Parenteral Manual

Interferon alfa-2b

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
INTRON-A, UNITRON PEG
Classification: 
Immunomodulating agent, antiviral agent, antineoplastic agent
Original Date: 
August 2005
Revised Date: 
December 2010
Indications: 
  • Hemangiomas of infancy
  • Hairy cell leukemia
  • Multiple investigational uses
  • Hepatitis B and hepatitis C
  • Malignant melanoma
Reconstitution and Stability: 

Interferon alfa-2b (INTRON-A):

  • Available as lyophilized powder for injection with diluent (Sterile Water for Injection) of 10 or 18 million units/vial
  • Available as ready-to-use solution (Albumin (human) free) of 10 million units/mL (1 mL, 2.5 mL vials) and 6 million units/mL (3 mL vials)
  • Available as solution for injection multi-dose pen (Albumin (human) free)containing 18 million units (15 million units/mL), 30 million units (25 million units/mL) and 60 million units (50 million units/mL)
  • Reconstituted lyophilized Intron-A should be used within 24 hours if stored in the fridge
  • Intron-A ready-to-use solution may be kept at room temperature for a maximum of 7 days.

-     10 MIU vials: After first use, any unused solution is stable 7 days in fridge

-     18 and 25 MIU vials: After first use, the solution is stable 4 weeks in the fridge.

  • Multidose pens must be discarded 28 days after first use. They may be kept at room temperature for up to 48 hours during the 28 days
  • Diluted solutions stable in 0.9% NaCl for 24 hours at room temperature or in the fridge at a concentration of greater than or equal to  0.3 million units/mL

Peginterferon alfa-2b (UNITRON PEG):

  • Available as a lyophilized powder for injection with diluent (Sterile Water for Injection) in vials of deliverable doses of 50 mcg/0.5 mL, 80 mcg/0.5 mL, 120 mcg/0.5 mL and 150 mcg/0.5 mL
  • Each vial must be reconstituted with 0.7 mL of Sterile Water for Injection to give a final volume of 0.74 mL for administration of up to 0.5 mL of solution. The reconstituted solutions will have concentration of 100, 160, 240, and 300 mcg/mL

Reconstituted solution is stable for 24 hours, refrigerated.  DO NOT SHAKE.

Compatibility: 

Interferon alfa-2b (INTRON-A):

- Solutions Compatible: 0.9% NaCl (interferon concentration > 0.3 million units/mL), Ringer's, RL, amino acid injections, 5% sodium bicarbonate at 0.5-1 million units/mL

- Additive/Above Cassette Compatible: do not mix with other medications

- Y-site compatible: do not mix with other medications

Incompatible: Dextrose solutions

Peginterferon alfa-2b (UNITRON PEG):

- Do not mix with any other solutions

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

Interferon alfa-2b (INTRON-A):

SC Yes, preferred route - rotate sites
IM Yes, patients > 18 years old
IV Direct No
IV Intermittent Infusion

Yes

Usual dilution: dilute in NS to > 0.3 million units/mL (300,000 units/mL)

Infusion time: 20 minutes

IV Continuous Infusion No

Peginterferon alfa-2b (UNITRON PEG)

SC Yes
IM NO
IV Direct NO
IV Intermittent Infusion NO
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Interferon alfa-2b (INTRON-A):

Pediatric dosing:

  • Chronic Hepatitis B: 3-10 million units/m2   SC 3 times weekly
  • Chronic Hepatitis C: 3-5 million units/m2    SC 3 times weekly
  • Hemangiomas: 3 million units/m2    SC daily
  • Gorham Syndrome: 1.5 million units/m2   SC daily
  • Malignant melanoma:
    -   Induction: 20 million units/m2 I.V. for 5 consecutive days per week for 4 weeks
    -  Maintenance: 10 million units/m2 SC 3 times/week for 48 weeks
  • Craniopharyngioma:  3 million units into ommaya reservoir 3 times weekly for 4 weeks

    All other indications for children should be protocol driven

 

Peginterferon alfa-2b (UNITRON PEG):

Children's Oncology Group protocol AOST0331:

  • Osteosarcoma 0.5-1 mcg/kg SC once weekly
Potential hazards of parenteral administration: 
  • Flu-like symptoms (fever, rigors, fatigue, arthralgia, headache, myalgia, chills) begin 2-6 hours after dose given and may last up to 24 hours- patients usually develop tolerance to these effects
  • Acute hypersensitivity reactions (<5%), urticaria, angioedema, bronchoconstriction, anaphylaxis
  • Injection site reaction- burning, pain, local erythema
  • Hypotension, arrhythmias (<5%)
  • Rash, alopecia (8-38%), pruritis
  • Anorexia, dry mouth, nausea, vomiting, taste alteration, sweating, dizziness
  • Myelosuppression (neutropenia, anemia, thrombocytopenia), hemolytic anemia
  • Increased transaminases, alkaline phosphatase
  • Alteration of mental status (depression, confusion, impaired concentration, emotional liability)
  • Increased­ BUN, serum creatinine, hyperuricemia, hyperglycemia
  • Ocular changes (loss of visual acuity or visual field - rare)

**Treatment for unusual side effects available from the study chair identified on the front page of the protocol and/or pharmacy

Notes: 
  • Monitor baseline EKG, opthalmic evaluation, CBC with differential, electrolytes, T4/TSH, liver and renal function tests, blood glucose, weight
  • Maintain adequate hydration to minimize hypotension
  • Pretreatment with acetaminophen (30 minutes prior to dose) may decrease fever and headache
  • Concurrent use of interferon and the Chinese herbal remedy Shosaikoto (Xiao Chai Hu Tang) increases the risk of interstitial pneumonitis and may result in fatality
  • Giving the drug at bedtime may decrease minor side effects
  • BRANDS OF INTERFERON ARE NOT INTERCHANGEABLE  
  • This medication (lyophilized powder for injection only) contains albumin or human blood products.  Consent (Informed Consent for Transfusion of Blood/Blood Products - form #1084) is required prior to administration to the patient.

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