Interferon-α

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Administration

  • Type: Antiviral, antineoplastic
  • Dosage Forms:
  • Routes of Administration: Injection
  • Common Trade Names:

Adult Dosing

  • Variable depending on indication and formulation (interferon-α2A, -α2B, -αn3, -alfacon, peginterferon α-2a, peginterferon α-2b)
  • Used to treat:
    • Chronic hepatitis B, chronic hepatitis C
    • Polycythemia vera, essential thrombocytopenia
    • Condyloma acuminatum (refractory/recurrent)
    • Kaposi's sarcoma, Malignant melanoma (adjunct)
    • Carcinoid tumor
    • Multiple myeloma, hairy cell leukemia, follicular lymphoma, chronic myelogenous leukemia (Philadelphia chromosome positive)
    • Metastatic renal cell carcinoma

Pediatric Dosing

  • Variable depending on indication and formulation (interferon-α2A, -α2B, -αn1, -αn3, -alfacon)
  • Used to treat:
    • chronic myelogenous leukemia (Philadelphia chromosome positive)
    • Chronic hepatitis B, chronic hepatitis C
    • Papillomatosis (adjunct)

Special Populations

  • Pregnancy Rating: C. When used with ribavirin, may lead to fetal defects or fetal death
  • Lactation risk: Infant risk cannot be ruled out
  • Renal dosing: IFN-α2B and pegylated IFN-α2B contraindicated if CrCl <50
  • Hepatic dosing: contraindicated in decompensated liver disease

Contraindications

  • Allergy to class/drug or inactive ingredients: may contain benzyl peroxide, bovine/ovine Ig, mouse IgG, polymyxin B, neomycin, egg protein
  • Autoimmune hepatitis
  • Decompensated liver disease
  • Hemoglobinopathies (e.g. thalassemia major, sickle cell) when used with ribavirin
  • Pregnancy or men with pregnant female partners (in combination with ribavirin)

Adverse Reactions

Serious

  • Dysrhythmia, hypotension, cardiomyopathy, MI
  • Raynaud's disease, vasculitis
  • Diabetes, hypertriglyceridemia, decreased body growth
  • GI bleed, ischemic colitis
  • Pancreatitis
  • Anemia, aplastic anemia, thrombocytopenia, lymphocytopenia, neutropenia
  • TTP
  • Hepatotoxicity
  • Autoimmune disease, lupus
  • Rhabdomyolysis, myositis
  • Stroke, cerebral hemorrhage, coma, encephalopathy
  • Seizure
  • Visual loss, optic neuritis, retinal hemorrhage, retinal artery/vein thrombosis
  • Suicidal ideation/behavior, depression, psychotic disorder, agressive behavior
  • Obliterative bronchiolitis, pneumonitis, pneumothorax, PE, pulmonary hypertension, sarcoidosis
  • Erythroderma, Stevens-Johnson syndrome
  • Infection


Common

  • Alopecia
  • Dermatitis, pruritus, dry skin, injection site reaction
  • Weight loss
  • Nausea/vomiting, abdominal pain, diarrhea, anorexia,
  • Neutropenia
  • Elevated AST/SGOT
  • Thyroid dysfunction
  • Musculoskeletal pain
  • Asthenia, dizziness, fatigue, paresthesias
  • Headache
  • Depression, anxiety
  • Cough dyspnea
  • Edema
  • Fever, influenza-like illness

Pharmacology

  • Half-life: 2 to 160h
  • Metabolism: Hepatic, renal (IFN-α2A)
  • Excretion: Renal

Mechanism of Action

  • Interferons induce various cell activities, such as antiviral activity, suppression of cell proliferation, augmentation of macrophage activity and other immunomodulating effects.

Comments

See Also

References