The composition of interferon preparations depends on their form of release.
Release form
Interferon preparations have the following forms of release:
- lyophilized powder for the preparation of eye and nasal drops, injection solution;
- injection solution;
- eye drops;
- eye films;
- nasal drops and spray;
- ointment;
- dermatological gel;
- liposomes;
- spray can;
- oral solution;
- rectal suppositories;
- vaginal suppositories;
- implants;
- microclysters;
- tablets (interferon tablets are available under the brand name Entalferon).
pharmachologic effect
IFN drugs belong to the group of drugs with antiviral and immunomodulatory effects.
All IFNs have antiviral and antitumor effects. Their property to stimulate action is considered no less important. macrophages - cells that play an important role in initiation.
IFNs increase the body's resistance to penetration viruses and also block reproduction viruses when they enter the cell. The latter is due to the ability of IFN to suppress translation of the messenger (informational) RNA of the virus .
At the same time, the antiviral effect of IFN is not directed against certain viruses , that is, IFNs are not virus-specific. This is what explains their versatility and a wide range of antiviral activity.
Interferon - what is it?
Interferons are a class of similar properties glycoproteins , which are produced by vertebrate cells in response to the effects of various inducers of both viral and non-viral nature.
According to Wikipedia, in order for a biologically active substance to be qualified as interferon, it must be of a protein nature, have a pronounced antiviral activity in relation to various viruses , at least, in homologous (similar) cells, "mediated by cellular metabolic processes, including the synthesis of RNA and protein."
The classification of IFNs proposed by the WHO and the Interferon Committee is based on differences in their antigenic, physical, chemical and biological properties. In addition, it takes into account their species and cellular origin.
By antigenicity (antigenic specificity) IFN is usually divided into acid-fast and acid-labile. Acid-fast are alpha and beta interferons (also called type I IFNs). Interferon gamma (γ-IFN) is acid-labile.
α-IFNs produce peripheral blood leukocytes (B- and T-type leukocytes), therefore it was previously designated as leukocyte interferon ... Currently, there are at least 14 varieties of it.
β-IFNs produce fibroblasts so it is also called fibroblastic .
Former designation γ-IFN - immune interferon , it is produced by stimulated T-type lymphocytes , NK cells (normal (natural) killers; from the English "natural killer") and (presumably) macrophages .
Main properties and mechanism of action of IFN
Without exception, all IFNs are characterized by polyfunctional activity against target cells. Their most common property is the ability to induce in them antiviral condition .
Interferon is used as a therapeutic and prophylactic agent for various viral infections ... A feature of IFN preparations is that their effect is weakened by repeated injections.
IFN's mechanism of action is related to its ability to inhibit viral infections ... As a result of treatment with interferon drugs in the patient's body around focus of infection a kind of barrier is formed from resistant to virus uninfected cells, which prevents the further spread of infection.
Interacting with still intact (intact) cells, it interferes with the implementation of the reproductive cycle viruses due to the activation of certain cellular enzymes ( protein kinases ).
The most important functions of interferons are considered the ability to suppress hematopoiesis ; modulate the body's immune response and inflammation response; regulate the processes of cell proliferation and differentiation; inhibit growth and inhibit reproduction viral cells ; stimulate the expression of surface antigens ; suppress individual functions B- and T-type leukocytes , stimulate activity NK cells etc..
The use of IFN in biotechnology
Development of synthesis methods and highly efficient purification leukocyte and recombinant interferons in quantities sufficient for production drugs, made it possible to discover the possibility of using IFN preparations for the treatment of patients diagnosed with viral hepatitis .
A distinctive feature of recombinant IFNs is that they are obtained outside the human body.
For example, recombinant interferon beta-1a (IFN β-1a) obtained from mammalian cells (in particular, from the cells of the ovaries of the Chinese hamster), and similar in its properties interferon beta-1b (IFN β-1b) produced by belonging to the enterobacteriaceae family colibacillus (Escherichia coli).
Interferon inducers - what are they?
IFN inducers are drugs that do not themselves contain interferon, but at the same time stimulate its production.
Pharmacodynamics and pharmacokinetics
The main biological effect of α-IFN is inhibition of viral protein synthesis ... The antiviral state of the cell develops within a few hours after the application of the drug or the induction of IFN production in the body.
At the same time, IFN does not affect the early stages. replicative cycle, that is, at the stage of adsorption, penetration virus into the cell (penetration) and release of the internal component virus in the process of undressing him.
Antivirus action α-IFN manifests itself even in the case of cell infection infectious RNA ... IFN does not enter the cell, but only interacts with specific receptors on cell membranes (gangliosides or structures similar to them, which contain oligosacchara ).
The mechanism of activity of IFN alpha resembles the action of individual glycopeptide hormones ... It stimulates activity genes , some of which are involved in coding the formation of products with direct antiviral action .
β interferons also possess antiviral action , which is associated with several mechanisms of action at once. Beta interferon activates NO-synthetase, which in turn increases the concentration of nitric oxide inside the cell. The latter plays a key role in suppressing reproduction. viruses .
β-IFN activates secondary, effector functions atural killerv , B-type lymphocytes , blood monocytes , tissue macrophages (mononuclear phagocytes) and neutrophilic , which are characterized by antibody-dependent and antibody-independent cytotoxicity.
In addition, β-IFN blocks the release of the internal component virus and disrupts methylation processes RNA virus .
γ-IFN is involved in the regulation of the immune response and regulates the severity inflammatory reactions. Despite the fact that he has an independent antivirus and antitumor effect , gamma interferon very weak. At the same time, it significantly enhances the activity of α- and β-IFN.
After parenteral administration, the maximum concentration of IFN in is observed after 3-12 hours. The bioavailability indicator is 100% (both after administration under the skin and after administration into the muscle).
The half-life of T½ is 2 to 7 hours. Plasma trace concentrations of IFN are not detected after 16-24 hours.
Indications for use
IFN is intended to treat viral diseases striking respiratory tract .
In addition, interferon preparations are prescribed for patients with chronic forms hepatitis, and Delta .
For treatment viral diseases and, in particular, predominantly IFN-α is used (and both of its forms are IFN-alpha 2b and IFN-alpha 2a). The "gold standard" of treatment hepatitis C it is considered to be pegylated interferons alpha-2b and alpha-2a. In comparison, conventional interferons are less effective.
Genetic polymorphism in the IL28B gene, which is responsible for encoding the IFN lambda-3, causes significant differences in the treatment effect.
Patients with genotype 1 hepatitis C with common alleles of the specified gene are more likely to achieve longer and more pronounced treatment results in comparison with other patients.
IFN is also often prescribed for patients with oncological diseases : malignant , pancreatic endocrine tumors , non-Hodgkin lymphoma , carcinoid tumors ; Kaposi's sarcoma due to; hairy cell leukemia ,multiple myeloma , kidney cancer etc..
Contraindications
Interferon is not prescribed to patients with hypersensitivity to it, as well as to children and adolescents suffering from severe mental disorders and nervous system disorders , which are accompanied by thoughts of suicide and suicide attempts, heavy and lingering.
Combined with antiviral drug Ribavirin IFN is contraindicated in patients diagnosed with serious functional impairment kidney (conditions in which CC is less than 50 ml / min).
Interferon preparations are contraindicated in (in cases where the appropriate therapy does not give the expected clinical effect).
Side effects
Interferon belongs to the category of drugs that can cause a large number of adverse reactions from various systems and organs. In most cases, they are the result of the administration of interferon intravenously, subcutaneously or intramuscularly, however, other pharmaceutical forms of the drug can also provoke them.
The most common adverse reactions to IFN ingestion are:
- anorexia;
- nausea;
- chills;
- trembling in the body.
Vomiting, increased, feeling of dry mouth, hair loss (), asthenia ; nonspecific symptoms resembling flu symptoms ; backache, depressive states , musculoskeletal pain , thoughts of suicide and attempted suicide, general malaise, impaired taste and concentration, increased irritability, sleep disorders (often), arterial hypotension , confusion of consciousness.
Rare side effects include: right upper abdominal pain, body rashes (erythematous and maculopapular), increased nervousness, soreness and severe inflammation at the injection site, secondary viral infection (including infection herpes simplex virus ), increased dryness skin, , pain in the eyes , conjunctivitis blurred vision, impaired function lacrimal glands , anxiety, mood lability; psychotic disorders , including increased aggression, etc .; hyperthermia , dyspeptic symptoms , respiratory problems, weight loss, loose stools, hyper- or hypothyroidism , hearing impairment (up to its complete loss), the formation of infiltrates in the lungs, increased appetite, bleeding gums, in the limbs, dyspnea , impaired renal function and development of renal failure , peripheral ischemia , hyperuricemia , neuropathies etc..
Treatment with IFN drugs can provoke reproductive dysfunction ... Studies in primates have shown that interferon disrupts the menstrual cycle in women ... In addition, in women treated with IFN-α drugs, the level of and decreased.
For this reason, in the case of prescribing interferon, women of childbearing age should use barrier contraceptives ... Men of reproductive age are also advised to be educated about potential side effects.
In rare cases, interferon treatment can be accompanied by ophthalmic disorders, which are expressed as retinal hemorrhage , retinopathies (including including macular edema ), focal changes in the retina, decreased visual acuity and / or limitation of visual fields, swelling of the discs optic nerves , optic (second cranial) nerve neuritis , obstruction of arteries or retinal veins .
Sometimes, while taking interferon, hyperglycemia , symptoms of nephrotic syndrome ,. In patients with diabetes mellitus may get worse clinical picture diseases.
The likelihood of occurrence, cerebrovascular hemorrhage , erythema multiforme , tissue necrosis at the injection site, cardiac and cerebrovascular ischemia , hypertriglyceridemia , sarcoidosis (or exacerbation of its course), Lyell's syndromes and Stevens-Johnson .
The use of interferon in monotherapy or in combination with Ribavirin in isolated cases can provoke aplastic anemia (AA) or even PAKKM ( complete aplasia of the red bone marrow ).
There were also recorded cases when, against the background of treatment with interferon drugs, the patient developed various autoimmune and immune-mediated disorders (including Werlhof disease and Moshkovitz disease ).
Interferon, application instruction (Way and dosage)
Instructions for the use of interferons alpha, beta and gamma indicate that before prescribing a drug to a patient, it is recommended to determine how sensitive to it , which became the cause of the disease.
The method of administration of human leukocyte interferon is determined depending on the diagnosis made to the patient. In most cases, it is prescribed as a subcutaneous injection, but in some cases, the drug can be injected into a muscle or vein.
The dose for treatment, the maintenance dose and the duration of treatment are determined depending on the clinical situation and the response of the patient's body to the prescribed therapy.
Under "children's" interferon means a drug in the form of suppositories, drops and ointment.
Instructions for the use of interferon for children recommends the use of this drug both as a therapeutic and as a prophylactic agent. The dose for infants and older children is selected by the attending physician.
For prophylactic purposes, INF is used in the form of a solution, for the preparation of which distilled or boiled water at room temperature is used. The finished solution is colored red and opalescent. It should be stored in the cold for no more than 24-48 hours. The drug is instilled into the nose for children and adults.
At viral ophthalmic diseases the drug is prescribed in the form of eye drops.
As soon as the severity of the symptoms of the disease decreases, the volume of instillations should be reduced to one drop. The course of treatment is from 7 to 10 days.
For the treatment of lesions caused by herpes viruses , the ointment is applied in a thin layer to the affected areas of the skin and mucous membranes twice a day, maintaining 12-hour intervals. The course of treatment is from 3 to 5 days (until the integrity of the damaged skin and mucous membranes is fully restored).
For prevention ARI and it is necessary to lubricate with ointment nasal passages ... The frequency of procedures during the 1st and 3rd week of the course - 2 times a day. It is recommended to take a break during the 2nd week. For prophylactic purposes, interferon should be used throughout the entire period respiratory disease epidemics .
The duration of the rehabilitation course in children who often have recurrent viral and bacterial infections of the respiratory tract , ENT organs , recurrent infection caused by herpes simplex virus , is two months.
How to dilute and how to use interferon in ampoules?
Instructions for the use of interferon in ampoules indicate that before use, the ampoule must be opened, pour water (distilled or boiled) into it at room temperature to the mark on the ampoule corresponding to 2 ml.
The contents are gently shaken until completely dissolved. The solution is introduced into each nasal passage twice a day, five drops, maintaining intervals of at least six hours between injections.
For medicinal purposes, IFN begins to be taken when the first flu symptoms ... The earlier the patient starts taking it, the higher the effectiveness of the drug.
The most effective is the inhalation method (through the nose or mouth). For one inhalation, it is recommended to take the contents of three ampoules of the drug, dissolved in 10 ml of water.
The water is preheated to a temperature of no more than +37 ° C. Inhalation procedures are carried out twice a day, maintaining an interval of at least one to two hours between them.
When spraying or instilling, the contents of the ampoule are dissolved in two milliliters of water and 0.25 ml (or five drops) are injected into each nasal passage three to six times a day. The duration of treatment is 2-3 days.
For prophylactic purposes, nasal drops for children are instilled (5 drops) twice a day, at the initial stage of the development of the disease, the frequency of instillations is increased: the drug should be injected at least five to six times a day every hour or two.
Many are interested in whether it is possible to drip an interferon solution into the eyes. The answer to this question is yes.
Overdose
Cases of overdose with interferon have not been described.
Interaction
β-IFN compatible with corticosteroid drugs and ACTH. Should not be taken during treatment myelosuppressive drugs , incl. cytostatics (this may provoke additive effect ).
IFN-β is prescribed with caution with agents, the clearance of which is largely dependent on cytochrome P450 systems (antiepileptic drugs , some antidepressants and etc.).
Do not take α-IFN and Telbivudine ... The simultaneous use of α-IFN provokes a mutual reinforcement of action in relation. When used together with phosphazide can mutually increase myelotoxicity both drugs (it is recommended to carefully monitor changes in the amount granulocytes and;
IFN is also used in therapy, the purpose of which is the rehabilitation of frequently ill respiratory infections children.
The most optimal way of taking for children is nasal drops: with this use, interferon does not penetrate into the gastrointestinal tract (before diluting the drug for the nose, the water should be warmed up to a temperature of 37 ° C).
For infants, interferon is prescribed in the form of suppositories (150 thousand IU). Suppositories for children should be administered once 2 times a day, maintaining 12-hour intervals between injections. The course of treatment is 5 days. To completely cure a child ARVI as a rule, one course is sufficient.
For treatment, you should take 0.5 g of ointment twice a day. The treatment lasts an average of 2 weeks. Over the next 2-4 weeks, the ointment is applied 3 times a week.
Numerous positive reviews of the drug indicate that in this dosage form, it also has established itself as effective remedy for treatment stomatitis and inflamed tonsils ... Inhalations with interferon for children are no less effective.
The effect of using the drug is significantly increased if a nebulizer is used for its introduction (it is necessary to use a device that sprays particles with a diameter of more than 5 microns). Inhalation through a nebulizer has its own specifics.
First, interferon must be inhaled through the nose. Secondly, before using the device, it is necessary to turn off the heating function in it (IFN is a protein, at temperatures above 37 ° C it is destroyed).
For inhalation in a nebulizer, the contents of one ampoule are diluted in 2-3 ml of distilled or mineral water (you can also use saline for this purpose). The resulting volume is enough for one procedure. The frequency of procedures during the day is from 2 to 4.
It is important to remember that long-term treatment of children with interferon is not recommended, since addiction develops to it and, therefore, the expected effect does not develop.
Interferon during pregnancy
An exception may be cases where the expected benefit of therapy for the expectant mother will outweigh the risk of adverse reactions and harmful effects on the development of the fetus.
The possibility of isolating the components of recombinant IFN in breast milk is not excluded. Due to the fact that the likelihood of exposure to the fetus through milk is not excluded, IFN is not prescribed for lactating women.
As a last resort, when IFN cannot be avoided, the woman is advised not to breastfeed during therapy. To mitigate the side effects of the drug (the occurrence of flu-like symptoms), concomitant administration with IFN is recommended .
Release form
Compound
Active ingredient: Interferon alpha (interferon alfa) Concentration active substance(units): 1000
Pharmacological effect
Interferon alpha is a mixture of different subtypes of natural alpha interferon from human blood leukocytes. It has antiviral, immunostimulating and antiproliferative effects. The antiviral effect of the drug is based mainly on increasing the resistance of body cells not yet infected with the virus to possible effects. By binding to specific receptors on the cell surface, interferon alpha changes the properties of the cell membrane, stimulates specific enzymes, affects the RNA of the virus and prevents its replication. The immunomodulatory effect of interferon alpha is associated with the stimulation of the activity of macrophages and NK (Natural killer) cells, which, in turn, are involved in the body's immune response to tumor cells.
Indications
Prevention and treatment of influenza and other acute respiratory viral infections
Contraindications
Hypersensitivity to drugs of protein origin
Precautionary measures
It is used with caution in patients with a history of indications of a recent myocardial infarction, as well as in cases of changes in blood clotting and myelodepression. With caution, use interferon alfa simultaneously with hypnotics, sedatives, opioid analgesics.
Application during pregnancy and lactation
The use of interferon alfa preparations during pregnancy is possible only in cases where the intended benefit to the mother outweighs the potential risk to the fetus. If necessary, use in a nursing mother during lactation should decide on the termination of breastfeeding. Patients of reproductive age during therapy should use reliable methods of contraception.
Method of administration and dosage
For children from the neonatal period (from birth), the drug is administered intranasally (by spraying or instillation). For children from 3 years of age and adults - additionally in the form of inhalation. Intranasally Open the ampoule with the drug immediately before use. Sterile distilled or boiled water cooled to room temperature is added to the ampoule to the line indicated on the ampoule corresponding to 2 ml, gently shake until the contents are completely dissolved. The dissolved preparation is a clear or slightly opalescent liquid, colorless or from light yellow to pink in color. The drug is used by instillation (using a medical pipette or syringe without a needle) or spraying. Spraying is done with any spray system or with the supplied spray nozzle. For prophylaxis, the introduction of the drug should be started at an imminent threat of infection and continued as long as the risk of infection persists. The drug is used intranasally by instilling 5 drops or spraying 0.25 ml into each nasal passage 2 times a day with an interval of at least 6 hours. For treatment, the drug is used at an early stage of the disease when the first clinical symptoms appear intranasally, 0.25 ml (5 drops) in each nasal passage after 1-2 hours at least 5 times a day. The earlier its use is started, the higher the effectiveness of the drug. Rules for using the spray nozzle: Put the needle on the syringe, fill it with the dissolved drug in a volume of 0.25 ml (mark 10 on a scale of 40 units or mark 25 on a scale of 100 units). Remove the needle and firmly put on the spray nozzle. the spray nozzle to the nasal passage and inject the drug into the nasal passage by pressing the plunger of the syringe. Remove the spray nozzle, put on the needle and draw 0.25 ml of the drug from the ampoule into the syringe. Remove the needle, put the spray nozzle tightly on again and inject the drug into another nasal passage in accordance with paragraph 3. The spray nozzle is inserted at a depth of 0.5 cm into the nasal passages, previously cleared of mucus. In this case, the patient should be in a sitting position with his head slightly thrown back and remain in this position for 1 minute after the administration of the drug. It is allowed to use one tip on only one patient. Inhalation Most effective way for treatment is inhalation. For its implementation, any type of inhaler is recommended. For one procedure, use the contents of 3 ampoules, which are dissolved in 10 ml of water. It is recommended to warm water up to a temperature not higher than 37 ° С. By inhalation, the drug is administered through the mouth and nose 2 times a day for 2-3 days. The introduction of the drug by injection is strictly prohibited!
Side effects
Allergic reactions.
Interaction with other drugs
Since interferons inhibit oxidative metabolism in the liver, a violation of the biotransformation of drugs metabolized in this way is possible. When used simultaneously with ACE inhibitors, synergism is possible with respect to hematotoxic action; with zidovudine - synergism in relation to myelotoxic action; with paracetamol - it is possible to increase the activity of liver enzymes; with theophylline - a decrease in theophylline clearance.
special instructions
In case of thrombocytopenia with a platelet count of less than 50,000 / μl, it should be used sc. If side effects from the central nervous system develop in elderly patients receiving interferon alfa in high doses, a thorough examination should be carried out and, if necessary, treatment should be interrupted. Patients should be hydrated. therapy, especially in the initial period of treatment. In patients with hepatitis C receiving interferon alpha therapy for systemic use, thyroid dysfunction, expressed in hypo- or hyperthyroidism, is possible. Therefore, before starting the course of treatment, the level of TSH in the blood serum should be determined and treatment should be started only if the level of TSH in the blood is normal.
Photo of the drug
Latin name: Interferon
ATX code: L03AB
Active substance: human α, β or γ interferon (IFN)
Manufacturer: Hoffmann-La Roche, Switzerland; Schering-Plow, USA; InterMune, USA
Description up to date on: 23.10.17
Interferon is an immunomodulating drug with antiviral action.
Active substance
Interferon alfa.
Release form and composition
Available in several dosage form: lyophilized powder for the preparation of eye and nasal drops, injection solution, injection solution, eye drops, eye films, nasal drops and spray, ointment, dermatological gel, liposomes, aerosol, oral solution, rectal suppositories, vaginal suppositories, implants, microclysters, tablets ...
The most common form of release is a lyophilisate for solution preparation. It is a porous amorphous mass or powder of white or light yellow to pink color, hygroscopic. Packaged in ampoules containing 1 dose of the active substance.
The dissolved preparation is a clear or slightly opalescent liquid, colorless or from light yellow to pink in color.
Indications for use
Prevention and treatment of various acute respiratory viral infections, influenza, chronic hepatitis C, acute and chronic hepatitis B, tick-borne encephalitis. The drug is indicated for use in diseases such as genital warts; multiple myeloma; cutaneous T-cell lymphoma, non-Hodgin lymphoma; Kaposi's sarcoma (in AIDS patients); hairy cell leukemia; chronic myeloid leukemia; melanoma; renal carcinoma and Bladder; respiratory papillomatosis of the larynx; primary and secondary thrombocytosis; granulocytic chronic leukemia in transitional form; reticulosarcoma and myelofibrosis.
It is prescribed rectally for the complex treatment of secondary immunodeficiency states, hemorrhagic fever with renal syndrome. Interferon for children from 2 to 12 years old, is also prescribed in the form of rectal suppositories, in the treatment of acute hepatitis B. In viral eye diseases - conjunctivitis, keratitis and keratouveitis, the drug is prescribed as instillation into the conjunctival sac.
Contraindications
Should not be administered to people with hypersensitivity and autoimmune diseases. The drug should not be used for myocardial infarction, CHF, diabetes mellitus, accompanied by ketoacidosis, with cirrhosis of the liver, severe mental disorders, epilepsy and impaired central nervous system function.
It is forbidden to prescribe to patients with thyroid diseases, severe disorders in the liver and kidneys.
It is prescribed with extreme caution for children under 2 years of age, pregnant and lactating women and patients who have taken immunosuppressants.
Instructions for use of Interferon (method and dosage)
The dose, frequency and duration of use are set depending on the indications, the severity of the disease, the route of administration, and the individual response of the patient.
Side effects
For parenteral administration side effects are observed much more often than with other routes of administration. The following side effects may occur:
- Flu-like symptoms: fever, headache, myalgia, weakness.
- From the digestive system: loss of appetite, nausea, vomiting, diarrhea. In rare cases, liver dysfunction.
- From the side of cardio-vascular system: arterial hypotension, arrhythmia.
- From the side of the central nervous system: drowsiness, impaired consciousness, ataxia.
- Dermatological reactions: rarely - minor alopecia, dry skin, erythema, skin rash.
- Others: general weakness, granulocytopenia.
Overdose
No cases of drug overdose have been registered.
Analogs
Analogues for the ATC code: human leukocyte interferon, human leukocyte liquid interferon, recombinant human gamma interferon.
Drugs with a similar mechanism of action (ATC level 4 match): Derinat.
Do not make the decision to change the drug yourself, consult your doctor.
pharmachologic effect
Interferon (human) is a mixture of different subtypes of natural interferon from human blood leukocytes.
The antiviral effect of Interferon is mainly based on an increase in the resistance of cells not infected with the virus to possible effects. On the cell surface, Interferon binds to specific receptors and changes the properties of cell membranes, stimulates enzymes, actively affects the RNA of the virus, effectively preventing its replication.
The immunomodulatory property of the substance is based on stimulating the activity of macrophages and NK cells involved in the body's immune response to specific tumor cells.
Suppresses chlamydia and viruses, normalizes the immune status of the body, suppresses the growth of tumor cells.
special instructions
- It is used with caution in patients with a history of indications of a recent myocardial infarction, as well as in cases of changes in blood clotting and myelodepression.
- For thrombocytopenia with a platelet count of less than 50,000 / μl, subcutaneous administration should be used.
- Patients should receive hydration therapy, especially during the initial period of treatment.
- In patients with hepatitis C receiving interferon alpha therapy for systemic use, thyroid dysfunction may occur, expressed in hypo- or hyperthyroidism. Therefore, before starting the course of treatment, the level of TSH in the blood serum should be determined and treatment should be started only if the level of TSH in the blood is normal.
- Use interferon alfa with caution in conjunction with hypnotics, sedatives, opioid analgesics.
During pregnancy and breastfeeding
The use of the drug during pregnancy is possible only in cases where the intended benefit to the mother outweighs the potential risk to the fetus.
If it is necessary to use Interferon in a nursing mother during lactation, the question of stopping breastfeeding should be resolved.
Patients of reproductive age during therapy should use reliable methods of contraception.
In childhood
Approved for use in children.
In old age
With the development of side effects from the central nervous system in elderly patients receiving interferon alfa in high doses, a thorough examination should be carried out and, if necessary, treatment should be interrupted.
With impaired renal function
The drug is contraindicated in severe renal impairment.
For violations of liver function
Contraindicated in severe liver dysfunction, chronic hepatitis and liver cirrhosis with symptoms of liver failure; chronic hepatitis in patients receiving or recently receiving treatment with immunosuppressants (with the exception of GCS treatment); autoimmune hepatitis.
Drug interactions
Since interferons inhibit oxidative metabolism in the liver, the biotransformation of drugs metabolized in this way may be impaired.
With simultaneous use with ACE inhibitors, synergism with respect to hematotoxic action is possible; with zidovudine - synergism in relation to myelotoxic action; with paracetamol - it is possible to increase the activity of liver enzymes; with theophylline - a decrease in theophylline clearance.
Instructions for use
Altevir instructions for use
Dosage form
Solution for injection, transparent, colorless
Compound
human recombinant interferon alfa-2b 3 mln IU / ml
Excipients: sodium acetate, sodium chloride, tetraacetic acid ethylenediamine disodium salt, tween-80, dextran 40, water d / i.
Pharmacodynamics
Interferon. Altevir® has antiviral, immunomodulatory, antiproliferative and antitumor effects.
Interferon alpha-2b, interacting with specific receptors on the cell surface, initiates a complex chain of changes inside the cell, including the induction of the synthesis of a number of specific cytokines and enzymes, disrupts the synthesis of viral RNA and virus proteins in the cell. The result of these changes is nonspecific antiviral and antiproliferative activity associated with the prevention of viral replication in the cell, inhibition of cell proliferation and the immunomodulatory effect of interferon. Interferon alpha-2b stimulates the process of antigen presentation to immunocompetent cells, has the ability to stimulate the phagocytic activity of macrophages, as well as the cytotoxic activity of T cells and "natural killer cells" involved in antiviral immunity.
Prevents the proliferation of cells, especially tumor cells. It has a depressing effect on the synthesis of some oncogenes, leading to inhibition of tumor growth.
Pharmacokinetics
Suction
With subcutaneous or intramuscular administration of interferon alfa-2b, its bioavailability ranges from 80% to 100%. After the introduction of interferon alfa-2b, Tmax in the blood plasma is 4-12 hours, T1 / 2 - 2-6 hours. 16-24 hours after administration, the recombinant interferon is not detected in the blood serum.
Metabolism
Metabolism is carried out in the liver.
Alpha interferons are capable of disrupting oxidative metabolic processes, reducing the activity of microsomal liver enzymes of the cytochrome P450 system.
Withdrawal
It is excreted mainly by the kidneys by glomerular filtration.
Side effects
General reactions: very often - fever, weakness (they are dose-dependent and reversible reactions, disappear within 72 hours after a break in treatment or its termination), chills; less often, malaise.
From the side of the central nervous system: very often - headache; less often - asthenia, drowsiness, dizziness, irritability, insomnia, depression, suicidal thoughts and attempts; rarely - nervousness, anxiety.
From the musculoskeletal system: very often - myalgia; less often - arthralgia.
From the digestive system: very often - decreased appetite, nausea; less often - vomiting, diarrhea, dry mouth, change in taste; rarely - abdominal pain, dyspepsia; possibly a reversible increase in the activity of liver enzymes.
From the side of the cardiovascular system: often - lowering blood pressure; rarely - tachycardia.
Dermatological reactions: less often - alopecia, increased sweating; rarely - skin rash, skin itching.
On the part of the hematopoietic system: reversible leukopenia, granulocytopenia, decreased hemoglobin levels, thrombocytopenia are possible.
Others: rarely - weight loss, autoimmune thyroiditis.
Selling features
prescription
Special conditions
Prior to treatment with Altevir for chronic viral hepatitis B and C, a liver biopsy is recommended to assess the extent of liver damage (signs of active inflammatory process and / or fibrosis). The effectiveness of the treatment of chronic hepatitis C increases with combination therapy with Altevir and ribavirin. The use of Altevir is not effective in the development of decompensated liver cirrhosis or hepatic coma.
In case of side effects during treatment with Altevir, the dose of the drug should be reduced by 50% or the drug should be temporarily canceled until they disappear. If side effects persist or reappear after lowering the dose, or progression of the disease is observed, then treatment with Altevir should be discontinued.
With a decrease in the platelet count below 50x109 / L or the granulocyte count below 0.75x109 / L, it is recommended to reduce the dose of Altevir by 2 times with a blood test control after 1 week. If these changes persist, then the drug should be canceled.
If the platelet count falls below 25x109 / l or the granulocyte count falls below 0.5x109 / l, it is recommended to discontinue Altevir® with a blood test control after 1 week.
In patients receiving interferon alpha-2b preparations, antibodies can be detected in the blood serum that neutralize its antiviral activity. In almost all cases, antibody titers are low, their appearance does not lead to a decrease in the effectiveness of treatment or the occurrence of other autoimmune disorders.
Indications
As part of complex therapy in adults:
In chronic viral hepatitis B without signs of liver cirrhosis;
In chronic viral hepatitis C in the absence of symptoms of hepatic failure (monotherapy or combination therapy with ribavirin);
With papillomatosis of the larynx;
With genital warts;
With hairy cell leukemia, chronic myeloid leukemia, non-Hodgkin's lymphoma, melanoma, multiple myeloma, Kaposi's sarcoma with AIDS, progressive kidney cancer.
Contraindications
history of severe cardiovascular disease (uncontrolled chronic heart failure, recent myocardial infarction, severe cardiac arrhythmias);
Severe renal and / or hepatic impairment (including those caused by the presence of metastases);
Epilepsy, as well as severe dysfunctions of the central nervous system, especially expressed by depression, suicidal thoughts and attempts (including a history);
Chronic hepatitis with decompensated cirrhosis of the liver and in patients receiving or recently receiving treatment with immunosuppressants (with the exception of a completed short-term course of GCS treatment);
Autoimmune hepatitis or other autoimmune disease;
Treatment with immunosuppressants after transplantation;
Disease of the thyroid gland that cannot be controlled by conventional therapeutic methods;
Decompensated lung diseases (including COPD);
Decompensated diabetes mellitus;
Hypercoagulation (including thrombophlebitis, thromboembo
Drug interactions
The drug interaction between Altevir and other drugs has not been fully studied. Altevir should be used with caution simultaneously with hypnotics and sedatives, narcotic analgesics and drugs that potentially have a myelodepressant effect.
With the simultaneous appointment of Altevir and theophylline, the concentration of the latter in the blood serum should be monitored and, if necessary, the dosage regimen should be changed.
When using Altevir in combination with chemotherapeutic drugs (cytarabine, cyclophosphamide, doxorubicin, teniposide), the risk of toxic effects increases.
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Dosage
Apply s / c, i / m and i / v. Treatment must be started by a physician. Further, with the permission of the doctor, the patient can inject himself a maintenance dose on his own (in cases where the drug is prescribed s / c or i / m).Chronic hepatitis B: Altevir® is administered subcutaneously or intramuscularly at a dose of 5-10 million IU 3 times a week for 16-24 weeks. Treatment is discontinued after 3-4 months of use in the absence of positive dynamics (according to a study of the DNA of the hepatitis B virus).
Chronic hepatitis C: Altevir® is administered subcutaneously or intramuscularly at a dose of 3 million IU 3 times a week for 24-48 weeks. In patients with a recurrent course of the disease and in patients who have not previously received treatment with interferon alfa-2b, the effectiveness of treatment is increased with combination therapy with ribavirin. The duration of the combination therapy is at least 24 weeks. Altevir therapy should be carried out for 48 weeks in patients with chronic hepatitis C and genotype 1 of the virus with a high viral load, in which by the end of the first 24 weeks of treatment, hepatitis C virus RNA is not detected in the blood serum.
Laryngeal papillomatosis: Altevir® is administered subcutaneously at a dose of 3 million IU / m2 3 times a week. Treatment begins after surgical (or laser) removal of tumor tissue. The dose is selected taking into account the tolerability of the drug. Achieving a positive response may require 6 months of treatment.
Hairy cell leukemia: The recommended dose of Altevir for SC administration to patients after or without splenectomy is 2 million IU / m2 3 times a week. In most cases, the normalization of one or more hematological parameters occurs after 1-2 months of treatment, it is possible to increase the duration of treatment up to 6 months.
Interferon has immunomodulatory, antiviral, antitumor and antiproliferative effects. You can use it from birth. Interferon is prescribed for the treatment and prevention of ARVI. It is produced by several Russian companies, for example, Biomed Krasnogorsk, Microgen NPO.
Dosage form
Interferon is produced in the form of a lyophilisate for the manufacture of a solution for inhalation and intranasal administration in ampoules of 5 or 10 pieces per package. Before use, the contents of the ampoules should be diluted in water. Also on sale there is already a ready-made solution of Interferon, which is produced in a plastic bottle with a dropper.
Description and composition
If the drug is produced in ampoules, then it is a white or light yellow to pink porous amorphous mass or powder, which is hygroscopic.
A ready-made solution of Interferon in a vial produced by Biomed Krasnogorsk is a white transparent liquid.
As an active ingredient, they contain interferon alpha at least 1000 IU. The medication is a group of proteins (alpha interferons), which are formed by the leukocytes of healthy volunteers under the influence of the interferon inducer virus and are purified by micro and ultrafiltration methods. The drug does not contain preservatives and antibiotics, antibodies to HIV 1 and 2, hepatitis C virus, surface antigens of hepatitis B viruses.
Pharmacological group
The active substance stimulates the cytotoxic activity of T-killers and NK cells, the phagocytic activity of macrophages. It indicates resistance to viral infections in tissues and modulates the immune response, as a result, the neutralization of viruses and the destruction of cells infected by them is observed. It is rapidly absorbed through the mucous membranes and excreted naturally from the body.
Indications for use
for adults
Interferon is used to treat and prevent respiratory viral diseases, including influenza.
for kids
According to indications, the drug can be prescribed to children from birth.
During the period of gestation and breastfeeding, Interferon can be used according to indications, when the benefits to the mother outweigh the danger to the child.
Contraindications
The drug should not be used in case of individual intolerance to its composition.
Applications and doses
for adults
Ampoule with drug open just before use. Distilled water is added to its contents to the mark. If it is not there, then you can use ordinary chilled boiled water. The finished solution is a clear or slightly opalescent liquid, the color of which can vary from pale yellow to pink. It is allowed to store it at a maximum temperature of 10 degrees for no more than a day.
It can be used intranasally or by inhalation.
For prophylaxis, the drug is instilled in 5 drops into each nostril 2 times a day, with an interval of at least 6 hours throughout the entire period as long as there is a threat of infection.
For the purpose of treatment, the medication must be applied at the first symptoms of the disease, 5 drops in each nostril every 1-2 hours at least 5 times a day.
For inhalation, you can use any type of inhaler. To do this, the contents of 3 ampoules should be dissolved in 10 ml of water heated to 37 degrees. Inhalation is carried out through the mouth and nose in the morning and in the evening for 2-3 days.
If the drug is used in a bottle in the form of drops, then they do not need to be diluted. It is used in the same dosages.
for kids
From the very birth of children, the drug can be administered intranasally, and from 3 years of age, inhalation can be done. Doses of Interferon in children are the same as in adults.
for pregnant women and during lactation
During pregnancy and lactation, Interferon is used as usual.
Side effects
Interferon can cause the following negative reactions:
- lethargy;
- dry mouth, lack of appetite, nausea, increased peristalsis, heartburn;
- fever and chills;
- myalgia and arthralgia;
- headaches, nervousness, drowsiness, vertigo, depression, sleep disorder, vision, consciousness;
- allergic skin reactions such as itching and rashes;
- sweating;
- ischemic retinopathy;
- hepatitis, abdominal pain, bloating, taste perversion, weight loss, loose stools, constipation, liver dysfunction.
Interaction with other medicinal products
Interferon blocks oxidative metabolism in the liver, which can provoke a violation of the biotransformation of drugs that are metabolized in this way.
With the parallel appointment of Interferon:
- synergism with respect to the hematotoxic effect may be observed with ACE inhibitors;
- synergism is possible with zidovudine in relation to the myelotoxic effect;
- an increase in the activity of liver enzymes may be observed;
- with theophylline, it is possible to reduce its clearance.
special instructions
The drug solution is prepared right before use. If you see signs of flu, you should drink. During therapy, you need to periodically monitor the picture of the blood and liver.
Overdose
No cases of interferon overdose have been reported.
Storage conditions
Store Interferon at a temperature of 2-8 degrees. Its shelf life is 2 years, after which the drug must be disposed of. Although Interferon is available over the counter without a prescription, it should not be taken without consulting your doctor.
Analogs
In addition to him, there are a number of complete and partial analogues of the medication on sale:
- ... It is a complete analogue of Interferon. The drug is available as a metered-dose spray for intranasal administration. It is prescribed for the prevention and treatment of acute respiratory viral infections, including influenza. It can be used from birth, and the drug is also approved for the treatment of pregnant and lactating patients. should not be prescribed to patients with hypersensitivity to the composition of the medication or suffering from severe forms of allergies.
- Light. It is produced in the form of a metered-dose spray, which contains, in addition to interferon. The drug can be used in children over 14 years of age. It is contraindicated in case of individual intolerance to the composition of the drug, it should be used with caution for nasal bleeding.
It is permissible to use an analog instead of Interferon only with the permission of a doctor, since each medication has its own characteristics.
Price
The cost of Interferon is 872 rubles on average. Prices range from 78 to 5000 rubles.