Drug reference
Polyethylene glycol-conjugated (‘pegylated’) derivatives of interferon alfa (peginterferon alfa-2a and peginterferon alfa-2b) are available; pegylation increases the persistence of the interferon in the blood.
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PEGASYS ® Combined with ribavirin for chronic hepatitis C | Monotherapy for chronic hepatitis C if ribavirin not tolerated or contra-indicated | Monotherapy for chronic hepatitis B ▶BY SUBCUTANEOUS INJECTION ▶Adult: (consult product literature)
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CONTRA-INDICATIONS, FURTHER INFORMATION For contra-indications consult product literature.
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CAUTIONS, FURTHER INFORMATION For cautions consult product literature.
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NICE decisions ▶Peginterferon alfa and ribavirin for mild chronic hepatitis C (August 2006 and September 2010) NICE TA200 The combination of peginterferon alfa and ribavirin can be used for treating mild chronic hepatitis C in patients over 18 years. Alternatively, treatment can be delayed until the disease has reached a moderate stage (‘watchful waiting’). Peginterferon alfa alone can be used if ribavirin is contra- indicated or not tolerated. www.nice.org.uk/guidance/ta200 ▶Peginterferon alfa, interferon alfa, and ribavirin for moderate to severe chronic hepatitis C (January 2004 and September 2010) NICE TA200 The combination of peginterferon alfa and ribavirin should be used for treating moderate to severe chronic hepatitis C in patients aged over 18 years: . not previously treated with interferon alfa or peginterferon alfa; . treated previously with interferon alfa alone or in combination with ribavirin; . whose condition did not respond to peginterferon alfa alone or to a combination of peginterferon alfa and ribavirin, or responded but subsequently relapsed; . co-infected with HIV. Peginterferon alfa alone should be used if ribavirin is contra-indicated or not tolerated. Interferon alfa for either monotherapy or combined therapy should be used only if neutropenia and thrombocytopenia are a particular risk. Patients receiving interferon alfa may be switched to peginterferon alfa. www.nice.org.uk/guidance/ta200
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→Appendix 1: interferons
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▶Common or very common Alopecia. anaemia. anxiety. appetite abnormal. arrhythmias. arthralgia. arthritis. asthenia. ataxia. behaviour abnormal. breast pain. chest discomfort. chills. concentration impaired. confusion. constipation. cough. crying. dehydration. depression. diarrhoea. dizziness. drowsiness. dry eye. dry mouth. dysphagia. dysphonia. dyspnoea. ear pain. eye discomfort. eye disorders. eye inflammation. feeling abnormal. fever. gastrointestinal discomfort. gastrointestinal disorders. haemolytic anaemia. haemorrhage. hair texture abnormal. headaches. hearing impairment. hyperbilirubinaemia. hypertension. hyperthyroidism. hyperuricaemia. hypotension. hypothyroidism. increased risk of infection. influenza like illness. leucopenia. lymphadenopathy. malaise. memory loss. menstrual cycle irregularities. mood altered. muscle complaints. muscle tone increased. muscle weakness. nail disorder. nasal complaints. nausea. neutropenia. oedema . oral disorders. ovarian disorder. pain. palpitations. photosensitivity reaction. prostatitis. respiratory disorders. sensation abnormal. sepsis. sexual dysfunction . skin reactions. sleep disorders. sweat changes. syncope. taste altered. thirst. throat complaints. thrombocytopenia. tinnitus. tremor. urinary disorders. urine abnormal. vaginal disorder. vasodilation. vertigo. vision disorders. vomiting. weight decreased ▶Uncommon Diabetes mellitus. hallucination. hypersensitivity. hypertriglyceridaemia. myocardial infarction. nerve disorders. pancreatitis. psychosis. sarcoidosis. suicidal tendencies. thyroiditis ▶Rare or very rare Angioedema. bone marrow disorders. cardiac inflammation. cardiomyopathy. cerebral ischaemia. CNS haemorrhage. coma. congestive heart failure. diabetic ketoacidosis. embolism and thrombosis. encephalopathy. facial paralysis. injection site necrosis. ischaemic heart disease. myopathy. renal failure. retinopathy. seizure (more common with high doses in the elderly). severe cutaneous adverse reactions (SCARs). systemic lupus erythematosus (SLE). ulcerative colitis. vasculitis ▶Frequency not known Homicidal ideation. pericardial effusion. peripheral ischaemia. pulmonary arterial hypertension. pure red cell aplasia. solid organ transplant rejection. tongue discolouration
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Effective contraception required during treatment—consult product literature.
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Manufacturers recommend avoid unless potential benefit outweighs risk (toxicity in animal studies).
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Manufacturers advise avoid—no information available.
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Manufacturer advises avoid in severe impairment and decompensated cirrhosis.
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For further information on peginterferon alfa use in renal impairment consult product literature. Dose adjustments Reduce dose in moderate to severe impairment. Monitoring Close monitoring required in renal impairment.
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Monitoring of lipid concentration is recommended.
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There can be variation in the licensing of different medicines containing the same drug. Solution for injection EXCIPIENTS: May contain Benzyl alcohol ▶Pegasys (Roche Products Ltd) Interferon alfa-2a (as Peginterferon alfa-2a) 180 microgram per 1 ml Pegasys 90micrograms/0.5ml solution for injection pre-filled syringes | 1 pre-filled disposable injection P £76.51 Interferon alfa-2a (as Peginterferon alfa-2a) 270 microgram per 1 ml Pegasys 135micrograms/0.5ml solution for injection pre-filled syringes | 1 pre-filled disposable injection P £107.76 DT = £107.76 Interferon alfa-2a (as Peginterferon alfa-2a) 360 microgram per 1 ml Pegasys 180micrograms/0.5ml solution for injection pre-filled syringes | 4 pre-filled disposable injection P £497.60 6.3b Chronic hepatitis C Other drugs used for Chronic hepatitis C Interferon alfa, p. 1008. Peginterferon alfa, p. 660 ANTIVIRALS › HCV INHIBITORS
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(consult product literature)
First-line fragment. Read the complete Indications and Dose section above.
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