Clinician's Pocket Drug Reference 2008

Interferon beta 1a 123Alfa-2b (Intron A): 3 M units/m 2 SQ 3 ×/wk × 1 wk, then 6 M units/m 2 3 ×/wk (Max10M units 3 ×/wk, total duration 16–24 wks). Follicular NHL (Intron A) 5 M unitsSQ 3 ×/wk for 18 mo; Melanoma (Intron A) 20 M units m 2 IV × 5 days/wk × 4 wks,then 10 M units/m 2 SQ 3 ×/wk × 48 wks; Kaposi sarcoma (Intron A) 30 M units/mIM/SQ 3 ×/wk X 10–12 wks, then 36 M units IM/SQ 3 ×/wk; Chronic hep C (IntronA) 3 m units 3 ×/wk × 16 wks (continue 18–24 mo if response) Roferon A: 3 M units3 ×/wk for 12 mo SQ/IM; Condyloma (Intron A) 1 M units/lesion (max 5 lesions)3 ×/wk for 3 wks. Peds. CML: Alfa-2a (Roferon-A): 2.5–5 M units/m 2 IM daily.Contra: Benzyl alcohol sens, decompensated liver Dz, autoimmune Dz, immunosuppressed,neonates, infants Disp: Inj forms (see also PEG interferon) SE: FlulikeSxs, fatigue, anorexia, neurotox at high doses; up to 40% neutralizing Ab w/therapyInterferon Alfa-2b & Ribavirin Combo (Rebetron) WARNING:Can cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic,and infectious disorders. Monitor patients closely. Contraindicated in pregnantfemales & their male partners Uses: *Chronic Hep C in pts w/compensatedliver Dz who relapse after α-interferon therapy* Action: Combo antiviral agents(see individual agents) Dose: 3 M units Intron A SQ 3 × wk w/ 1,000–1,200 mg ofRebetron PO ÷ bid dose for 24 wk. Pts < 75 kg: 1000 mg of Rebetron/d Caution:[X, ?] Contra: PRG, males w/ PRG female partner, autoimmune hepatitis, CrCl 75 kg: Identical except84 Rebetol caps/pack SE: See warning, flulike synd, HA, anemia Notes: MonthlyPRG test; instruct in self-administration of SQ Intron AInterferon Alfacon-1 (Infergen) WARNING: Can cause or aggravatefatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectiousdisorders. Monitor patients closely Uses: *Chronic Hep C* Action: Biologic responsemodifier Dose: 9 mcg SQ 3 ×/wk × 24 wk Caution: [C, M] Contra: E. coliproduct allergy Disp: Inj 9, 15 mcg SE: Flulike synd, depression, blood dyscrasias,colitis, pancreatitis, hepatic decompensation, ↑ SCr, eye disorders, ↓ thyroidNotes: Allow > 48 h between inj; monitor CBC, plt, SCr, TFTInterferon Beta 1a (Rebif) WARNING: Can cause or aggravate fatal orlife-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders.Monitor patients closely Uses: *MS, relapsing* Action: Biologic response modifierDose: 44 mcg SC 3 ×/wk; start 8.8 mcg SC 3 ×/wk × 2 wk, then 22 mcg SC 3×/wk × 2 wk Caution: [C, ?] w/ hepatic impair, depression, Sz disorder, thyroidDz Contra: Human albumin allergy Disp: 0.5 mL prefilled syringes w/ 29 ga needleTitrate Pak 8.8 and 22 mcg; 22 or 44 mcg SE: Inj site rxn, HA, flu like Sx,malaise, fatigue, rigors, myalgia, depression w/suicidal ideation, hepatotoxicity,↓ BM Notes: Dose > 48 h apart; CBC 1, 3, 6 mo; TFTs q6mo w/hx thyroid dz