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Indications

Peginterferon Alfa-2a is used to treat long-term (chronic) hepatitis B and chronic hepatitis C infections of the liver in adults and some children. For hepatitis C it is usually given together with other antiviral medicines such as Ribavirin. It is prescribed and monitored by a liver specialist.

How It Works

Interferons are proteins the body makes naturally to fight viruses. This medicine is a man-made interferon attached to a substance called polyethylene glycol (PEG), which makes it last longer in the body, so it needs only one injection a week. It boosts the immune system's attack on the virus and slows the virus from multiplying in liver cells.

Dosage and Administration

It is given as an injection under the skin, usually once a week, by a doctor or nurse, or by the patient after proper training. The dose and length of treatment (often 24 to 48 weeks) are set by the doctor depending on the type of hepatitis, the virus genotype, body weight and response. Use exactly as prescribed. Inject on the same day each week and rotate injection sites.

Interactions

• Theophylline: its levels may rise; monitoring may be needed.
• Telbivudine: risk of nerve damage (peripheral neuropathy); should not be combined.
• Zidovudine and Didanosine (HIV medicines): higher risk of anaemia, liver failure or other problems.
• Methadone: levels may increase.
• Other medicines that suppress the bone marrow may add to low blood counts.

Contraindications

• Allergy to interferons or any ingredient.
• Autoimmune hepatitis.
• Severe or decompensated liver disease (cirrhosis with complications).
• Severe heart disease, including unstable heart disease in the last 6 months.
• Newborns and infants under 3 years (the product contains benzyl alcohol).
• In combination with Ribavirin: pregnancy and men whose partners are pregnant.

Side Effects

Flu-like symptoms (fever, chills, muscle aches, headache) are very common, especially after the first doses. Other common effects are tiredness, loss of appetite, weight loss, hair thinning, sleep problems, irritability, low mood, itching, redness at the injection site and lower blood counts. Thyroid problems may develop.

Get urgent medical help if you have severe depression or thoughts of harming yourself, chest pain, severe stomach pain, bloody diarrhoea, yellowing of the skin or eyes, high fever, signs of infection, changes in vision, breathing difficulty, or signs of a severe allergic reaction.

Pregnancy and Lactation

Do not use during pregnancy unless the doctor decides it is essential. When used with Ribavirin, it must not be used by pregnant women or by men whose partners are pregnant, because Ribavirin causes birth defects; both partners must use effective contraception during treatment and for several months afterwards as advised. Breastfeeding is not recommended during treatment.

Precautions and Warnings

Regular blood tests, liver tests and thyroid checks are needed. Tell your doctor about any history of depression or mental illness, heart disease, diabetes, thyroid disease, autoimmune disease, eye problems or kidney disease. Eye checks are advised. Avoid alcohol. It can cause tiredness or dizziness; take care when driving.

Overdose

An overdose may cause severe tiredness, flu-like symptoms or abnormal blood counts. Contact your doctor or hospital immediately.

Therapeutic Class

Immunomodulator; antiviral; pegylated interferon.

Storage

Store in a refrigerator at 2 to 8°C. Do not freeze. Keep in the original pack to protect from light and out of the reach of children.