interferon alfa 2b

CLINICAL USE

Intron A:Chronic hepatitis B —Chronic hepatitis C —Hairy cell leukaemia —Multiple myeloma —Carcinoid tumour —Chronic myelogenous leukaemia —Follicular lymphoma —Malignant melanoma —

DOSE IN NORMAL RENAL FUNCTION

Chronic hepatitis B: 5–10 million IU 3 times a weekChronic hepatitis C: 3 million IU 3 times a weekHairy cell leukaemia: 2 million IU/m 2 3 times a weekMultiple myeloma: 3 million IU/m 2 3 times a weekCarcinoid tumour: 3–9 million IU/m 2 3 times a weekChronic myelogenous leukaemia: 4–5 million IU/m2 dailyFollicular lymphoma: 5 million IU 3 times a weekMalignant melanoma: 20 million IU/m 2 (

IV infusion

) daily for 5 days, decreasing to 10 million IU/m2 (SC) 3 times a week

PHARMACOKINETICS

Molecular weight                           :15 000–21 000

%Protein binding                           :0

%Excreted unchanged in urine     : Negligible

Volume of distribution (L/kg)       :0.4

half-life – normal/ESRD (hrs)      :2–7

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50     : Dose as in normal renal function Monitor renal function closely

10 to 20     : Dose as in normal renal function Monitor renal function closely

<10           : Use with great caution.

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      :Not dialysed. Dose as in GFR=10–20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsImmunosuppressants, e.g. ciclosporin, tacrolimus, sirolimus may have an antagonistic effectAdministration of interferon in combination with other chemotherapeutic agents, e.g. cytarabine, cyclophosphamide, doxorubicin, teniposide may lead to increased risk of severe toxicity

ADMINISTRATION

Reconstition

–

Route

IM, SC, IV

Rate of Administration

20 minutes

Comments

Add to sodium chloride 0.9%

OTHER INFORMATION

Interferon 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

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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