Interferon Alfa 2b

Interferon Alfa 2b Brand Names- Intron A | Intron A Multidose Pen

What is Interferon Alfa 2b

Interferon alfa 2b is a recombinant alpha interferon (IFN).

The alpha IFNs include more than 25 subtypes; interferon alfa-2b represents only one specific subtype of alpha interferon (i.e., interferon alpha-2). Alpha and beta IFNs are structurally and functionally related.

Interferon alfa 2b is highly purified protein containing 165 amino acids and is produced by recombinant DNA technology that uses a genetically engineered Escherichia coli bacterium containing a plasmid that codes for the protein. Interferon alfa-2b differs from interferon alfa-2a by only one amino acid at position 23.

In the treatment of hepatitis B, interferon alfa-2b can produce virologic remission (i.e., loss of serum HBeAg) and normalization of serum transaminases.

In patients with hepatitis C, interferon alfa-2b treatment may result in normalization of transaminases and a reduction in liver necrosis and degeneration.

As adjuvant therapy, interferon alfa-2b increases relapse-free and overall survival in patients with melanoma who are disease-free post surgery but at high risk for recurrence.

Interferon alfa 2b is indicated for the treatment of hairy cell leukemia, malignant melanoma, follicular non-Hodgkin’s lymphoma, venereal or genital warts, AIDS-related Kaposi’s sarcoma, chronic hepatitis C, and chronic hepatitis B. Interferon alfa-2b has also been studied in patients with chronic myelogenous leukemia.

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-2b for the treatment of hairy cell leukemia.

An extended release formulation of interferon alfa-2b (PEG-Intron) has been approved by the FDA (see separate monograph, peginterferon alfa-2b).

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

Indications

1. adenovirus
2. chronic myelogenous leukemia (CML)
3. condylomata acuminata
4. encephalomyocarditis virus
5. hairy-cell leukemia
6. hemangioma
7. hepatitis B infection
8. hepatitis B virus
9. hepatitis C infection
10. hepatitis C virus
11. hepatitis D virus
12. herpes simplex virus type 1
13. herpes simplex virus type 2
14. human immunodeficiency virus (HIV)
15. human papillomavirus (HPV)
16. human papillomavirus (HPV) infection
17. human T-lymphotropic virus type I (HTLV-I)
18. hypereosinophilic syndrome
19. Kaposi’s sarcoma
20. malignant melanoma
21. multiple myeloma
22. non-Hodgkin’s lymphoma (NHL)
23. poliovirus
24. renal cell cancer
25. rhinovirus
26. St. Louis encephalitis
27. St. Louis encephalitis virus
28. T-cell leukemia/lymphoma
29. varicella-zoster virus
30. variola virus (smallpox)
31. vesicular stomatitis virus
32. West Nile virus
33. West Nile virus infection

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. arthralgia
12. ascites
13. asthenia
14. autoimmune disease
15. back pain
16. bronchospasm
17. cardiomyopathy
18. chest pain (unspecified)
19. chills
20. colitis
21. coma
22. confusion
23. cough
24. depression
25. diabetes mellitus
26. diaphoresis
27. diarrhea
28. dizziness
29. dysgeusia
30. dyspnea
31. elevated hepatic enzymes
32. emotional lability
33. encephalopathy
34. erythema multiforme
35. fatigue
36. fever
37. GI bleeding
38. growth inhibition
39. hallucinations
40. headache
41. hemolytic anemia
42. hepatic failure
43. hostility
44. hot flashes
45. hyperbilirubinemia
46. hyperglycemia
47. hypertension
48. hyperthyroidism
49. hypertriglyceridemia
50. hypotension
51. hypothyroidism
52. infection
53. injection site reaction
54. insomnia
55. leukopenia
56. lupus-like symptoms
57. macular edema
58. malaise
59. musculoskeletal pain
60. myalgia
61. myocardial infarction
62. nasal congestion
63. nausea
64. nephrotic syndrome
65. neutropenia
66. non-arteritic anterior ischemic optic neuropathy
67. optic neuritis
68. pancreatitis
69. papilledema
70. paresthesias
71. pericarditis
72. pharyngitis
73. pneumonitis
74. proteinuria
75. pruritus
76. psoriasis
77. psychosis
78. pulmonary fibrosis
79. pulmonary hypertension
80. purpura
81. rash
82. red cell aplasia
83. renal failure (unspecified)
84. retinal hemorrhage
85. retinal thrombosis
86. retinopathy
87. rhabdomyolysis
88. seizures
89. sinus tachycardia
90. sinusitis
91. Stevens-Johnson syndrome
92. stroke
93. suicidal ideation
94. supraventricular tachycardia (SVT)
95. thrombocytopenia
96. tongue discoloration
97. toxic epidermal necrolysis
98. urticaria
99. vasculitis
100. visual impairment
101. vomiting
102. weight loss
103. xerosis
104. xerostomia

Monitoring Parameters

• CBC with differential
• chest x-ray
• ECG
• LFTs
• thyroid function tests (TFTs)

Contraindications

• acute bronchospasm
• albumin hypersensitivity
• alcoholism
• anemia
• angina
• ascites
• autoimmune disease
• bleeding
• bone marrow suppression
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• children
• chronic obstructive pulmonary disease (COPD)
• colitis
• contraception requirements
• coronary artery disease
• dental disease
• dental work
• depression
• diabetes mellitus
• diabetic ketoacidosis
• diabetic retinopathy
• driving or operating machinery
• E. coli protein hypersensitivity
• geriatric
• growth inhibition
• heart failure
• hepatic disease
• hepatic encephalopathy
• hepatitis
• hepatitis B exacerbation
• hyperlipidemia
• hypertension
• hyperthyroidism
• hypothyroidism
• immunosuppression
• infants
• infection
• infertility
• intramuscular injections
• jaundice
• Kaposi’s sarcoma
• myocardial infarction
• neonates
• neoplastic disease
• neutropenia
• non-arteritic anterior ischemic optic neuropathy
• ocular disease
• organ transplant
• pancreatitis
• pregnancy
• psoriasis
• psychiatric event
• pulmonary disease
• radiation therapy
• renal failure
• renal impairment
• reproductive risk
• rheumatoid arthritis
• seizure disorder
• stroke
• substance abuse
• suicidal ideation
• systemic lupus erythematosus (SLE)
• thrombocytopenia
• thrombophlebitis
• thyroid disease
• ulcerative colitis
• urticaria
• use with ribavirin
• vaccination
• 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