|
|
| Brand
Name: PEG-Intron
Therapeutic Category:
Antiviral Agent, Hepatitis; Interferon
Use: PEG-Intron
treats chronic hepatitis C in adult patients who have never received interferon
alpha and have compensated liver disease. It is indicated for use alone
or in combination with Ribavirin.
|
|
|
|
Warnings:
Severe psychiatric adverse effects, including depression, suicidal ideation,
and suicide attempt, may occur with the use of interferons. Avoid use in
renal dysfunction (Clcr <50 mL/minute).
Adverse Reactions:
The incidence of some common adverse effects resulting with the use of
interferons such as injection site reactions (47%), fever, rigors, and
nausea were higher with the use of PEG-Intron. "Flu-like" symptoms, occurring
in about 50% of patients, may decrease in severity as treatment continues.
Other notable adverse effects are: anorexia, abdominal pain, diarrhea,
fatigue, fever, headache, nausea, vomiting, and weight loss.
|
|
|
Drug Interactions:
Cytochrome P450 (CYP)
Effect:
Interferons, including alpha, have been shown to depress (to varying degrees)
the CYP enzyme system.
Ethanol/Nutrition/Herb
Interactions: Ethanol: Avoid use in those patients with hepatitis
C virus.
Herb/Nutraceutical:
Interactions stemming from concurrent use of PEG-Intron with the following
herbs are highlighted. Licorice may increase the effectiveness of interferons.
N-Acetyl cysteine may improve treatment response. S-Adenosyl-L-methionine
(SAMe) causes a decrease in beneficial effects. Sho-saiko-To TJ-9 contains
glycyrrhizin and may increase the risk of drug-induced pneumonitis.
|
|
|
|
|
"Other notable adverse
effects are: anorexia, abdominal pain, diarrhea, fatigue, fever, headache,
nausea, vomiting, and
weight loss."
|
|
|
|
|
Mechanism
of Action: Alpha interferons are a family of proteins, produced by
nucleated cells that have antiviral, antiproliferative, and immune-regulating
activity.
Editors Note: Interferons
belong to the cytokine family and alpha is one of the five classes of interferons.
The other four are beta, gamma, mega, and tau. As noted in the May/June
2000 HIV ReSource Review issue, Interferon alpha-2b (Intron A) is commonly
taken with Ribavirin, a nucleoside analog, for the treatment of chronic
hepatitis C. PEG-Intron is a longer-acting interferon alpha protein with
anti-viral activity. Intron A normally requires three times weekly subcutaneous
injections while PEG-Intron requires only once-weekly dosing. Therefore,
along with Ribavirin, the combination therapy will most likely become the
new standard of care for the treatment of chronic hepatitis C. The Food
and Drug Administration recently approved another interferon, Peginterferon
alfa-2a (Pegasys) made by Hoffmann-La Roche, which also requires only
once-weekly dosing for hepatitis C treatment.
|
