Multiple sclerosis:
Indications for REBIF:
Relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease.
Adult:
Pre-medicate with analgesics and/or antipyretics on treatment days to ameliorate flu-like symptoms. Give by SC inj at least 48hrs apart, preferably in the PM. Rotate inj site. Initially 4.4mcg 3 times per week for 2 weeks, titrate to target 22mcg 3 times per week by Week 5; or, initially 8.8mcg 3 times per week for 2 weeks, titrate to target 44mcg 3 times per week by Week 5. See full labeling. May need dose reduction if SGPT >5xULN or leukopenia occurs.
Children:
Not established.
Warnings/Precautions:
Depression; consider discontinuing if occurs. Suicidal ideation. Discontinue immediately if jaundice or other signs of liver dysfunction occur. Active or history of liver disease. Increased serum SGPT >2.5xULN. Alcohol abuse. Seizure disorders. Risk of thrombotic microangiopathy; discontinue if occurs. History of thyroid dysfunction; do thyroid tests every 6 months. Monitor blood counts and liver function at 1, 3, and 6 months after initiation, then periodically thereafter. If myelosuppression, monitor CBCs with differential and platelets more intensively. Elderly. Pregnancy. Nursing mothers.
Pharmacologic Class:
Immunomodulator.
Interactions:
Risk of hepatic injury with concomitant hepatotoxic drugs or alcohol.
Adverse Reactions:
Inj site reaction/necrosis, flu-like symptoms, abdominal pain, depression, elevated liver enzymes, hematologic abnormalities; rare: hepatic failure, anaphylaxis (discontinue if occurs).
Generic Availability:
NO
How Supplied:
Prefilled syringe (22mcg, 44mcg)—1, 12; Rebidose autoinjector (22mcg, 44mcg)—12; Titration Pack: Prefilled syringes or Rebidose autoinjectors (6x8.8mcg + 6x22mcg)—1
