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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :40 000
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :No data
  • %Excreted unchanged in urine &nbsp &nbsp : 30

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.99

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

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function. See ‘Other Information’
  • 10 to 20 &nbsp &nbsp : 135 mcg (Pegasys) once weekly. See ‘Other Information’
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : 135 mcg (Pegasys) once weekly. See ‘Other Information’

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

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

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/min
  • HDF/high flux &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp: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

    SC

    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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