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Beta-interferon-1a - Patient Information

 

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Patient Information For:
  • Interferon beta-1a

Brand Name
  • Avonex® and Rebif®

What it is
  • Avonex® and Rebif® are self-injectable medications, both containing the active ingredient, interferon beta-1a, but are clinically different formulations and should not be interchanged. These are also similar to Betaseron® (interferon beta-1b) but should not be interchanged. These medications are sometimes referred to as “injectables” or “A, B, C therapy.”

What it does
  • Reduces the number of relapses
  • Slows the accumulation of physical disability

How it works
  • Interferon beta-1a is a naturally occurring protein that is usually produced in response to certain infections. Its role, though, is thought to be more of a regulatory one, keeping the immune system in check. It alters the way in which certain white blood cells, T-cells, respond to “foreign” material.

How it’s given
Avonex®
  • Avonex® prefilled syringes are available in cartons of 4 single-use prefilled syringes so it does not have to be prepared or drawn up ahead of time.
                o Each syringe should only be used once and then discarded appropriately.
  • Avonex® is also available in vials containing powder that must be mixed prior to injection. Although, not commonly used, you will be instructed on this process if you are given these and provided with all supplies necessary.
  • Dose: 30 mcg once a week
  • Avonex® is injected intramuscularly (in the muscle)
  • A nurse or your physician should show you how to inject this medication.
                o You should review the information provided for you when you begin Avonex® therapy and with each refill.
                o Your first, self-administered dose should be done under the direct supervision of an appropriately qualified health care practitioner.
  • After the injection, dispose the used syringe into a hard-welled container.
Rebif®
  • Rebif® is available in single-use prefilled syringes so it does not have to be prepared or drawn up ahead of time.
                o Each syringe should only be used once and then discarded appropriately. You may only use part of a syringe when starting therapy (see dosing below), but you should still discard unused portions.
  • Dose: increased slowly to 22 mcg or 44 mcg three times weekly
                o Dose is slowly increased to reduce side effects

                    Percentage of final dose    For final target dose of Rebif® 22 mcg    For final target dose of Rebif® 44 mcg
Weeks 1-2                20%                                    4.4 mcg                                            8.8 mcg
Weeks 3-4                50%                                    11 mcg                                             22 mcg
Weeks 5+                 100%                                    22 mcg                                            44 mcg

  • Rebif® is injected subcutaneously (under the skin)
  • A nurse or your physician should show you how to inject this medication.
                o You should review the information provided for you when you begin Rebif® therapy and with each refill.
                o Your first, self-administered dose should be done under the direct supervision of an appropriately qualified health care practitioner.
  • After the injection, dispose the syringe into a hard-welled container.

Storage
  • Prefilled Avonex® and Rebif® syringes should be kept in their original blister package and in the original carton, under refrigeration (36-46oF or 2-8oC).
                    o You may store Avonex® in its original blister packages and in the original carton at room temperature (59-86oF or 15-30oC), for up to 7 days.
                    o You may store Rebif® in its original blister packages and in the original carton at room temperature (59-86oF or 15-30oC), for up to 30 days.
                    o Avonex® and Rebif® should NEVER be stored in the freezer.
                    o Avonex® and Rebif® are sensitive to light, meaning that it will degrade with excessive exposure, so you should always protect the syringes from direct light until its time to inject it.
                    o The solution should be clear but may appear slightly yellow. Do not use a syringe if the solution appears cloudy or you see that it contains particles.  Return it to your pharmacy.

General Injection Information
  • If storing Avonex® or Rebif® under refrigeration, remove the syringe from the refrigerator 30 minutes before you inject, allowing it to warm to room temperature.
  • Always wash and dry your hands before and after injecting.
  • Never inject into the same area on your body more than once a week.
  • Acceptable sites
                o Rebif®: stomach, arm, thigh, hip
                        - Chose a site that is at least 2 inches from the last site of injection.
                o Avonex®: upper arm or thigh muscle
                        - After the injection, dispose the used syringe into a hard-welled container.

Possible Side Effects
  • Flu-like symptoms: fever, chills, fatigue, muscle aches
  • Dizziness, headache
  • Pain, redness, swelling, and irritation at the injection site
  • Depression, mood changes, anxiety
  • Liver damage: pain in the upper, right area of your torso, yellow coloring of skin and eyes
  • Thyroid changes: feeling hot or cold all of the time or weight change without a change in your diet or activity are common symptoms
  • Blood disorders such as anemia or easy bruising or abnormal bleeding

Tips
  • Do not stop taking this medication or change the dose or dosing schedule without speaking with your physician.
                o Always call your refills in to your pharmacy before you are out of medication to avoid any disruption in therapy.
  • This medication should not be used if you are pregnant or breastfeeding.

                o Always use birth control to prevent pregnancy while on this medication and speak with your physician or pharmacist before breastfeeding while on this medication.

                        - For information about birth control options, speak with your physician or pharmacist.

  • If you are experiencing flu-like symptoms (fever, chills, fatigue, muscle aches) you can try taking some over-the-counter medications to prevent this. Check with your pharmacist or physician before taking these.
                o Tylenol® (acetaminophen) or Advil® (ibuprofen)
  • Taking this medication may make you more susceptible to infections so you should avoid contact with sick people and wash your hands often.
  • If you miss a dose of your medication, take it as soon as you remember:
                o Avonex®: you can resume your regular schedule but don’t take doses within 2 days of each other
                o Rebif®: you should skip the next day if you are scheduled to take it. It should not be taken on 2 consecutive days. You can resume your normal schedule the following week.
  • Always have your blood checked when scheduled by your physician.
  • Talk to your health care provider before receiving any vaccines.
                o Some vaccines you should avoid while others may not work while on this medication.

When to contact your healthcare provider
If you are experiencing:
  • Chest tightness, trouble breathing, wheezing
  • Rash, hives or severe itching
  • Swelling of face, lips, tongue or throat
  • High fever, severe sore throat or any other signs of infection
  • Fast heartbeat, sweating, confusion
  • Signs and symptoms of depression or any thoughts of suicide
  • If you were told you have liver damage or you think you may be having symptoms of liver toxicity: pain in the upper, right area of your torso, yellow coloring of skin and eyes (jaundice) or itching.
                o Other non-specific symptoms include: fatigue, weakness, abdominal pain, loss of appetite
  • You should not become pregnant or breastfeed an infant while using this medication.
                o Contact your physician if you are or if you think you may be or if you would like to become pregnant or breastfeed an infant.



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