Drug reference

Interferon beta

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 917, 918, 919

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

AVONEX ® INJECTION For relapsing, remitting multiple sclerosis | For a single demyelinating event with an active inflammatory process (if severe enough to require intravenous corticosteroid and patient at high risk of developing multiple sclerosis) ▶BY INTRAMUSCULAR INJECTION Immune system and malignant disease ▶Adult: (consult product literature) AVONEX ® VIAL For relapsing, remitting multiple sclerosis (characterised by at least two attacks of neurological dysfunction over the previous 2 or 3 years, followed by complete or incomplete recovery) who are able to walk unaided | For a single demyelinating event with an active inflammatory process (if severe enough to require intravenous corticosteroid and patient at high risk of developing multiple sclerosis) ▶BY INTRAMUSCULAR INJECTION ▶Adult: (consult product literature) BETAFERON ® INJECTION For relapsing, remitting multiple sclerosis | For secondary progressive multiple sclerosis with active disease | For a single demyelinating event with an active inflammatory process (if severe enough to require intravenous corticosteroid and patient at high risk of developing multiple sclerosis) ▶BY SUBCUTANEOUS INJECTION ▶Adult: (consult product literature) EXTAVIA ® For relapsing, remitting multiple sclerosis | For secondary progressive multiple sclerosis with active disease | For a single demyelinating event with an active inflammatory process (if severe enough to require intravenous corticosteroid and patient at high risk of developing multiple sclerosis) ▶BY SUBCUTANEOUS INJECTION ▶Adult: (consult product literature) REBIF ® CARTRIDGE For relapsing, remitting multiple sclerosis | For a single demyelinating event with an active inflammatory process (if at high risk of developing multiple sclerosis) ▶BY SUBCUTANEOUS INJECTION ▶Adult: (consult product literature) REBIF ® PRE-FILLED PEN AND SYRINGE For relapsing, remitting multiple sclerosis | For a single demyelinating event with an active inflammatory process (if at high risk of developing multiple sclerosis) ▶BY SUBCUTANEOUS INJECTION ▶Adult: (consult product literature)

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Contra Indications

Severe depressive illness CONTRA-INDICATIONS, FURTHER INFORMATION Consult product literature for further information on contra-indications.

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Cautions

History of cardiac disorders. history of depressive disorders (avoid in severe depression or in those with suicidal ideation). history of seizures. history of severe myelosupression CAUTIONS, FURTHER INFORMATION Consult product literature for further information on cautions.

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Prescribing And Dispensing Information

Interferon beta is a biological medicine. Biological medicines must be prescribed and dispensed by brand name, see Biological medicines and Biosimilar medicines, under Guidance on prescribing p. 1; manufacturer advises to record the brand name and batch number after each administration.

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National Funding Access Decisions

NICE decisions ▶Beta interferons and glatiramer acetate for treating multiple sclerosis (June 2018) NICE TA527 Interferon beta-1a (Avonex ®, Rebif ®) is recommended as an option for treating multiple sclerosis, only if: . the person has relapsing–remitting multiple sclerosis, and . the manufacturer provides it according to the commercial arrangement. Interferon beta-1b (Extavia ®) is recommended as an option for treating multiple sclerosis, only if: . the person has relapsing–remitting multiple sclerosis and has had 2 or more relapses within the last 2 years, or . the person has secondary progressive multiple sclerosis with continuing relapses, and . the manufacturer provides it according to the commercial arrangement. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta527 ▶Beta interferons and glatiramer acetate for treating multiple sclerosis (June 2018) NICE TA527 Interferon beta-1b (Betaferon ®) is not recommended within its marketing authorisation as an option for treating multiple sclerosis. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta527 NHS restrictions NHS England Clinical Commissioning Policy NHS England (May 2014) has provided guidance on the use of interferon beta p. 895 for the treatment of multiple sclerosis in England. An NHS England Clinical Commissioning Policy outlines the funding arrangements and the criteria for initiating and discontinuing this treatment option, see www.england.nhs.uk/commissioning/spec-services/npc-crg/ group-d/d04.

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Safety

Interactions

→Appendix 1: interferons

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Side Effects

GENERAL SIDE-EFFECTS ▶Common or very common Alopecia. appetite decreased. arthralgia. asthenia. chills. confusion. depression. diarrhoea. fever. headaches. hypothyroidism. inﬂuenza like illness (decreasing over time). insomnia. malaise. menstrual cycle irregularities. nausea. pain. skin reactions. vasodilation. vomiting. weight changes ▶Uncommon Emotional lability. glomerulosclerosis. hepatic disorders. nephrotic syndrome. seizure. thrombocytopenia ▶Rare or very rare Cardiomyopathy. dyspnoea. haemolytic uraemic syndrome. hyperthyroidism. thrombotic Immune system and malignant disease microangiopathy ▶Frequency not known Anxiety. chest pain. dizziness. injection site necrosis. muscle weakness. palpitations. pulmonary arterial hypertension SPECIFIC SIDE-EFFECTS ▶Common or very common ▶With intramuscular use Muscle complaints. musculoskeletal stiffness. neuromuscular dysfunction. rhinorrhoea. sensation abnormal. sweat changes ▶With subcutaneous use Anaemia. tachycardia ▶Uncommon ▶With subcutaneous use Suicide attempt ▶Rare or very rare ▶With subcutaneous use Bronchospasm. pancreatitis. thyroid disorder ▶Frequency not known ▶With intramuscular use Angioedema. arrhythmias. arthritis. congestive heart failure. hypersensitivity. neurological effects. pancytopenia. psychosis. suicide. syncope. systemic lupus erythematosus (SLE) ▶With subcutaneous use Abdominal pain. abscess. capillary leak syndrome. conjunctivitis. constipation. cough aggravated. ear pain. erectile dysfunction. eye disorder. hyperhidrosis. hypertension. increased risk of infection. lupus-like syndrome. lymphadenopathy. muscle tone increased. myalgia. paraesthesia. peripheral oedema. urinary disorders. visual impairment

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Pregnancy

Manufacturer advises use if clinically needed—possible toxicity in animal studies, but limited human data do not suggest an increased risk.

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Breast Feeding

Manufacturer advises suitable for use during breast feeding—amount in milk probably too small to be harmful (recommendation also supported by specialist sources).

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Hepatic Impairment

Manufacturer advises caution; avoid in decompensated liver disease.

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Renal Impairment

Manufacturer advises caution in severe impairment.

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Monitoring Requirements

▶Liver Function Manufacturer advises monitor liver function at baseline, then 1 month, 3 months and 6 months after initiation of therapy. Consider dose reduction if alanine aminotransferase (ALT) exceeds 5 times the upper limit of normal (consult product literature). ▶Thrombotic Microangiopathy Manufacturer advises patients should be monitored for clinical features of thrombotic microangiopathy (TMA), including thrombocytopenia, new onset hypertension, fever, central nervous system symptoms (e.g. confusion and paresis), and impaired renal function. Any signs of TMA should be investigated fully and, if diagnosed, interferon beta should be stopped immediately and treatment for TMA promptly initiated (consult product literature for details). ▶Nephrotic Syndrome Manufacturer advises patients should also be monitored for signs and symptoms of nephrotic syndrome, including oedema, proteinuria, and impaired renal function—monitor renal function periodically. If nephrotic syndrome develops, treat promptly and consider stopping interferon beta treatment. ▶Thyroid Function Manufacturer advises baseline thyroid function tests and repeat if signs or symptoms of thyroid dysfunction occur.

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Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Solution for injection EXCIPIENTS: May contain Benzyl alcohol ▶Avonex (Biogen Idec Ltd) Interferon beta-1a 12 mega unit per 1 ml Avonex 30micrograms/0.5ml (6million units) solution for injection pre-filled syringes | 4 pre-filled disposable injection P £654.00 | 12 pre- filled disposable injection P £1,962.00 Avonex 30micrograms/0.5ml (6million units) solution for injection pre- filled pens | 4 pre-filled disposable injection P £654.00 | 12 pre- filled disposable injection P £1,962.00 ▶Rebif (Merck Serono Ltd) Interferon beta-1a 12 mega unit per 1 ml Rebif 22micrograms/0.5ml (6million units) solution for injection pre-filled syringes | 12 pre-filled disposable injection P £613.52 Rebif 22micrograms/0.5ml (6million units) solution for injection 1.5ml cartridges | 4 cartridge P £613.52 Rebif 8.8micrograms/0.2ml (2.4million units) solution for injection pre- filled syringes | 6 pre-filled disposable injection P s Rebif 22micrograms/0.5ml (6million units) solution for injection pre- filled pens | 12 pre-filled disposable injection P £613.52 Interferon beta-1a 24 mega unit per 1 ml Rebif 44micrograms/0.5ml (12million units) solution for injection pre-filled syringes | 12 pre-filled disposable injection P £813.21 Rebif 44micrograms/0.5ml (12million units) solution for injection pre- filled pens | 12 pre-filled disposable injection P £813.21 Rebif 44micrograms/0.5ml (12million units) solution for injection 1.5ml cartridges | 4 cartridge P £813.21 Powder and solvent for solution for injection ▶Betaferon (Bayer Plc) Interferon beta-1b 300 microgram Betaferon 300microgram powder and solvent for solution for injection vials | 15 vial P £596.63 (Hospital only) ▶Extavia (Novartis Pharmaceuticals UK Ltd) Interferon beta-1b 300 microgram Extavia 300microgram powder and solvent for solution for injection vials | 15 vial P £596.63

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Dose text by age group

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

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Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

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Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 917

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 917

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 917

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 917

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Interferon beta

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 917, 918, 919

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 917

Contra Indications

Severe depressive illness CONTRA-INDICATIONS, FURTHER INFORMATION Consult product literature for further information on contra-indications.

PDF page 917

Cautions

PDF page 917

Prescribing And Dispensing Information

PDF page 918

National Funding Access Decisions

PDF page 918

Safety

Interactions

→Appendix 1: interferons

PDF page 917

Side Effects

PDF page 918

Pregnancy

Manufacturer advises use if clinically needed—possible toxicity in animal studies, but limited human data do not suggest an increased risk.

PDF page 918

Breast Feeding

Manufacturer advises suitable for use during breast feeding—amount in milk probably too small to be harmful (recommendation also supported by specialist sources).

PDF page 918

Hepatic Impairment

Manufacturer advises caution; avoid in decompensated liver disease.

PDF page 918

Renal Impairment

Manufacturer advises caution in severe impairment.

PDF page 918

Monitoring Requirements

PDF page 918

Dose and formulations

Medicinal Forms

PDF pages 918, 919

Dose text by age group

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 917

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 917

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 917

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 917

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 917

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 917

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.