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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :15 000–21 000

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :No data

%Excreted unchanged in urine &nbsp &nbsp : Negligible

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.2–0.6

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :5.9

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : No data on use in renal impairment. Dose as for normal renal function and monitor renal function closely

10 to 20 &nbsp &nbsp : No data on use in renal impairment. Dose as for normal renal function and monitor renal function closely

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : Use with caution due to risk of accumulation. Monitor renal function closely

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL/min

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux &nbsp :Dialysed. Dose as in GFR

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/min

CAV/VVHD &nbsp &nbsp &nbsp:Unlikely dialysability. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAvoid with vaccines

ADMINISTRATION

Reconstition

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Route

SC

Rate of Administration

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Comments

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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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