peginterferon alfa

CLINICAL USE

Treatment of chronic hepatitis B and C infection with or without ribavirin

DOSE IN NORMAL RENAL FUNCTION

ViraferonPeg: 1.5 mcg/kg once weekly in combination with ribavirin
Monotherapy: 0.5–1 mcg/kg once weekly Pegasys: 180 mcg weekly

PHARMACOKINETICS

Molecular weight :40 000

%Protein binding :No data

%Excreted unchanged in urine : 30

Volume of distribution (L/kg) :0.99

half-life – normal/ESRD (hrs) :40–80/increased by about 25–45%

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function. See ‘Other Information’

10 to 20 : 135 mcg (Pegasys) once weekly. See ‘Other Information’

<10 : 135 mcg (Pegasys) once weekly. See ‘Other Information’

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HD :Dialysed. Dose as in GFR

<10 : mL/min

HDF/high flux :Dialysed. Dose as in GFR

<10 : mL/min

CAV/VVHD :Unknown dialysability. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsImmunosuppressants: (e.g. ciclosporin, tacrolimus, sirolimus) may have an antagonistic effectTheophylline: inhibits metabolism of theophylline (enhanced effect)

ADMINISTRATION

Reconstition

0.7 mL water for injection or pre-filled syringes

Route

Rate of Administration

–

Comments

Stable for 24 hours at 2–8°C after reconstitution

OTHER INFORMATION

Administer 12 hours after haemodialysis ViraferonPeg is contraindicated once GFR<50 mL/min – monitor closely and reduce dose if requiredIn haemodialysis patients, 135 mcg Pegasys is equivalent to a 180 mcg dose in the general populationIn patients with CKD 5 undergoing haemodialysis there is a 25–45% reduction in clearance compared with patients with normal renal function

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