Viferon, gripferon, altevir [Interferon alfa-2b]
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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 within 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 non-specific antiviral and anti-proliferative activity associated with the prevention of viral replication in the cell, inhibition of cell proliferation and the immunomodulatory effects of interferon. Interferon alpha-2b stimulates the presentation of antigen 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 cell proliferation, especially tumor. It has a depressing effect on the synthesis of certain oncogenes, leading to inhibition of tumor growth.
Altevir is used in complex therapy in adults:
- in chronic viral hepatitis B without signs of cirrhosis,
- in chronic viral hepatitis C in the absence of signs of liver failure (monotherapy or combination therapy with ribavirin),
- with papillomatosis of the larynx, genital warts,
- with hairy cell leukemia, chronic myeloid leukemia, non-Hodgkin's lymphoma, melanoma, multiple myeloma, Kaposi's sarcoma on the background of AIDS, progressive kidney cancer.
1 ml of solution contains:
Active substance: 1 million IU of interferon alpha-2b human recombinant;
Excipients: sodium acetate, sodium chloride, ethylenediaminetetraacetic acid disodium salt, Tween 80, dextran 40, water for injection.
Interferon alfa-2b is marketed under different brands and generic names, and comes in different dosage forms:
|Brand name||Manufacturer||Country||Dosage form|
|Viferon for external use||Feron||Russia||gel|
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Dosage and Administration
Subcutaneously, intramuscularly, intravenously.
Treatment must be initiated by a doctor. Further, with the permission of the doctor, the patient can administer the dose to himself (in the case of subcutaneous or intramuscular administration).
In chronic viral hepatitis B - n / a or / m in a dose of 5-10 million ME 3 times a week for 16-24 weeks. Treatment is stopped after 3-4 months of use in the absence of positive dynamics (according to the Hepatitis B DNA).
In chronic viral hepatitis C - n / a or / m in a dose of 3 million IU 3 times a week for 6–12 months. In patients with a relapsing course of the disease and in patients who have not previously received treatment with interferon alfa-2b, the effectiveness is increased when using Altevir® in combination with ribavirin. The duration of combination therapy is at least 6 months. Patients with chronic hepatitis C with 1 virus genotype and a high viral load, in which by the end of the first 6 months of treatment the RNA of the hepatitis C virus is not detected in the serum, Altevir therapy® should be carried out 12 months.
Laryngeal papillomatosis - sc in a dose of 3 million IU / m2 3 times a week. Treatment begins after the surgical (laser) removal of tumor tissue. The dose is selected taking into account the tolerability of the drug. To achieve a therapeutic effect, therapy for 6 months may be required.
Hairy cell leukemia- sc in a dose of 2 million IU / m2 3 times a week (for patients after and without splenectomy). In most cases, the normalization of one or more hematological parameters occurs within 1–2 months of treatment, it is possible to increase the duration of treatment up to 6 months. This dosing regimen should be adhered to continuously, unless, in this case, there is a rapid progression of the disease or the onset of symptoms of severe intolerance to the drug.
Chronic myeloid leukemia - the recommended dose of Altevira® as monotherapy from 4–5 million IU / m2 per day SubQ daily. To maintain the number of leukocytes, it may be necessary to use a dose of 0.5-10 million IU / m2. If treatment allows to achieve control of the number of leukocytes, then to maintain hematological remission, the drug should be used in the maximum tolerated dose (4-10 million IU / m2) daily. The drug should be discontinued after 8–12 weeks of treatment if the therapy did not lead to partial hematological remission or a clinically significant decrease in the number of leukocytes.
When non-Hodgkin's lymphoma- Altevir® used as adjuvant therapy in combination with standard chemotherapy regimens. The drug is injected s / c in a dose of 5 million IU / m2 within 2–3 months The dose must be adjusted depending on the tolerability of the drug.
With melanoma- Altevir® used as an adjuvant therapy with a high risk of recurrence in adults after tumor removal. Altevir® administered IV a dose of 15 million IU / m2 5 times a week for 4 weeks, and then - sc at a dose of 10 million IU / m2 3 times a week for 48 weeks. The dose must be adjusted depending on the tolerability of the drug.
With multiple myeloma- sc in a dose of 3 million IU / m2 3 times a week. Altevir® appointed in the period of achieving sustainable remission.
With Kaposi's sarcoma with AIDS- The optimal dose has not been established. The drug is used p / to or / m in a dose of 10-12 million IU / m2 in a day. In the case of stabilization of the disease or response to treatment, the therapy is continued until tumor regresses or the drug is withdrawn.
Kidney cancer - The optimal dose and pattern of use have not been established. It is recommended to apply sc in doses from 3 to 10 million IU / m2 3 times a week.
Most often - fever, weakness (are dose-dependent and reversible reactions, disappear within 72 hours after a break in treatment or its termination), headache, myalgia, chills, loss of appetite, nausea.
Less often- vomiting, diarrhea, arthralgia, asthenia, drowsiness, dizziness, dry mouth, alopecia, depression, suicidal thoughts and attempts, malaise, increased sweating, change in taste, irritability, insomnia, decreased blood pressure.
Seldom- abdominal pain, skin rash, nervousness, itchy skin, anxiety, weight loss, dyspepsia, tachycardia, autoimmune thyroiditis. Changes (reversible) laboratory parameters: leukopenia, granulocytopenia, decrease in hemoglobin level, thrombocytopenia, increased activity of liver enzymes.
- hypersensitivity to recombinant interferon alpha-2b or any of the components of the drug;
- history of severe cardiovascular diseases (uncontrolled chronic heart failure, recent myocardial infarction, marked cardiac arrhythmias);
- severe renal and / or liver failure (including caused by the presence of metastases);
- epilepsy and / or other severe dysfunctions of the central nervous system, especially manifested by depression, suicidal thoughts and attempts (including a history);
- chronic hepatitis with decompensated liver cirrhosis and in patients with or after previous therapy with immunosuppressants (with the exception of the condition after the completion of short-term treatment of GCS);
- autoimmune hepatitis and other autoimmune diseases, as well as taking immunosuppressive drugs after transplantation;
- thyroid disease not controlled by conventional therapeutic methods;
- decompensated lung diseases (including COPD);
- diabetes mellitus prone to ketoacidosis;
- hypercoagulation (including thrombophlebitis, pulmonary thromboembolism);
- severe myelosuppression;
- breastfeeding period.
Drug Interactions Between Altevir® and other drugs are not fully understood. Be careful with Altevir.® simultaneously with sleeping pills and sedatives, narcotic analgesics and drugs that have a myelosuppressive effect.
With the simultaneous appointment of Altevira® and theophylline it is necessary to control the concentration of the latter in the serum and, if necessary, change the mode of its dosing.
When using Altevira® in combination with chemotherapeutic anticancer drugs (cytarabine, cyclophosphamide, doxorubicin, teniposide) increases the risk of toxic effects.
Pregnancy and Lactation
Contraindicated in pregnancy. At the time of treatment should stop breastfeeding.
Prior to Altevir’s treatment of chronic viral hepatitis B and C, a liver biopsy is recommended in order to assess the extent of liver damage (signs of active inflammation and / or fibrosis). The effectiveness of the treatment of chronic hepatitis C is increased with the combination therapy with Altevir and ribavirin. The use of Altevira is not effective in the development of decompensated liver cirrhosis or hepatic coma.
In the event of side effects during treatment with Altevir, the dose of the drug should be reduced by 50% or the drug should be temporarily discontinued until they disappear. If side effects persist or reappear after dose reduction, or if disease progression is observed, treatment with Altevir should be stopped.
If the platelet level drops below 50x109 / l or the level of granulocytes below 0.75x109 / l, it is recommended to reduce the dose of Altevira by 2 times with the control of the blood test after 1 week. If these changes remain, Altevir should be canceled.
If the platelet level drops below 25x109 / l or the level of granulocytes below 0.5x109 / l, it is recommended that Altevir be withdrawn with a blood test after 1 week.
In patients receiving interferon alfa-2b preparations, antibodies can be detected in the serum, neutralizing 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 appearance of other autoimmune disorders.
Preparation of the solution for intravenous infusion: gain the volume of Altevir solution needed to prepare the required dose, add to 100 ml of sterile 0.9% NaCl solution and inject over 20 minutes.
- Brand name: Altevir
- Active ingredient: Interferon alfa-2b
- Dosage form: Injection
- Manufacturer: Pharmstandard Ufavita
- Country of Origin: Russia
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