Mechanism of effect
Has antiviral, antiproliferative, and immunoregulatory activities. Binds to specific cell membrane receptors that induce the expression of a number of gene products that mediate the biological actions of interferon beta-1a.
Pharmacodynamic
Interferon beta upregulates the expression of MHC I proteins, allowing for increased presentation of peptides derived from viral antigens. This enhances the activation of CD8+ T cells that are the precursors for cytotoxic T lymphocytes (CTLs) and makes the macrophage a better target for CTL-mediated killing. Type I interferons also induce the synthesis of several key antiviral mediators including 2'-5' oligoadenylate synthetase (2'-5' A synthetase), beta-2 microglobulin and neopterin
Pharmacokinetics
T max is 3 to 15 h ( Avonex ). C max is 5.1 units/mL; AUC 0 to 96 is 294 units•h/mL; T max is 16 h ( Rebif ). The t ½ is 10 h ( Avonex ). Total Cl is approximately 33 to 55 L/h; t ½ is 69 h ( Rebif ).
Drug indications
(multiple sclerosis (MSDosage
Adults Avonex IM 30 mcg once weekly. Rebif Subcutaneous Titrate dose to 22 or 44 mcg 3 times/wk. Titration schedule for 22 mcg Wk 1 and 2, administer 4.4 mcg 3 times/wk. Wk 3 and 4, administer 11 mcg 3 times/wk. Wk 5 and on, administer 22 mcg 3 times/wk. Titration schedule for 44 mcg Wk 1 and 2, administer 8.8 mcg 3 times/wk. Wk 3 and 4, administer 22 mcg 3 times/wk. Wk 5 and on, administer 44 mcg 3 times/wk.
Drug contraindications
hypersensitivity to drug or its components. , hypersensitivity to human albuminSide effects
nausea , Headache , chest pain , dry mouth , abdominal pain , dizziness , fatigue , Seizures , Increased risk of suicidal thinking , Hepatic dysfunction , rash , Depression , asthenia , Chills , thrombocytopenia , neutropenia , lymphopenia , leukopenia , anemia , chronic heart failure , Urinary tract infection , edema , sinusitis , respiratory tract infection , fever , Hyperthyroidism , hypothyroidism , cardiomyopathy , psychotic symptoms , myalgia , Hypertonia , Flu-like symptoms , Alopecia , Injection-site reactionInteractions
Interferon beta-1b , Infliximab , Trastuzumab , Rituximab , Cetuximab , atovaquone/proguanil , Gefitinib , RemdesivirAlerts
Monitor Ensure that Hgb, CBC with differential, platelet count, and blood chemistries, including LFTs, are performed before initiating therapy, at 1, 3, and 6 mo after starting therapy, and then periodically thereafter. Ensure that thyroid function tests are performed before starting therapy and every 6 mo during therapy in patients with thyroid dysfunction.
Points of recommendation
Avonex Administer via IM route only. Not for intradermal, subcutaneous, or IV administration. Rotate injection sites (thighs and upper arms). Use a different area from where last injection was administered. Do not inject into areas where the skin is infected, tender, bruised, red, or hard. Allow prefilled syringe to warm to room temperature before administering. Do not warm using external heat source (eg, hot water). Reconstitute powder for injection using supplied diluent only. Swirl vial gently to dissolve. Do not shake vial. Reconstituted solution should be clear to slightly yellow. Do not administer if particulate matter, cloudiness, or discoloration is noted. Withdraw prescribed dose into syringe for injection and administer immediately or within 6 h if stored in refrigerator (36° to 46°F) after reconstitution. Vials contain no preservative. Discard any unused portion. Do not combine unused portions. Rebif Administer via subcutaneous route only. Not for intradermal, IM, or IV administration. Rotate injection sites (buttocks, thighs, abdomen, back of arms). Use a different area from where last injection was administered. Do not inject into areas where the skin is tender, bruised, red, or hard. Do not mix with other drug solutions.
Ask a Pharmacist