Interferon gamma 1b

CLINICAL USE

Adjunct to antibiotics to reduce the frequency of serious infections in patients with chronic granulomatous disease

DOSE IN NORMAL RENAL FUNCTION

50 mcg/m2 3 times a weekor 1.5 mcg/kg 3 times a week if surface area <0.5 m2

PHARMACOKINETICS

  • Molecular weight                           :15 000–21 000
  • %Protein binding                           :No data
  • %Excreted unchanged in urine     : Negligible
  • Volume of distribution (L/kg)       :0.2–0.6
  • half-life – normal/ESRD (hrs)      :5.9

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : No data on use in renal impairment. Dose as for normal renal function and monitor renal function closely
  • 10 to 20     : No data on use in renal impairment. Dose as for normal renal function and monitor renal function closely
  • <10           : Use with caution due to risk of accumulation. Monitor renal function closely

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Not dialysed. Dose as in GFR <10 mL/min
  • HD                     :Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   :Dialysed. Dose as in GFR
  • <10           : mL/min
  • CAV/VVHD      :Unlikely dialysability. Dose as in GFR 10 to 20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugsAvoid with vaccines

    ADMINISTRATION

    Reconstition

    Route

    SC

    Rate of Administration

    Comments

    OTHER INFORMATION

    Pre-treatment with paracetamol is recommended to reduce incidence of flu-like symptomsInterferon up-regulates the cell surface presentation of class II histocompatibility antigens, which raises the possibility of drug-induced allograft rejection. There are numerous clinical reports of allograft rejection, acute renal failure and graft loss after interferon therapy. Hence extreme care should be exercised in the use of interferon after renal transplantationInterferon is metabolised primarily in the kidney. It is excreted in the urine, but is reabsorbed by the tubules where it undergoes lysosomal degradation. In patients undergoing haemodialysis, the interferon molecule may accumulate as it is too large to be dialysed and will not undergo renal degradation. Hence, the dose may need to be adjusted

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