Subcutaneous Peginterferon Alfa-2b (Subcutaneous)

Overview

Subcutaneous peginterferon alfa-2b is a drug prescribed to those suffering from conditions such as chronic hepatitis C infection and malignant melanoma.

Subcutaneous peginterferon alfa-2b acts where the body has failed to by providing substances the body would create if it was healthy. The aim of this synthetic substance is to tackle infection, and it is often used either alone or in conjunction with a drug known as ribavirin. (In the case of hepatitis C patients, it is also used alongside a hepatitis C virus protease inhibitor.)

Usually, this drug will only be prescribed to those who have not yet been treated for their condition by a class of drugs known as alpha interferons.

This drug is only available with a prescription from your physician, so cannot be purchased over the counter. It is available either as a powder for a solution or as a kit, and it is administered via a needle which must be injected under the skin. In the USA it has a number of brand names, including Peg Intron RP, PEG-Intron and Sylatron. You may see it referred to in this way on marketing materials, safety and information leaflets, in stores and more.

Conditions Treated

• Chronic hepatitis C

Type Of Medicine

• Antineoplastic agent

Side effects

As with all forms of medication, subcutaneous peginterferon alfa-2b can cause unwanted effects in addition to making you feel better and relieving the symptoms of your main condition.

These unwanted problems are known as side effects and can come in many different forms. If you have any concerns about how potential side effects might affect you, you should speak to your physician.

• The first category of potential side effects you may experience when taking subcutaneous peginterferon alfa-2b are those which require immediate medical attention from your physician. Some of these side effects are considered more common, which means you are more likely to experience them compared to other side effects.

Symptoms in this category include stomach problems like abdominal pains, black or bloody stools, vomiting, feeling nauseous and more. Mental health problems, such as depression or anxiety, are also located in this category.

In addition, conditions like the chills, fever, difficulty falling to sleep, unusual patterns of bleeding and more are all in this category. Problems with the throat are also common in this category, such as a hoarse voice, coughs, feeling as though your chest is tight, and more.

• There are also some side effects of this medication which do still require medical treatment, but which clinical research has indicated are less likely to occur. These include symptoms which only affect women, such as an unusual change to the menstrual cycle. Other problems in this category include a feeling of being drowsy, problems with dry skin, feeling excessively cold, constipation and more.

Other side effects in this category are considered to be rare. These include a variety of physical health problems such as an ache in the back, problems speaking, lower quality of vision, feelings of dizziness and more. Some mental or psychological health problems also exist in this category, such as becoming addicted to drugs, attempts at suicide and feelings of nervousness.

• In addition to the side effects outlined above, some potential side effects of taking subcutaneous peginterferon alfa-2b do not necessarily require medical attention. In most cases, these side effects can be left to go away on their own. The only time you may need to consult a medical professional is if these conditions are causing you lots of problems or they do not go away naturally.

Some side effects in this category are considered more common. The symptoms in this category include a change in how you perceive foodstuffs to taste, problems moving around, experiencing a flushing sensation on your skin, feelings of "pins and needles", and more.

Problems specifically around the site on your body where the medication was injected can also be considered side effects. If you experience a feeling of irritation around that area, or you notice bruises, these may be effects of the medication.

Issues with your sinuses also fall into this category. If you feel an aching sensation or you experience tension in the sinus region, this may be a consequence of your medication.

Finally, a number of other miscellaneous problems fit into this category. These include problems digesting food, runny noses or excessive sneezing, hair loss and more.

• One side effect of this medication which does not require medical treatment is considered less common, and that is rigidity in your muscles.
• It is important to remember that these lists of side effects are non-exhaustive, and that not every patient experiences the same set of side effects when they take this drug. For that reason, it's wise to speak to your physician if you have any questions.

In addition, healthcare professionals can provide you with some tips and tricks on how to get through the treatment process if side effects occur.

Dosage

When it comes to dosages of this medication, you should always follow the instructions provided to you by your physician. This goes for the exact amount of the drug you need to take, and also for related instructions such as how frequently you need to take it and in what format.

However, the medical authorities have released a standard dosage sheet for information purposes only. This should never supersede the instructions of a qualified medical professional, but may be used as an indicator.

• For those adults taking this medication in its injection format to treat a hepatitis C virus infection, you are usually prescribed an amount based on body weight, worked out by a physician. In most cases, this dosage will be between 40 and 150 micrograms (mcg), and patients will need to have it injected into their system under their skins once per week often on the same day and at the same time. For children, the dose will be determined by a physician. For children aged over three, this will ordinarily be determined based on body weight.
• For those who are taking this medication in conjunction with ribavirin, the dosages may be slightly different. For adults, the dosage is again based on your overall body weight but will often be between 50 and 150 micrograms (mcg). Again, it will be injected underneath the surface of the skin, and it will take place once a week at the same day and time. The ribavirin capsules (or, in some cases, ribavirin solution) will need to be taken twice per day.

In the case of children aged three years old or more, the total amount prescribed will usually be based on the surface area of the body. Generally, parents can expect their children to be prescribed around 60 micrograms per square meter (expressed mathematically as mcg/m[2]) of the child's body surface area. Once again, this will need to be injected under the outer layer of the skin once per week at the same day and time, and again must be taken alongside ribavirin capsules or solution twice per day. For those children aged under three years, the usage and dosage of this drug must be determined by a physician.

• For those who are taking this medication to treat melanoma, it is likely that the dosage will be different once again. For adults, the dosage will be based on body weight and often will be around six micrograms per kilogram of total body weight, and this will be injected again underneath the surface of the skin once per week, for around eight doses. Following this, there is usually a very long period of follow up doses, usually around three micrograms per kilogram of body weight given in the same format once per week for a period of up to five years. For children taking this medication, the usage and dosage will often be determined by a doctor.
• Because this medication is administered via a needle, it is important to follow a number of additional instructions to ensure that you take it correctly.

Sometimes, this medication will be administered in a clinical environment such as a hospital by a medical professional. In that case, you do not have to concern yourself with dosage and application information.

However, you may also be shown how to apply this medication to yourself or your child at home. If your healthcare professional goes for this option, you will be shown how to do it correctly and you will have the opportunity to ask questions. Before doing it yourself for the first time, you need to feel confident that you know how to inject it under the skin correctly, otherwise you may not do it in the right way. If you are uncertain in any way, you should consult your physician or other healthcare professional to get clarification on any relevant points.

Your physician may advise that you might experience a number of unwanted side effects when taking this medication, such as feverish feelings and pains in your joints. For that reason, you should check with your physician how to go about mitigating these problems, such as by drinking more water or by taking extra medication to relieve symptoms.

When you receive this information from your physician or you read the accompanying information leaflet which comes with your supplies of subcutaneous peginterferon alfa-2b, you should ask yourself some questions about your understanding of the information provided.

Do you know, for example, how to prepare the needle prior to injection, and how to deliver it? You should also be sure that you know how to check that the injection is stable before using it.

• You should endeavour to take this medication at the regular times prescribed by your physician. If, however, you do miss a dose, you should contact either your physician or a pharmacist for advice on what to do.

Interactions

Because of their powerful properties, many drugs can interact with other medications once they are inside the human system, and subcutaneous peginterferon alfa-2b is no exception.

• Some other medications may cause severe interactions when taken alongside subcutaneous peginterferon alfa-2b. In most circumstances, your physician will not usually prescribe this drug to you if this risk is present.

Drugs which are included in this category are some immunosuppressants and immunosuppressive agents, such as talimogene laherparepvec, some vaccines such as live BCG (Bacillus Calmette-Gurin vaccine) and drugs like natalizumab.

• Other drugs can cause serious level interactions when taken with subcutaneous peginterferon alfa-2b. They can still be prescribed by a physician, but if you receive a prescription for this medication you should ensure you speak to your healthcare professional about the effect it may have on you.

Some of the drugs included in this category again include immunosuppressives such as fingolimod and ocrelizumab. Some myelosuppressive agents, meanwhile, are also on the list. These include deferiprone and clozapine.

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• Finally, there are some medications which can cause a moderate level of interaction with subcutaneous peginterferon alfa-2b. If you have any questions about taking these drugs alongside your subcutaneous peginterferon alfa-2b, you should consult your healthcare professional to find out more.

Some of the drugs included in this category are interferon-alpha mixed with colchicine, while a range of medications which limit the production of the enzyme CYP1A2 - such as theophylline derivatives - can also cause moderate-level interactions.

Some medications which have anti-angiogenic properties can interfere with subcutaneous peginterferon alfa-2b as well. These include drugs like erlotinib.

• In order to cut down on the risk of interactions taking place, it is wise to let your physician know what other drugs you are taking well in advance of you beginning your treatment. Your physician may choose to change your current arrangement of drugs in order to accommodate the subcutaneous peginterferon alfa-2b without unnecessarily raising the risk of interactions, so you should ensure that you are fully upfront about your current drugs.

When you provide your list of current medications to your physician, you should take care to include any over the counter medications you currently take as well as any prescription medications you are on.

Warnings

As with many medications, subcutaneous peginterferon alfa-2b comes with a wide range of associated warnings which you should familiarise yourself with prior to taking this medication.

This medication usually comes with a leaflet containing information on how to take it and how to look after it. You should ensure you keep this leaflet in a safe place so that you can refer back to it in the future if you need to.

Your doctor should check in with you regularly while you are taking this medication in order to ascertain whether or not it is working. You should make sure your physician schedules regular visits for the duration of your treatment plan.

Regardless of whether or not you have a personal history of mental health problems, you may find that taking this medication increases the prevalence of suicidal thoughts. In the event that any mental health problems appear or you start to find that you want to hurt yourself, you should inform your physician. If you have previously abused substances such as drugs and alcohol, you should inform your physician just in case symptoms reappear. Any of these symptoms may continue for up to six months following your use of subcutaneous peginterferon alfa-2b, so you should monitor the problem and speak to your physician if there are any issues.

Before taking this medication, women who are of an age where they can conceive and who are prescribed the drug should take a pregnancy test in order to ensure that they are not pregnant. This test must come back negative before taking it alongside ribavirin. Because it is paramount that those who do take this medication do not get pregnant, it is important those taking this medication use two separate forms of birth control. This applies to the women partners of men patients in addition to women patients, too. This must last during treatment and for six months following the treatment.

It is possible that this medication can cause allergic reactions. In the event that you experience problems like loose skin, feverish feelings, chills or more, you should speak to your doctor. In some cases, this medication can lead to a very serious condition known as anaphylaxis which can be life-threatening in some cases. Again, should you experience any problems like a hoarse throat, itchy skin, difficulty breathing or more, you should speak to your physician.

While taking this medication alongside ribavirin, the number of white blood cells or platelets in your body can temporarily drop. This, in turn, can raise the possibility you'll suffer from an infection or blood clot. For that reason, there are some steps you should take in order to reduce the risk of this happening. You can, for example, reduce the amount of time you spend around people who may be at risk of passing an infection on to you, while you should also exercise caution when using dental hygiene products such as floss or brushes as these can cause bleeding. Other personal items which may cause bleeding include razor blades, so you should also take care not to cut yourself when using these.

Remember, this list is not exhaustive. You should consult the list of warnings in the booklet which is issued alongside your subcutaneous peginterferon alfa-2b so that you are fully informed. Even if you do not believe these warnings apply to you, you should read the full list anyway to prevent missing any which are relevant.

Storage

It is important that this medication is stored in a closed container, and that it is kept away from a range of adverse environmental conditions such as moisture, light and high levels of heat. In addition, you should never freeze this medication as that may damage it.

In addition, it is vital that this medication is stored away from the reach of children so that it will not be accidentally consumed. Even if you do not have children staying with you at your home, you should ensure you keep it stored in a place where children cannot reach it to prevent any accidental consumption if you ever have children visiting you.

You should always follow your physician's instructions when it comes to taking this medication and you should not stop taking the amount you have been prescribed unless you are told to by a doctor. If, however, you do for any reason find yourself with excess medication you should dispose of it right away. If you are unsure how to go about doing this appropriately, you should consult a healthcare professional to find out how and where you can get rid of any excess medication.

As this medication comes in vials and requires needles, there are some specific instructions regarding the correct storage which you must follow. For example, once you open a vial of this medication you should ensure you use it straight away.

Ideally, the same should apply once you have mixed this medication, although it is possible to store the mixture in a fridge for up to 24 hours if necessary. If 24 hours pass and you have not used the mixture, you should dispose of it. While you can store it in the fridge, you should never freeze it.

When disposing of used needles, there are some extra precautions which you should take to prevent problems for others. It is vital that you dispose of the medication in a container which is hard and which the excess needles cannot poke or fit through. Once you have closed this container, you should dispose of it in a location where any children who (or animals which) live in your home cannot access.

Summary

Subcutaneous peginterferon alfa-2b is designed to help patients suffering from chronic hepatitis C and malignant melanoma. By fighting infections and replacing substances usually created naturally by the body, this drug is often only prescribed to those who have not yet been treated by alpha interferons. Technically known as an antineoplastic agent, this drug can only be used with a prescription from a physician.

This drug is associated with a number of potential side effects which may cause problems even as the medication begins to make you feel better. Some of these side effects, such as feverish tendencies, abdominal pain and vomiting, require you to speak to a physician right away. Other side effects, such as problems with taste and issues like hair loss, usually only require medical treatment if they persist or if they are causing you serious issues.

You should always follow the instructions of your physician when it comes to your dosage of subcutaneous peginterferon alfa-2b, although standard dosages have been developed for general information purposes only. The dosage you will receive can vary based on a wide range of factors, including your age, your body weight and your body's surface area. If you miss a dose, you should contact your physician or pharmacist straight away for advice.

This medication can interact with other drugs once it is inside the human body. In some cases, the interactions can be severe, while in other cases they can be serious or moderate. You should provide your physician with a full breakdown of the medications you are currently taking, and you should include over the counter medications in this list as well as any you have received via a prescription.

This medication comes with a number of warnings, and as a result, you should ensure that you read and retain the information booklet which is usually provided. This booklet should contain a full list of warnings, and you should read them all even if you suspect none of them apply to you. Some of the specific warnings associated with subcutaneous peginterferon alfa-2b include a possible occurrence of allergic reactions such as anaphylaxis, the emergence of mental health conditions such as suicidal thoughts, and more. Women who are taking this medication - and the women partners of men taking it - should use two forms of birth control in order to prevent falling pregnant.

This medication should be stored in a location where it cannot be accessed by children either now or in the future. It should be kept away from problematic environmental conditions, such as lots of heat or light. It should be kept in a closed container. Once you have opened a vial of this medication it should be used right away, and once you have created the appropriate mixture you should only refrigerate it for a period of up to 24 hours. If you have any of this medication left over after your course of treatment has finished, you should find out from a healthcare professional how to dispose of it appropriately, then go about doing this. In addition, you should take extra care when disposing of your leftover needles.