| PEGINTERFERON ALFA-2B
Classifications: immunomodulator; interferon; Therapeutic: immunomodulator; interferon
Prototype: Interferon alfa-2a
Pregnancy Category: C
100 mcg/mL, 160 mcg/mL, 240 mcg/mL, 300 mcg/mL powder for injection
Binds to specific membrane receptors on the cell surface, thereby initiating enzyme induction, suppression of cell proliferation,
enhanced phagocytic activity of macrophages, augmentation of specific cytotoxic lymphocytes for target cells, and inhibition
of viral replication in virus-infected cells.
Induces antiviral effects by activation of macrophages, natural killer cells, and T-cells, thus boosting cellular immunity
and suppressing hepatic inflammation and replication of hepatitis C virus.
Chronic hepatitis C.
Hypersensitivity to peginterferon; autoimmune hepatitis; decompensated liver disease; persistently severe or worsening S&S
of life-threatening neuropsychiatric, autoimmune, ischemic, or infectious disorders; pregnancy (category C).
History of neuropsychiatric disorder; bone marrow suppression; ulcerative and hemorrhagic colitis; pulmonary disorders;
HBV or HIV coinfection; thyroid dysfunction; diabetes mellitus; cardiovascular disease; autoimmune disorders; pulmonary
disease, COPD; retinal disease; renal impairment with creatinine clearance <50 mL/min; older adults; lactation. Safety and
efficacy in children <18 y are not established.
Route & Dosage
|Chronic Hepatitis C
Adult: SC Based on weight and injected once weekly x 1 y: 3745 kg, 40 mcg; 4656 kg, 50 mcg; 5772 kg, 64 mcg; 7388 kg, 80 mcg; 89106 kg, 96 mcg; 107136 kg, 120 mcg; 137160 kg, 150 mcg
- Give dose on the same day of each week.
- Be aware that two Safety LokTM syringes are provided in the drug package: one for reconstitution and one for injection. Reconstitute with only 0.7 mL
of supplied diluent and discard remaining diluent. Enter the vial only once as it does not contain a preservative. Swirl
gently to produce a clear, colorless solution. Use solution immediately.
- Serious adverse reactions warrant reduction or discontinuation of dose.
- Store dry vial at 15°30° C (59°86° F). If necessary, store reconstituted solution up to 24
h at 2°8° C (36°46° F).
Adverse Effects (≥1%)Body as a Whole: Musculoskeletal pain, fatigue, inflammation at injection site, flu-like symptoms, rigors, fever, weight loss, viral infection,
pain, malaise, hypertonia. CNS: Headache, depression, anxiety, emotional lability, irritability, insomnia, dizziness. GI: Nausea, anorexia, diarrhea, abdominal pain,
vomiting, dyspepsia, hepatomegaly. Endocrine:
Thrombocytopenia, neutropenia. Respiratory: Pharyngitis, sinusitis
, cough. Skin: Alopecia, pruritus, dry skin,
sweating, rash, flushing.
May increase theophylline
levels; additive myelosuppression with antineoplastics
may increase hematologic toxicity; increase doxorubicin
toxicity, increase neurotoxicity with vinblastine; aldesleukin (IL-2)
may potentiate the risk of kidney failure.
1544 h. Duration:
4872 h. Elimination:
30% in urine. Half-Life:
40 h (2260 h).
Assessment & Drug Effects
- Monitor for S&S of hypersensitivity (e.g., angioedema, bronchoconstriction) and, if noted, institute appropriate medical
action immediately. Note that transient rashes are not an indication to discontinue treatment.
- Monitor for and report immediately S&S of neuropsychiatric disorders (e.g., psychosis, hallucinations, suicidal ideation,
- Monitor respiratory and cardiovascular status; report dyspnea, chest pain, and hypotension immediately; baseline and periodic
ECG and chest X-ray.
- Lab tests: Baseline and periodic creatinine clearance, CBC with differential, platelet count, Hct & Hgb, TSH, ALT, AST,
bilirubin, blood glucose; with diabetics or hypertensives. Serum HCV RNA levels are assessed after 24 wk of treatment.
- Withhold drug and notify physician for any of the following: severe neuropsychiatric events, severe neutropenia or thrombocytopenia,
abdominal pain accompanied by bloody diarrhea and fever, S&S of pancreatitis, or any other severe adverse event (see CAUTIOUS USE).
- Baseline and periodic ophthalmology exams are recommended.
Patient & Family Education
- Drink fluids liberally while taking this drug, especially during the initial stages of therapy.
- Learn reasons for withholding drug (see ASSESSMENT & DRUG EFFECTS).
- Use effective means of contraception while taking this drug. Women should not become pregnant.
- Follow up with lab tests; compliance with lab testing is extremely important while taking this drug.