Interferon Alfa 2a

Interferon Alfa 2a Brand Name– Roferon A

What is Interferon Alfa 2a

Interferon alfa 2a is a recombinant alpha interferon (IFN). The alpha IFNs include more than 25 subtypes; interferon alfa-2a represents only one specific subtype (i.e., interferon alpha-2).

Alpha and beta IFNs are structurally and functionally related. Interferon alfa-2a is a highly purified protein containing 165 amino acids and is produced by recombinant DNA technology that uses a genetically engineered Escherichia coli bacterium containing DNA that codes for the protein.

Interferon alfa-2a differs from interferon alfa-2b by only one amino acid at position 23. Studies have shown that interferon alfa 2a can normalize serum ALT, improve liver histology, and reduce viral load in patients with hepatitis C. A long-lasting pegylated formulation of interferon alfa 2a (peginterferon alfa-2a, Pegasys®) has been approved by the FDA (see Peginterferon alfa-2a monograph).

In a phase II/III study of hepatitis C patients with cirrhosis, response rates with peginterferon alfa-2a were higher than those seen in patients treated with standard alpha interferon.

Use of peginterferon alfa with ribavirin is recommended in consensus guidelines for the treatment of chronic hepatitis C.

Other studies have shown that interferon alfa-2a can produce clinical responses or disease stabilization in patients with hairy cell leukemia or AIDS-related Kaposi’s sarcoma.

In patients with Philadelphia-chromosome positive chronic myelogenous leukemia (CML), interferon alfa-2a in combination with chemotherapy can prolong overall survival and delay disease progression as compared to patients treated with chemotherapy alone.

Interferon alfa 2a has achieved sustained complete cytogenetic responses in a small subset of patients with CML in the chronic phase. Interferon alfa-2a has also been studied in the treatment of melanoma, renal cell carcinoma, and non-Hodgkin’s lymphoma including cutaneous T-cell lymphoma.

Extensive study of alfa interferons in combination with 5-fluorouracil (5-FU) for the treatment of colorectal cancer has shown no benefit over 5-FU therapy alone. In 1986, the FDA approved interferon alfa-2a for the treatment of hairy cell leukemia.

In September 1999, the FDA oncology advisory panel recommended against approval of interferon alfa-2a (Roferon® A) for the treatment of early-stage melanoma.

Interferon alfa 2a is available only in prefilled syringes; according to the manufacturer, the drug vials were discontinued due to a business decision.

Indications

  1. adenovirus
  2. chronic myelogenous leukemia (CML)
  3. cutaneous T-cell lymphoma (CTCL)
  4. encephalomyocarditis virus
  5. hairy-cell leukemia
  6. hepatitis B virus
  7. hepatitis C infection
  8. hepatitis C virus
  9. hepatitis D virus
  10. herpes simplex virus type 1
  11. herpes simplex virus type 2
  12. human immunodeficiency virus (HIV)
  13. human papillomavirus (HPV)
  14. human T-lymphotropic virus type I (HTLV-I)
  15. Kaposi’s sarcoma
  16. malignant melanoma
  17. non-Hodgkin’s lymphoma (NHL)
  18. poliovirus
  19. renal cell cancer
  20. rhinovirus
  21. varicella-zoster virus
  22. variola virus (smallpox)
  23. vesicular stomatitis virus

Side Effects

  1. abdominal pain
  2. alopecia
  3. anaphylactoid reactions
  4. anemia
  5. angina
  6. angioedema
  7. anorexia
  8. antibody formation
  9. anxiety
  10. aplastic anemia
  11. arrhythmia exacerbation
  12. arthralgia
  13. ascites
  14. asthenia
  15. back pain
  16. bronchospasm
  17. cardiomyopathy
  18. chest pain (unspecified)
  19. chills
  20. colitis
  21. coma
  22. confusion
  23. cough
  24. depression
  25. diaphoresis
  26. diarrhea
  27. dizziness
  28. dysgeusia
  29. dyspnea
  30. elevated hepatic enzymes
  31. emotional lability
  32. epistaxis
  33. erythema
  34. fatigue
  35. fever
  36. GI bleeding
  37. hallucinations
  38. headache
  39. heart failure
  40. hepatic failure
  41. hepatitis
  42. hot flashes
  43. hyperglycemia
  44. hypertension
  45. hyperthyroidism
  46. hypertriglyceridemia
  47. hypothyroidism
  48. impaired cognition
  49. impotence (erectile dysfunction)
  50. infection
  51. injection site reaction
  52. insomnia
  53. irritability
  54. leukopenia
  55. lupus-like symptoms
  56. macular edema
  57. malaise
  58. mania
  59. menstrual irregularity
  60. myalgia
  61. myocardial infarction
  62. nausea
  63. neutropenia
  64. non-arteritic anterior ischemic optic neuropathy
  65. optic neuritis
  66. pancreatitis
  67. papilledema
  68. paresthesias
  69. pneumonitis
  70. proteinuria
  71. pruritus
  72. psoriasis
  73. psychosis
  74. pulmonary hypertension
  75. rash
  76. renal failure (unspecified)
  77. retinal detachment
  78. retinal hemorrhage
  79. retinal thrombosis
  80. retinopathy
  81. rhabdomyolysis
  82. rhinorrhea
  83. seizures
  84. sinusitis
  85. stroke
  86. suicidal ideation
  87. supraventricular tachycardia (SVT)
  88. thrombocytopenia
  89. urticaria
  90. vasculitis
  91. vertigo
  92. visual impairment
  93. vomiting
  94. weight loss

Monitoring Parameters

  • CBC with differential
  • ECG
  • LFTs
  • thyroid function tests (TFTs)

Contraindications

  • acute bronchospasm
  • alcoholism
  • anemia
  • angina
  • angioedema
  • ascites
  • autoimmune disease
  • benzyl alcohol hypersensitivity
  • bipolar disorder
  • bone marrow suppression
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • children
  • chronic obstructive pulmonary disease (COPD)
  • coagulopathy
  • colitis
  • coronary artery disease
  • dental disease
  • dental work
  • depression
  • diabetes mellitus
  • diabetic ketoacidosis
  • diabetic retinopathy
  • driving or operating machinery
  • E. coli protein hypersensitivity
  • geriatric
  • Graves’ disease
  • heart failure
  • hepatic disease
  • hepatitis
  • hyperlipidemia
  • hypertension
  • hyperthyroidism
  • hypertriglyceridemia
  • hypothyroidism
  • immune thrombocytopenic purpura (ITP)
  • immunosuppression
  • infants
  • infection
  • intramuscular administration
  • intramuscular injections
  • jaundice
  • Kaposi’s sarcoma
  • labor
  • mania
  • myocardial infarction
  • neonates
  • neoplastic disease
  • neutropenia
  • non-arteritic anterior ischemic optic neuropathy
  • ocular disease
  • optic neuritis
  • organ transplant
  • pancreatitis
  • papilledema
  • pregnancy
  • psoriasis
  • psychiatric event
  • psychosis
  • pulmonary disease
  • radiation therapy
  • Raynaud’s phenomenon
  • renal disease
  • renal failure
  • renal impairment
  • rheumatoid arthritis
  • seizure disorder
  • stroke
  • substance abuse
  • suicidal ideation
  • systemic lupus erythematosus (SLE)
  • thrombocytopenia
  • thyroid disease
  • ulcerative colitis
  • urticaria
  • vaccination
  • vasculitis
  • visual disturbance

Interactions

  • Abacavir
  • Abacavir; Dolutegravir; Lamivudine
  • Abacavir; Lamivudine, 3TC
  • Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Alteplase
  • Altretamine
  • Amprenavir
  • Anticoagulants
  • Antithrombin III
  • Antithymocyte Globulin
  • Antitumor antibiotics
  • Apixaban
  • Argatroban
  • Arsenic Trioxide
  • Atazanavir
  • Atazanavir; Cobicistat
  • Azathioprine
  • Bacillus Calmette-Guerin Vaccine, BCG
  • Basiliximab
  • Betrixaban
  • Bictegravir; Emtricitabine; Tenofovir Alafenamide
  • Bivalirudin
  • Carbamazepine
  • Chloroquine
  • Clozapine
  • Corticosteroids
  • Dabigatran
  • Dalteparin
  • Danaparoid
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Desirudin
  • Diclofenac
  • Diclofenac; Misoprostol
  • Digoxin
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Dolutegravir; Lamivudine
  • Dolutegravir; Rilpivirine
  • Doravirine; Lamivudine; Tenofovir disoproxil fumarate
  • Edoxaban
  • Efalizumab
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Emtricitabine
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Emtricitabine; Tenofovir alafenamide
  • Emtricitabine; Tenofovir disoproxil fumarate
  • Enoxaparin
  • Entecavir
  • Esomeprazole; Naproxen
  • Estramustine
  • Ethanol
  • Etodolac
  • Famotidine; Ibuprofen
  • Filgrastim, G-CSF
  • Fluorouracil, 5-FU
  • Flurbiprofen
  • Folate analogs
  • Fondaparinux
  • Fosamprenavir
  • Heparin
  • Hydrocodone; Ibuprofen
  • Hydroxyurea
  • Ibritumomab Tiuxetan
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Imatinib
  • Indinavir
  • Influenza Virus Vaccine
  • Intranasal Influenza Vaccine
  • Ketoprofen
  • Ketorolac
  • Lamivudine, 3TC
  • Lamivudine, 3TC; Zidovudine, ZDV
  • Lamivudine; Tenofovir Disoproxil Fumarate
  • Lansoprazole; Naproxen
  • Lepirudin
  • Live Vaccines
  • Lomustine, CCNU
  • Lopinavir; Ritonavir
  • Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
  • Measles/Mumps/Rubella Vaccines, MMR
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Melphalan
  • Methotrexate
  • Methoxsalen
  • Mitoxantrone
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Natural Antineoplastics
  • Nelfinavir
  • Nevirapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Oxaprozin
  • Palifermin
  • Pegfilgrastim
  • Pemetrexed
  • Penicillamine
  • Pentosan
  • Pexidartinib
  • Piroxicam
  • Pralatrexate
  • Protease inhibitors
  • Purine analogs
  • Reteplase, r-PA
  • Rilpivirine
  • Riluzole
  • Ritonavir
  • Rivaroxaban
  • Rotavirus Vaccine
  • Rubella Virus Vaccine Live
  • Saquinavir
  • Smallpox and Monkeypox Vaccine, Live, Nonreplicating
  • Smallpox Vaccine, Vaccinia Vaccine
  • Stavudine, d4T
  • Streptokinase
  • Sulindac
  • Tbo-Filgrastim
  • Telbivudine
  • Tenecteplase
  • Theophylline, Aminophylline
  • Thrombolytic Agents
  • Tinzaparin
  • Tipranavir
  • Tolmetin
  • Tositumomab
  • Tretinoin, ATRA
  • Tuberculin Purified Protein Derivative, PPD
  • Typhoid Vaccine
  • Urokinase
  • Varicella-Zoster Virus Vaccine, Live
  • Vigabatrin
  • Warfarin
  • Yellow Fever Vaccine, Live
  • Zalcitabine, ddC
  • Zidovudine, ZDV
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