Posted on April 28th, 2009 by
Class: Biologic response modifier
Generic Name: Interferon alpha (in-ter-FEER-on), alpha interferon, IFN-alpha
Trade Name: Intron® A (interferon alfa-2b), Roferon-A® (interferon alfa-2a)
How is this drug used? Interferon alpha is FDA approved for the treatment of hairy cell leukemia, malignant melanoma, AIDS-related Kaposi’s sarcoma, follicular non-Hodgkin’s lymphoma, and Condylomata Acuminata. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action? Interferon alpha belongs to a group of agents called cytokines. Interferon alpha produces its anti-cancer effects by stimulating the immune system to help fight the cancer.
How is interferon alpha given (administered)? Interferon alpha may be administered as an injection under the skin (subcutaneous), as an injection into a muscle (intramuscular), as an injection directly into the cancer (intralesional) or as an injection into a vein (intravenous) and the dose depends on several factors, including the condition being treated, the size of the patient, the particular treatment regimen being used, and the overall health of the patient.
How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with interferon alpha. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy. Patients will also have their thyroid function monitored and undergo an eye exam, as interferon alfa may produce side effects that affect the thyroid or eyes. Patients may also undergo examinations of their lungs and heart. In addition, patients may be assessed for emotional stability, as interferon alpha has been associated with depression.
What are the common (occur in 30% or more of patients) side effects of treatment with interferon alfa?
• Generalized achiness
• Generalized pains
• Loss of appetite
• Low white blood cell levels – increases the risk of infection
• Low red blood cell levels – increases the risk of anemia
• Low platelet levels – increases the risk of bleeding
• Abnormalities in some electrolyte levels
• Abnormalities in glucose levels
• Abnormalities in triglyceride levels
• Loss of hair
• Weight loss
What are the less common (occur in 10% to 29% of patients) side effects of treatment with interferon alfa?
• Nausea and vomiting
• Changes in blood pressure
• Difficulty breathing
• Dry mouth
• Inflammed gums (gingivitis)
• Abdominal pain
• Numbness or tingling of hands or feet
• Changes in taste
• Memory loss
• Impaired concentration
• Fluid retention resulting in swelling of feet or ankles
• Dry skin
• Redness, pain at the site of injection
• Sore throat
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?
• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• If possible, avoid large crowds or people who are sick or not feeling well, as this drug may leave some patients susceptible to infection.
• Wash hands often to reduce the risk of infection.
• Eat small meals frequently to help alleviate nausea.
• Avoid activities that may cause injury or bruising.
• Use a soft toothbrush and an electric razor to prevent cuts on the mouth or skin.
Are there any special precautions patients should be aware of before starting treatment?
• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• Diabetic patients should monitor their glucose levels carefully and talk to their doctor about the possible affects interferon alfa may have on their glucose levels.
• Patients should use caution when driving or completing tasks that require mental alertness until effects of the drug are known, as they may experience fatigue, vision changes, and confusion.
When should patients notify their physician?
• Change in mental status (confusion, hallucinations, paranoia)
• Depression/feelings of suicide
• Seizures, tremors
• Persistent fever
• Swelling of ankles or feet
• Chest pain
• Difficulty breathing, cough
• Noticeable changes in heart rate or rhythm
• Vision changes
• Excessive urinating and extreme thirst
• Yellowing of skin or eyes
• Abdominal pain
• Numbness or tingling of hands or feet
• Flu or cold-like symptoms – fever, sore throat, cough, chills
• Signs of infection – redness, swelling, pus, tenderness
• Persistent or severe fatigue
• Unusual bleeding or bruising
• Mouth sores
• Allergic type reaction (rash, hives, tightness of throat, difficulty breathing)
What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. Click here to view the package insert
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