle in the rubber top of the vial.
  • Pull back on the syringe plunger and withdraw 1mL of the solution.
  • Continue holding the syringe with the needle facing upward. Give the side of the syringe two or three gentle taps in order to dispel any air bubbles that may have formed. This action should cause the bubble to rise to the top.
  • Next, depress the plunger in order to release the trapped air out through the needle.
  • Remove the needle tip from the vial and carefully put the needle cover back onto the syringe.
  • Any remaining solution that is left in the vial should be discarded in a safe and appropriate manner.

Patients are reminded that this drug must be injected directly after it has been mixed. If for some reason you cannot administer the medication right away, place the prepared syringe in the refrigerator for use within three hours. Do not ever allow this medication to freeze or store it in the freezer.

Instructions for the self-administration of interferon beta-1b:

Patients who are self-injecting this medication will be educated about the eight various locations where the medicine should be injected. Each area contains a lower, middle, and upper site. It is important to rotate the location of each injection in order to minimize the chance of infection or irritation to a single site.

Any areas that may contain knots, bumps, any lumps, or are painful to the touch should be avoided. Likewise, an area that has been infected or is showing signs of irritation such as skin redness or scabs must also be avoided.

  • First, thoroughly clean the area with an alcohol pad and allow it to dry thoroughly before proceeding.
  • Take the pre-mixed syringe that you have just filled with both diluent and interferon beta-1b. While taking great care to not touch any part of the needle surface, remove the cover from the tip.
  • Pinch the clean skin gently and lift it away from the body.
  • Insert the tip of the needle directly into the injection site at a 90-degree angle. Utilize a firm and quick motion when doing this.
  • Now, with a steady movement, depress the plunger slowly the entire length of the syringe. All of the solution should be injected with this one steady motion.
  • Place a piece of sterile cotton on the site of the injection and remove the needle with a straight and firm motion.
  • Massage the skin in a gentle and firm manner until most discomfort has dissipated.

Needles, syringes, and vials should be used for only one injection. Place all used syringes, needles, and vials in a syringe disposal unit or in a hard-walled plastic container, such as a liquid laundry detergent container. Keep the cover closed tightly, and keep the container out of the reach of children. When the container is full, check with your physician or nurse about proper disposal, as laws vary from state to state.

Follow all instructions provided by the prescribing physician, and request additional assistance if you experience any difficulty with administering the interferon beta-1b.

All equipment that is used in the injection process, such as alcohol swabs, syringes, and needles should all be disposed of properly. Your doctor may provide you with a puncture-proof container to use for disposal, if one is not provided a common household container, such as one that contained laundry detergent, can be effective. Discuss any questions or concerns that you may have relating to the proper disposal of this medication and the tools used for its injection.

Typical dosage amounts for interferon beta-1b are usually:

0.0625 milligrams self-administered every other day for a period of six weeks. Following this dosage course, your physician may make adjustments to increase your daily dosage of interferon beta-1b. The maximum dosage of this medication is 0.25 mg taken every other day.

Patients are advised to wait for 48 hours between scheduled doses.

Major Drug Interactions:

Similar to most other drugs, interferon beta-1b is contraindicated for use with a number of other drugs. Patients who are taking any other prescription drugs should provide their medical team with a comprehensive medical history that includes information on all prescription and non-prescription drugs that they are taking.

Patients that suffer from any of the following medical conditions may experience further complications while taking interferon beta-1b. If you are currently being treated for any of the following ailments, be sure to stay in close contact with your doctor and inform them of any negative reactions that you experience while taking interferon beta-1b.

  • Seizures
  • Depression
  • Blood or bone marrow problems
  • Thyroid problems
  • Congestive heart failure
  • Liver problems
  • Infections

Warnings

Patients who have an allergy or sensitivity to latex are advised to discuss this condition with their doctor prior to taking interferon beta-1b as the cap over the pre-filled syringe does contain latex. Your doctor or another member of your medical team will be able to provide insights on how to minimize any reaction that you may experience.

While taking this medication your doctor will likely order diagnostic testing, such as blood and urine tests, on a regular basis. This practice can help them to manage the efficacy of the interferon beta-1b as well as monitor the existence of any unwanted side effects. It is important that all appointments and orders for testing are kept as scheduled.

The following symptoms may actually be a sign of a more serious issue, such as a liver problem, and should be brought to your doctor's attention right away:

  • Light-colored stools
  • Flu-like symptoms
  • A general feeling of weakness
  • Continuing vomiting
  • Dark urine
  • Unexplained tiredness
  • Headaches
  • Pain or tenderness in the right upper quadrant of the stomach
  • Persistent loss of appetite
  • Yellow eyes or skin

Patients who are taking this medication should familiarize themselves with the symptoms of anaphylaxis, an allergic reaction that can occur that can become very harmful or even fatal in some cases. Seek emergency medical treatment right away if you experience:

  • Rash
  • Itching
  • Hoarseness
  • Difficulty breathing
  • Trouble swallowing
  • Swelling of the hands, face, or mouth

Interferon beta-1b has been reported to cause anxiety, irritation, and abnormal behavior in some cases. If you experience any suicidal ideation or experience a worsening depression please notify your doctor right away. Any caregivers that are working with you should also be aware of these symptoms and what action to take should they occur.

Due to the injection that this medication requires, patients should be prepared for some irritation in the area of the injection. In some cases, necrosis can occur, which is a permanent divet at the site of the injection. Skin infections have also been reported in some instances.

Your doctor should be notified as soon as possible if you notice at the location of your injection:

  • Depressed or indented skin
  • Blue-green to black skin discoloration
  • Pain, redness, or peeling skin

Patients who experience low white blood cells may be more susceptible to infection. Notify your doctor if you show any signs of infection, such as:

  • Fever
  • Chills
  • A persistent sore throat

There are different thrombotic conditions that can occur while taking this medication, including thrombotic microangiopathy, thrombocytopenic purpura, and hemolytic uremic syndrome. Notify your doctor immediately if you experience:

  • Black, tarry stools
  • Stomach pain
  • Problems with speaking
  • Yellow eyes or skin
  • Red spots on the skin that are the size of a pin
  • Seizures
  • Fever
  • Unexplained bleeding or bruising
  • Blood in the urine

There is a possibility of drug-induced lupus erythematosus occurring in patients who are taking interferon beta-1b; contact your doctor immediately if you experience:

  • Rash
  • Bloody or cloudy urine
  • Drowsiness
  • Headaches
  • Paleness
  • Cold feeling in fingertips and toes
  • Tingling or pain in fingers or toes when exposed to cold
  • Swelling of the face, feet, or lower legs
  • Difficulty breathing
  • Unexplained weight gain

Interferon beta-1b is made by utilizing donated blood. As part of the donation process, both the donor and the blood are fully screened for the presence of viruses or other infectious materials. Patients who have any concerns about the risks that are present with the use of this medication should discuss them with their doctor prior to beginning their course of treatment.

Storage

Interferon beta-1b should be stored in the refrigerator and never the freezer or countertop. It is important that you not freeze this medication.

Patients who are in a situation where refrigeration of their medication is not possible, it is possible to store the vials for up to three months at room temperature levels. It is important that if you are storing your medication in this manner that the temperature never climbs above 86 degrees Fahrenheit.

It is always best to store medications in their original packaging; do not remove the interferon beta-1b from its vial prior to usage.

Like all other medications, keep this medicine out of the reach of both small children and pets.

Consult with your doctor or pharmacist about the safe and appropriate disposal method for any unused or excess medication. Do not keep any medication that you are not planning to use.

Summary

Interferon beta-1b is a prescription medication that treats relapsing-remitting multiple sclerosis. While there is no cure for MS, this medication has been reported to slow some of the debilitating effects of MS in some patients.

This medication is often self-administered via injection. The injection process can be quite complex and some patients may have difficulty injecting themselves with interferon beta-1b. If you do not feel capable of self-administering this medication, speak with your doctor and other members of your medical team about your concerns. In some instances, it may be possible to have a home healthcare aid administer this medication for you.

Similar to other drugs of this type, interferon beta-1b is created by using human blood that has been donated by other people. This blood, as well as the blood donor, is thoroughly tested and analyzed prior to its inclusion in any medication, however, there have been some reported cases where viruses have been transmitted via donated blood.