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
- adenovirus
- chronic myelogenous leukemia (CML)
- cutaneous T-cell lymphoma (CTCL)
- encephalomyocarditis virus
- hairy-cell leukemia
- hepatitis B virus
- hepatitis C infection
- hepatitis C virus
- hepatitis D virus
- herpes simplex virus type 1
- herpes simplex virus type 2
- human immunodeficiency virus (HIV)
- human papillomavirus (HPV)
- human T-lymphotropic virus type I (HTLV-I)
- Kaposi’s sarcoma
- malignant melanoma
- non-Hodgkin’s lymphoma (NHL)
- poliovirus
- renal cell cancer
- rhinovirus
- varicella-zoster virus
- variola virus (smallpox)
- vesicular stomatitis virus
Side Effects
- abdominal pain
- alopecia
- anaphylactoid reactions
- anemia
- angina
- angioedema
- anorexia
- antibody formation
- anxiety
- aplastic anemia
- arrhythmia exacerbation
- arthralgia
- ascites
- asthenia
- back pain
- bronchospasm
- cardiomyopathy
- chest pain (unspecified)
- chills
- colitis
- coma
- confusion
- cough
- depression
- diaphoresis
- diarrhea
- dizziness
- dysgeusia
- dyspnea
- elevated hepatic enzymes
- emotional lability
- epistaxis
- erythema
- fatigue
- fever
- GI bleeding
- hallucinations
- headache
- heart failure
- hepatic failure
- hepatitis
- hot flashes
- hyperglycemia
- hypertension
- hyperthyroidism
- hypertriglyceridemia
- hypothyroidism
- impaired cognition
- impotence (erectile dysfunction)
- infection
- injection site reaction
- insomnia
- irritability
- leukopenia
- lupus-like symptoms
- macular edema
- malaise
- mania
- menstrual irregularity
- myalgia
- myocardial infarction
- nausea
- neutropenia
- non-arteritic anterior ischemic optic neuropathy
- optic neuritis
- pancreatitis
- papilledema
- paresthesias
- pneumonitis
- proteinuria
- pruritus
- psoriasis
- psychosis
- pulmonary hypertension
- rash
- renal failure (unspecified)
- retinal detachment
- retinal hemorrhage
- retinal thrombosis
- retinopathy
- rhabdomyolysis
- rhinorrhea
- seizures
- sinusitis
- stroke
- suicidal ideation
- supraventricular tachycardia (SVT)
- thrombocytopenia
- urticaria
- vasculitis
- vertigo
- visual impairment
- vomiting
- 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