INTERFERON ALFACON-1
| INTERFERON ALFACON-1 (in-ter-fer'on al'fa-con) Infergen Classifications: immunomodulator; antiviral; interferon; Therapeutic: antiviral; interferon Prototype: Interferon alfa-2a Pregnancy Category: C |
Availability
9 mcg, 15 mcg injection
Action
DNA recombinant Type 1 interferon. Its antiviral, antiproliferative, and natural killer (NK) cell activity is five times greater than interferon alpha-2a or interferon alpha-2b.
Therapeutic Effect
Effectiveness is measured by normalization of ALT level and serum HCV RNA <100 copies/mL. Type 1 interferons bind to the cell surface receptors inducing biologic responses including antiviral, antiproliferative, and immunomodulatory activities.
Uses
Treatment of chronic hepatitis C.
Contraindications
Hypersensitivity to alpha interferons or E. coli products; patients with decompensated liver disease such as jaundice, ascites, etc.; pregnancy (category C), lactation, children <18 y.
Cautious Use
History of severe psychiatric disorder, depression, or suicidal ideation; preexisting cardiac disease, myelosuppression, previous hypersensitivity to interferon therapy; history of endocrine disorders; ophthalmic disorders or autoimmune disorders.
Route & Dosage
| Chronic Hepatitis C Adult: SC 9 mcg 3 times/wk x 24 wk |
Administration
Subcutaneous- Allow at least 24 h to elapse between doses of interferon alfacon-1.
- Give only one dose per vial or per prefilled syringe. Enter each vial only once. Discard unused portion of a vial or prefilled syringe immediately.
- Initiate treatment only if acceptable baseline lab values are obtained: Platelet count ≥75 x 109/L, Hgb ≥100 g/L, ANC ≥1500 x 106/L, serum creatinine <2.0 mg/dL, serum albumin ≥25 g/L, bilirubin WNL, TSH, and T4 WNL.
- Store vials and syringes at 2°–8° C (36°–46° F). Avoid direct sunlight and vigorous shaking.
Adverse Effects (≥1%)
Body as a Whole: Asthenia, headache, fatigue, fever, chills, injection site reaction (pain, edema, hemorrhage, inflammation), pain, myalgia, arthralgia, increased sweating. CNS: Insomnia, depression, dizziness, paresthesia, nervousness, depression, anxiety, agitation. CV: Hypertension, palpitation. GI: Nausea, diarrhea, abdominal pain, anorexia, vomiting, dyspepsia, constipation, flatulence, toothache, hemorrhoids, weight loss, hepatotoxicity. Hematologic: Granulocytopenia, thrombocytopenia, leukopenia, ecchymosis, lymphadenopathy, lymphocytosis. Respiratory: Cough, bronchitis, dyspnea, pneumonia, rhinitis, pharyngitis. Skin: Alopecia, rash, dry skin, pruritus, erythema. Urogenital: Dysmenorrhea, vaginitis, menstrual disorder.Interactions
No clinically significant interactions established.Pharmacokinetics
Peak: 24–36 h.Nursing Implications
Assessment & Drug Effects
- Monitor for and report any of the following S&S immediately: Depression, suicidal ideation, suicide attempt, or other indications of psychiatric disturbance.
- Withhold drug and notify physician if symptoms of hepatic decompensation such as jaundice or ascites develop. Withhold drug and notify physician if any other severe adverse reaction occurs.
- Lab tests: Baseline, 2 wk after initiation of therapy, and periodically thereafter: platelet count, Hgb and Hct, WBC and ANC, serum creatinine, serum albumin, bilirubin, thyroid function, and triglyceride; periodic ALT to determine liver functions.
Patient & Family Education
- Report immediately any signs of psychiatric disturbance including depression, thoughts of suicide, nervousness, anxiety, agitation, apathy, or significant mood swings to physician.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug