PEGINTERFERON ALFA-2A

Indications & Dose:

Chronic Hepatitis C virus (HCV) infection; more effective when combined with ribavirin.
 Adult

• HCV, genotype 1 and 4:

• BY SUBCUTANIOUS

SC 180 µg qweek for 48 weeks; for patients receiving hemodialysis, reduce dose to 135 µg qweek

• HCV, genotype 2 and 3:

• BY SUBCUTANIOUS

SC 180 µg qweek for 24 weeks

• In consultation with experts, consider stopping peginterferon therapy if virologic response absent at 12-24 weeks (see monitoring parameters below) 

Contraindications:

Side Effects:

CNS: Anxiety (19%), depression (18%), dizziness (16%), fatigue (60%), headache (54%), insomnia (19%), suicidal ideation (<1%)
EENT: Blurred vision, dry mouth (6%)
GI: Abdominal pain (15%), anorexia (16%), diarrhea (16%), nausea (24%), transaminase elevation (5%)
HEME: Anemia , neutropenia, thrombocytopenia 
METAB: Thyroid function change (6%)
MS: Arthralgia (28%), back pain (9%), myalgia (37%) RFSP: Cough, dyspnea
SKIN: Alopecia (23%), dry skin, injection site reaction (20%), pruritus (12%), rash (5%)
MISC: Fever (40%) 

Cautions:

Precautions:

Anemia or disease that predisposes to anemia; autoimmune diseases; depression; diabetes; heart disease; HIV or hepatitis B virus coinfection; leukopenia; organ transplant recipients; renal insufficiency (CRCL <50 ml/min); retinal disease; thyroid disease

Interaction:

Drugs

• (note additional interactions occur when peginterferon combined with ribavirin; see ribavirin monograph)

• Theophylline: Peginterferon increases plasma theophylline level by up to 25%

Warnings:

Adverse Effects:

Lactations:

Pregnancy category C (category X when used with ribavirin); breast milk excretion unknown 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: