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Care During Chemotherapy and Beyond

Interferon Alfa

(In-ter-FEER-on Al-fa)

Trade names: Intron® A (interferon alfa-2b), Roferon®-A (interferon alfa-2a)
Other names: alpha interferon, IFN-alpha

Interferon alpha is the generic name for the trade name drugs Intron® A, Roferon®-A. In some cases, health care professionals may use the trade names Intron® A, Roferon®-A or other names such as IFN-alpha and alpha interferon when referring to the generic drug name interferon alfa.

Drug type: Interferon alfa is a "biologic response modifier." This medication is classified as a "cytokine." (For more detail, see "How this drug works" section below).

What Interferon Alfa Is Used For:

  • Approved for use in hairy cell leukemia, malignant melanoma, AIDS-related Kaposi's sarcoma, follicular non-Hodgkin's lymphoma, and condyloma acuminata.
  • Other uses: Chronic myelogenous leukemia (CML), renal cell carcinoma, neuroendocrine tumors (carcinoid syndrome; islet cell tumor), multiple myeloma, , non-follicular non-Hodgkin's lymphoma, cutaneous T-cell lymphoma,Desmoid tumor
  • Blood disorders such as: polycythemia vera, essential thrombocytopenia, thrombocytopenia purpura.

Note: If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.

How Interferon Alfa Is Given:

  • By injection under the skin (subcutaneous, SubQ)
  • By injection through a vein (intravenously, by IV)
  • By injection into a muscle (intramuscular, IM)
  • There is no oral (by mouth) form of interferon alfa
  • Due to differences in dosage, you should not change brands of interferons. Discuss with your doctor or health care professional if there is a problem with supply.

The amount of interferon alfa you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer you have. Your doctor will determine your dosage and schedule.

Side Effects:

Important things to remember about the side effects of interferon alfa:

  • Most people do not experience all of the side effects listed
  • Side effects are often predictable in terms of their onset and duration
  • Side effects are almost always reversible and will go away after treatment is complete
  • There are many options to help minimize or prevent side effects
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
  • The side effects of interferon alpha and their severity depend on how much of the drug is given. In other words, high doses may produce more severe side effects.

The following side effects are common (occurring in greater than 30%) for patients taking interferon alfa:

  • Early: Flu-like syndrome : Fever, chills, generalized aches and pains, headache, poor appetite. Occurs within 1-2 hours of treatment, may last up to 24 hours (over time the intensity of these symptoms decreases depending on the dose, how it is given, and the schedule of administration).
  • Fatigue , drowsiness
  • Low blood counts . Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding. Decreases are dose dependent.

o Nadir: Meaning low point, is the point in time between chemotherapy cycles in which you experience low blood counts.

  • Onset: 7-10 days
    Nadir: 14 days, may be delayed 20-40 days in hairy cell leukemia
    Recovery: 21 days

These are less common side effects (occurring in 10-29%) for patients receiving interferon:

These side effects are rare but serious (occurring in <5%) for patients taking interferon

  • Changes in vision
  • Weakness or loss of function of one side of body
  • Thoughts of suicide or of harming others (Black Box Warning)
  • Liver damage
  • Severe skin reactions

Not all side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

  • Shortness of breath, chest pain, rapid heart beat
  • Depressed or have any thoughts of hurting yourself or others
  • Changes in your vision
  • Signs of an allergic reaction, such as difficulty breathing, wheezing, chest tightness, or swelling of face, lips, tongue, or throat
  • Signs of liver damage, such as dark urine, feeling tired, loss of appetite, upset stomach or stomach pain, light-colored stools, vomiting, or yellow skin or eyes
  • Signs of a serious skin reaction such as red, swollen, blistered, or peeling skin

The following symptoms require medical attention, but are not emergency situations. Contact your health care provider within 24 hours of noticing any of the following:

  • Diarrhea (more than 4 to 6 episodes in a 24-hour period)
  • Nausea that interferes with eating and is not relieved by prescribed medications
  • Vomiting (more than 4 to 5 episodes within a 24-hour period)
  • Unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools or urine
  • Extreme fatigue (unable to perform self-care activities)
  • Persistent fever (fever lasting/occurring beyond expected timeframe for dose and schedule).
  • Anxiety, changes in thinking or mood, confusion, difficulty concentrating or trouble sleeping.
  • Swelling of the feet or ankles, sudden weight gain

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

  • Before starting interferon alpha treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin or products containing aspirin unless your doctor specifically permits this.
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking interferon alpha.
  • Inform your doctor if you have had a transplant, autoimmune disease, or liver disease
  • Due to differences in dosage, you should not change brands of interferon. Discuss with your doctor or health care professional if there is a problem with supply.
  • Interferon alfa may cause patients to develop mood or behavioral problems. Make sure to tell your doctor if you are being treated for a mental illness or had treatment in the past for any mental illness, including depression and suicidal behavior. You should also tell your doctor if you have ever been addicted to drugs or alcohol.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus).
  • For both men and women: Do not conceive a child (get pregnant) while taking interferon alfa. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • Do not breast feed while taking this medication.

Self-Care Tips:

  • Drink at least two to three quarts of fluid every 24 hours (unless you are instructed otherwise), to keep yourself well hydrated throughout therapy.
  • Wash your hands often.
  • You may be at risk of infection so try to avoid crowds or people with colds or not feeling well, and report fever or any other signs of infection immediately to your health care provider.
  • For flu-like symptoms, keep warm with blankets and drink plenty of liquids. There are medications that can help reduce the discomfort caused by chills.
  • Acetaminophen or ibuprofen may help relieve discomfort from fever, headache and/or generalized aches and pains. However, be sure to talk with your doctor before taking it.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
  • Avoid sun exposure. Wear SPF 30 (or higher) sunblock and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • You may experience drowsiness or dizziness; avoid driving or engaging in tasks that require alertness until your response to this drug is known.
  • Conserve energy, try to get plenty of rest.
  • Maintain good nutrition.
  • Remain active as you are able. Gentle exercise is encouraged such as a daily walk.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing:

  • You will be checked regularly by your healthcare professional while you are taking interferon alfa, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.
  • Your thyroid gland may also be affected by this medication. Your healthcare professional may order a blood test periodically to assess your thyroid function.
  • An eye exam should be done if any changes in vision occur.
  • If you have any heart conditions, additional test may be done to test your heart function.

How Interferon Alfa Works:

Interferon alfa belongs to the category of therapies called biologic response modifiers (BRM), also called immunotherapy. This is a type of treatment that mobilizes the body's immune system to fight cancer. The therapy mainly consists of stimulating the immune system to help it do its job more effectively.

Interferon alfa is part of a family of proteins called cytokines. Cytokines act primarily by communicating between the various cells of the body's immune system.

Interferon alfa interacts with receptors on the surface of cells. There are several ways that interferon alfa fights cancer; directly by interfering with the cancer cells ability to divide, and indirectly by modifying the body's response to the cancer cells.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

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