interferon alfa 2b (Rx)

Brand and Other Names:Intron A, Interferon alfa-2b
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 6 million International Units/mL (3.8mL vial)
  • 10 million International Units/mL (3.2mL vial)

multidose pen; 6 doses each

  • 22.5 million International Units/1.5mL
  • 37.5 million International Units/1.5mL
  • 75 million International Units/1.5mL

powder for injection

  • 10 million International Units/vial
  • 18 million International Units/vial
  • 50 million International Units/vial

Hairy Cell Leukemia

2 million Units/m² IM/SC 3 times/wk for up to 6 mo  

If severe adverse reaction (ADR) develop: reduce dose by 50% or temporarily withhold, THEN

Resume at 50% after ADRs abate: 1 million Units/m² IM/SC 3 times/wk

If severe ADRs persist discontinue permanently

Discontinue Intron A for progressive disease or failure to respond after 6 mo of treatment

Malignant Melanoma

Induction 20 million Units/m² IV over 20 min, 5 days/wk for 4 wk  

Maintenance dose: 10 million Units/m² SC 3 times/wk for 48 wk

Withhold treatment if ANC <500/mm³ or ALT/AST >5 times upper limit of normal (ULN); re-start at 50% previous dose

Permanently discontinue if the following is observed

  • Toxicity does not abate after withholding
  • Severe ADRs recur in patients receiving reduced doses
  • ANC <250/mm³ or ALT/AST >10x ULN

Follicular Lymphoma

5 million units 3 times/week for up to 18 mo in conjunction with anthracycline-containing combination chemotherapy in patients >18 years old

See Mfr's prescribing packet for additional chemo dosing information

Condylomata Acuminata

1 million units injected into each lesion 3 times/week qODay for 3week

May repeat course if unsatisfactory results 12-16 wk after initial treatment

Max 5 lesions/single course of treatment

Do not use the 18 or 50 million Units powder for injection

Do not use the 18 million Units multidose Intron A solution for injection

Do not use multidose pens

AIDS-related Kaposi's Sarcoma

30 million Units/m² IM/SC 3 times/wk for 16 wk  

Dose reduction frequently required: See Mfr's PI

Chronic Hepatitis C

3 million units IM/SC 3 times/wk for16 wk

If ALT normalized after 16 wk, continue treatment for 18-24 mo

If ALT not normalized or high levels of HCV RNA after 16 wk, consider discontinuing treatment

Acute Hepatitis C

5 million Units SC/IM qd for 4 wk, then 3 times/wk for 20 wk

If severe adverse reactions develop reduce dose by 50% or temporarily withhold until adverse reactions abate

If intolerance persists discontinue permanently

Chronic Hepatitis B

30-35 million Units SC/IM per wk, either as 5 million Units qDay or 10 millon Units 3 times/wk for 16 wk

Reduce 50%: WBC <1.5 x 10^9/L; Granulocyte <0.75 x 10^9/L; platelets <50 x 10^9/L

Discontinue permanently: WBC < 1.0 x 10^9/L; Granulocyte <0.5 x 10^9/L; platelet < 25 x 10^9/L

If severe adverse reactions develop reduce dose by 50% or temporarily withhold until adverse reaction abate

If intolerance persists discontinue permanently

Other Information

Monitor: LFTs, CBC, platelets, Hgb, Electrolytes, TSH

See also combo with ribavirin

Dosage Forms & Strengths

injectable solution

  • 6 million International Units/mL (3.8mL vial)
  • 10 million International Units/mL (3.2mL vial)

multidose pen; 6 doses each

  • 22.5 million International Units/1.5mL
  • 37.5 million International Units/1.5mL
  • 75 million International Units/1.5mL

powder for injection

  • 10 million International Units/vial
  • 18 million International Units/vial
  • 50 million International Units/vial

Chronic Hepatitis B

3 million Units/m² IM/SC 3 times/wk for 1 wk; increase to 6 million U/m² 3 times/wk SC for 16-24 wk; not to exceed 10 million Units/dose 3 times/wk  

Dose adjustments: See manufacturer's package insert

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Interactions

Interaction Checker

and interferon alfa 2b

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      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (0)

              Serious - Use Alternative (4)

              • deferiprone

                deferiprone, interferon alfa 2b. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis; if an alternative is not possible, monitor absolute neutrophil count more frequently.

              • palifermin

                palifermin increases toxicity of interferon alfa 2b by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hr before, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.

              • pexidartinib

                interferon alfa 2b and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.

              • pretomanid

                interferon alfa 2b, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.

              Monitor Closely (8)

              • acalabrutinib

                acalabrutinib, interferon alfa 2b. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may increase risk of myelosuppressive effects.

              • hydroxyurea

                interferon alfa 2b, hydroxyurea. Other (see comment). Use Caution/Monitor. Comment: Cutaneous vasculitic toxicities (eg, vasculitic ulcerations and gangrene) were reported during therapy with hydroxyurea in patients with a history of, or currently receiving, interferon therapy.

              • lamivudine

                interferon alfa 2b, lamivudine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of liver decompensation.

              • ponesimod

                ponesimod and interferon alfa 2b both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.

              • siponimod

                siponimod and interferon alfa 2b both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.

              • theophylline

                interferon alfa 2b increases levels of theophylline by decreasing metabolism. Use Caution/Monitor. Greater risk of interaction in smokers.

              • tobramycin inhaled

                tobramycin inhaled and interferon alfa 2b both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

              • zidovudine

                interferon alfa 2b increases levels of zidovudine by decreasing metabolism. Use Caution/Monitor.

              Minor (1)

              • shark cartilage

                interferon alfa 2b, shark cartilage. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Enhanced anti angiogenesis (theoretical interaction).

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              Adverse Effects

              >10%

              Fatigue (8-96%)

              Fever (34-94%)

              Neutropenia (92%)

              Flu-like syndrome (79%)

              Myalgia (28-75%)

              Anorexia (1-69%)

              Leukopenia (68%)

              Nausea (17-66%)

              Transaminases increased (13-63%)

              Weakness (63%)

              Headache (21-62%)

              Chills (54%)

              Diarrhea (2-45%)

              Rigors (42%)

              Depression (up to 40% of pts), suicidal ideation/ attempts, suicide

              Alopecia (38%)

              Dyspnea (34%)

              Somnolence (33%)

              Vomiting (2-32%)

              Anemia (32%)

              Cough (31%)

              Pharyngitis (31%)

              Chest pain (28%)

              Xerostomia (28%)

              Rash (25%)

              Dizziness (24%)

              Taste alteration (24%)

              Abdominal pain (1-23%)

              Irritability (22%)

              Sinusitis (21%)

              Skeletal pain (21%)

              Diaphoresisi (1-21%)

              Paresthesias (1-21%)

              Arthralgia/back pain (19%)

              Pain (18%)

              Moniliasis (17%)

              Thrombocytopenia (15%)

              Amnesia (14%)

              Constipation (14%)

              Gingivitis (14%)

              Impaired concentration (14%)

              Malaise (14%)

              Weight loss (1-13%)

              Amenorrhea (12%)

              BUN increased (12%)

              Confusion (12%)

              Insomnia (12%)

              Iruritus (11%)

              1-10%

              Bronchitis (10%)

              Dry skin (10%)

              Edema (10%)

              Hypoestheisa (10%)

              Loose stools (10%)

              Nasal congestion (10%)

              Polyuria (10%)

              Anxiety (9%)

              Hypertension (9%)

              Dermatitis (8%)

              Dyspepsia (8%)

              Vertigo (8%)

              Agitation (7%)

              Infection (7%)

              SCr increased (6%)

              Herpes virus infections (5%)

              UTI (5%)

              <1%

              Acute hypersensitivity reactions; exacerbation of preexisting psoriasis & sarcoidosis

              Myelosuppression, thyroid dysfunction, hepatotox., pulmonary infiltrates, retinal hemorrhage

              Severe cytopenias incl aplastic anemia

              Autoimmune dz, DM/hyperglycemia (rare)

              Posmarketing reports

              Pulmonary fibrosis

              Hepatitis B virus reactivation in HCV/HBV co-infected patients

              Pericarditis

              Pancreatitis

              Tongue pigmentation

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              Warnings

              Black Box Warnings

              Alfa interferons cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders

              The risk of serious depression, with suicidal ideation and completed suicides, and other serious neuropsychiatric disorders are increased with alpha interferons

              Discontinue drug if persistently severe or worsening signs or symptoms of the above conditions are present; disorders typically resolve after stopping therapy

              These disorders may not resolve after the drug is discontinued

              Monitored closely with periodic clinical and laboratory evaluations

              Combination therapy with ribavirin

              • Ribavirin may cause birth defects and/or fetal death
              • Extreme care must be taken to avoid pregnancy in women taking peginterferon alfa-2a and in female partners of men taking peginterferon alfa-2a
              • Ribavirin causes hemolytic anemia; associated anemia may result in worsening of cardiac disease
              • Because ribavirin is genotoxic and mutagenic, consider it a potential carcinogen

              Contraindications

              Hypersensitivity

              Autoimmune hepatitis

              Decompensated liver disease (Child-Pugh >6 [class B and C])

              Contraindications for combination therapy with ribavirin:

              • Pregnant women and men whose female partners are pregnant.
              • Hemoglobinopathies (e.g., thalassemia major, sickle-cell anemia)
              • Creatinine clearance less than 50 mL/min

              Cautions

              Life-threatening or fatal neuropsychiatric events, including suicide, suicidal and homicidal ideation, depression, relapse of drug addiction/overdose, and aggressive behavior sometimes directed towards others reported in patients with and without a previous psychiatric disorder during therapy and follow-up; psychoses, hallucinations, bipolar disorders, and mania have been observed in patients treated with interferon alpha should be used with caution in patients with a history of psychiatric disorders; discontinue if severe depression develops

              If psychiatric symptoms persist or worsen, or suicidal or homicidal ideation or aggressive behavior towards others identified, discontinue therapy and follow patient closely, with psychiatric intervention as appropriate; narcotics, hypnotics, or sedatives may be used concurrently with caution and patients should be closely monitored until adverse effects resolved

              Dyspnea, pulmonary infiltrates, pneumonia, bronchiolitis obliterans, interstitial pneumonitis, pulmonary hypertension, and sarcoidosis, some resulting in respiratory failure or patient deaths, may be induced or aggravated by therapy; recurrence of respiratory failure has been observed with interferon rechallenge; monitor

              Development or exacerbation of autoimmune disorders (e.g., thyroiditis, thrombotic thrombocytopenic purpura, idiopathic thrombocytopenic purpura, rheumatoid arthritis, interstitial nephritis, systemic lupus erythematosus, and psoriasis) observed; use with caution in patients with autoimmune disorders

              Caution in pre-existing cardiac abnormalities &/or advanced cancer Ischemic and hemorrhagic cerebrovascular events reported

              Pancreatitis and ulcerative or hemorrhagic/iscemic colitis may occur

              Severe decreases in neutrophil or platelet counts reported

              Hepatitis C (CHC) patients with cirrhosis may be at risk of hepatic decompensation and death when treated with alpha interferons, including peginterferon alpha 2b; cirrhotic CHC patients co-infected with HIV receiving highly active antiretroviral therapy (HAART) and alpha interferons with or without ribavirin appear to be at increased risk for development of hepatic decompensation compared to patients not receiving HAART; monitor clinical status and hepatic function during treatment and discontinue immediately if decompensation (Child-Pugh score greater than 6) observed

              Monitor patients with impaired renal function, for signs and symptoms of interferon toxicity, including increases in serum creatinine; adjust dose or discontinue therapy accordingly

              Serious, acute hypersensitivity reactions and cutaneous eruptions reported

              Dental/periodontal disorders reported with combination therapy Hypertriglyceridemia may result in pancreatitis (e.g., triglycerides greater than 1000 mg/dL)

              Weight loss and growth inhibition reported during combination therapy in pediatric patients

              Long-term growth inhibition (height) reported in some patients

              Peripheral neuropathy observed when used in combination with telbivudine

              Risk of visual impairment and retinal disorders; discontinue if ophthalmologic problems develop

              Use with caution in patients with endocrine disorder: thyroid disease; DM prone to ketoacidosis

              Pre-existing cardiac abnormalities &/or advanced cancer

              AIDS-related Kaposi's Sarcoma: do not use in patients w/ rapidly progressive disease

              Discontinue if acute hypersensitivity occurs

              Risk of exacerbation of preexisting psoriasis & sarcoidosis; risk of developing new sarcoidosis

              Patients should be well hydrated during initial treatment

              If platelets <50,000/mm³, do not administer IM (may admin SC)

              Do not use the 18 million IU or 50 million IU powder for injection or the18 million IU multidose vial for condylomata acuminata

              Increases risk of hepatic decompensation and death in patients with cirrhosis; any patient developing liver function abnormalities during treatment should be monitored closely and if appropriate, treatment should be discontinued

              Numerous cardiotoxicities, including arrhythmias, ischemia, infarction, and cardiomyopathy occur during and immediately after infusion

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              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: unknown

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Inhibits HBV replication; immunomodulatory actions; may induce gene transcription; interferes with oncogene expression, may change cell surface antigen expressoin; cytotoxic activity of macrophages increases

              Suppresses cell proliferation

              Pharmacokinetics

              Half-Life: 2-3 hr (IM/SC); 2 hr (IV)

              Peak Plasma Time: 3-12 hr (IM/SC); 30 min (IV)

              Pharmacogenomics

              Polymorphic cytokine genes (encoding IL-10, a Th2 cytokine); Th2 responses are associated with production of large amounts of antibodies

              Patients with chronic hepatitis C are 5 times more likely to have a favorable response to interferon alfa if they carried the IL-10 genetic polymorphism that results in low expression of IL-10 than if they did not

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              Administration

              IV Preparation

              General

              • Reconstitute vials with provided diluent
              • Preparation should be clear & colorless to light yellow

              IM, SC, or Intralesional Preparation

              • Inject 1 mL diluent (SWI, supplied) into drug vial
              • Swirl gently to dissolve powder
              • Withdraw appropriate dose to be injected
              • Refer to Medication Guide for detailed instructions

              IV Administration

              • Prepare immediately prior to use
              • Reconstitute w/ diluent provided
              • Inject 1 mL diluent (SWI, supplied) into drug vial
              • Swirl gently to dissolve powder
              • Withdraw appropriate dose & inject into a 100 mL bag of NS
              • Make sure final conc of Intron A is NOT <10 MIU/100 mL
              • Refer to Medication Guide for detailed instructions

              Intron A Solution for Injection not recommended for IV

              SC Administration

              SC administration is suggested for those who are at risk for bleeding or thrombocytopenic

              Rotate SC injection site

              Storage

              Refrigerate intact vials

              Powder & premixed solutions are stable at room temp for 7 d & for 30 d if refrigerated

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Intron A injection
              -
              10 million unit/mL vial
              Intron A injection
              -
              50 million unit (1 mL) vial
              Intron A injection
              -
              18 million unit (1 mL) vial
              Intron A injection
              -
              10 million unit (1 mL) vial
              Intron A injection
              -
              6 million unit/mL vial

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              interferon alfa-2b injection

              INTERFERON ALFA - INJECTION

              (in-ter-FEER-on AL-fuh)

              COMMON BRAND NAME(S): Alferon N, Intron A, Roferon-A

              WARNING: This medication can rarely cause or worsen serious (rarely fatal) medical conditions, including mental/mood conditions (e.g., depression), immune system problems (autoimmune conditions such as lupus or rheumatoid arthritis), circulation problems, or infections. If your medical history includes any of these conditions, tell your doctor promptly. Also, tell your doctor right away if any serious symptoms or side effects occur (see Side Effects section).This medication may be combined with ribavirin to treat chronic hepatitis C. Ribavirin may cause harm to an unborn baby or death. Women must avoid pregnancy while they or their male partners are using ribavirin. Ribavirin may cause a blood disorder (hemolytic anemia), which can worsen heart disease. If you are using this medication with ribavirin to treat chronic hepatitis C, also carefully read the drug information for ribavirin.

              USES: This medication is used to treat various cancers (e.g., leukemia, melanoma, AIDS-related Kaposi's sarcoma). It is also used to treat virus infections (e.g., chronic hepatitis B, chronic hepatitis C, condylomata acuminata). This medication is the same as a protein that your body naturally produces (interferon). In the body, it is thought to work by affecting cell function/growth and the body's natural defenses (immune system) in many ways. Adding more interferon may help your body fight off cancer or virus infections.

              HOW TO USE: Read the Medication Guide available from your pharmacist before you start using this drug and each time you get a refill. Learn all preparation and usage instructions given by the manufacturer. If you have any questions, consult your doctor or pharmacist.This medication is given by injection into a muscle or under the skin as directed by your doctor. Rotate the injection site each time you inject this medication to prevent soreness. It may also be given by injection into a vein or directly into a lesion, usually by a health care professional.If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Do not shake the medication container (vial or syringe). Doing so may decrease the effectiveness of the drug. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely. Never reuse single-use syringes or needles. It is okay to reuse the multidose pen. It is best used in the evening before bedtime to reduce side effects.Drink plenty of fluids while using this medication unless otherwise directed by your doctor.Dosage is based on your medical condition and response to therapy. Do not change the dose or how often you use this medication without your doctor's approval. Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each evening that you have a scheduled dose.Different brands of interferon alfa can result in different amounts of medication in the blood. This medication comes in different forms (a powder in a vial, a solution in a vial, and a multidose pen). The way you inject this medication depends on the form you are using. Follow your doctor's directions carefully. Do not switch brands without your doctor's permission.

              SIDE EFFECTS: Injection site reactions (pain/swelling/redness), headache, tiredness, diarrhea, upset stomach, loss of appetite, back pain, dizziness, dry mouth, taste changes, nausea, or vomiting may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Flu-like symptoms such as fever, chills, and muscle aches may occur, especially when you first start this medication. These symptoms usually last about 1 day after the injection and improve or go away after a few weeks of continued use. You can reduce these side effects by injecting this medicine at bedtime and using a fever reducer/pain reliever such as acetaminophen before each dose. Consult your doctor or pharmacist for more information.Tooth and gum problems may sometimes occur during treatment. Having a dry mouth can worsen this side effect. Prevent dry mouth by drinking plenty of water or using a saliva substitute. Brush your teeth well at least twice a day and have regular dental exams. If you experience vomiting during treatment, rinse your mouth afterwards to lessen the chance of tooth and gum problems.Temporary hair loss may occur. Normal hair growth should return after treatment has ended.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: feeling too hot or cold (more than others around you), fast/irregular heartbeat, increased thirst/urination, menstrual changes (absent/delayed/irregular periods), numbness/tingling of hands/feet, swelling (especially of face/hands/feet), trouble sleeping, trouble walking, vision changes (such as blurred vision, partial loss of vision), easy bleeding/bruising, persistent nausea/vomiting, signs of infection (e.g., fever, persistent sore throat), stomach/abdominal pain, dark urine, black/tarry stools, yellowing eyes/skin.Get medical help right away if any of these very serious side effects occur: chest pain, seizures, weakness on one side of the body, trouble speaking.This drug may cause you to develop serious mental/mood changes that may get worse during treatment or after your last dose. Tell your doctor right away if you have symptoms such as confusion, depression, thoughts of suicide or hurting others, unusual irritability, or aggressive behavior. If this occurs, psychiatric therapy and monitoring is recommended during and after treatment with this medication.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: See also Warning section.Before using interferon alfa, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as albumin), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood cell disorders (e.g., anemia, neutropenia, thrombocytopenia), blood clots, cancer, diabetes, eye problems, heart disease (e.g., angina, irregular heartbeat), high blood pressure, HIV infection, immune system diseases (e.g., lupus, psoriasis, rheumatoid arthritis), intestinal disease (e.g., colitis), kidney disease, liver disease (e.g., autoimmune hepatitis, decompensated liver disease), lung diseases (e.g., chronic obstructive pulmonary disease-COPD, asthma, pneumonia), mental/mood disorders (e.g., anxiety, depression), high blood triglyceride levels, pancreatitis, seizure disorder, thyroid disease, use/abuse of drugs/alcohol.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Do not have immunizations/vaccinations without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).To lower your risk of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Children may be more sensitive to the side effects of this drug, especially mental/mood changes (such as severe depression, thoughts/attempts of suicide). Interferon and ribavirin may also slow down a child's rate of growth. Normal weight gain and rate of growth usually return after treatment is completed but the final adult height may be lower than expected. Monitor your child's height and weight periodically during treatment.Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug, especially dizziness, mental/mood changes, and effects on the heart.During pregnancy, interferon alfa should be used only when clearly needed. Discuss the risks and benefits with your doctor.Interferon alfa, when used in combination with ribavirin, must not be used during pregnancy by either the pregnant woman or her male partner. The combination may cause harm to an unborn baby. Two reliable forms of birth control (such as condoms, birth control pills) must be used whenever at least one sexual partner is using these medicines together, and for at least 6 months after stopping treatment. If you or your partner become pregnant, or if you think you or your partner may be pregnant, tell your doctor right away.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: barbiturates (e.g., phenobarbital), colchicine, drugs that may affect your immune system (e.g., cancer chemotherapy, aldesleukin, cyclosporine), hydroxyurea, telbivudine, theophyllines (e.g., aminophylline, theophylline).

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: chest pain, persistent nausea/vomiting, stomach/abdominal pain, dark urine.

              NOTES: Do not share this medication with others.Laboratory and/or medical tests (such as blood counts, thyroid tests, kidney/liver function, triglyceride levels, eye exams) should be performed before you start treatment, periodically to monitor your progress, or to check for side effects. Depending on your medical history, other tests (such as EKG) may be needed. Consult your doctor for more details.Do not change brands of interferon without checking with your doctor or pharmacist. Other interferons may not have the same effects on your disease.

              MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

              STORAGE: Store in the refrigerator between 36-46 degrees F (2-8 degrees C) away from light and moisture. Do not freeze. Keep all medications away from children and pets. Consult the product instructions or your pharmacist for more storage details once this medication is mixed.The multidose pen may be used for up to 4 weeks after the first injection. Do not leave this medication outside of the refrigerator for more than 48 hours. After 4 weeks of use, discard the pen, even if it still contains unused solution.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised September 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.